FROM: REGINALD McELHANNON, INTERIM DIRECTOR
SUBJECT: INCREASE IN VENDOR MINIMUM MONTHLY MAINTENANCE STANDARDS AND SHELTER STANDARDS ADJUSTMENTS IN VENDOR
MANUAL REVISION #103
0815.030.10.10.10
0815.030.10.10.20
APPENDIX B
DISCUSSION:
Effective July 1, 2019, the Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Standard for Vendor cases are increased. FAMIS adjusted all Vendor cases on June 8, 2019.
This memorandum discusses the following:
NEW MMMNA AND SHELTER STANDARD
CASES ADJUSTED DURING MASS ADJUSTMENT
NOTICES
MANUAL UPDATES
FAIR HEARING REQUEST
NEW MMMNA AND SHELTER STANDARD
Allotments for community spouses, minor children, and eligible dependents and the Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Standard are revised for actions effective the month of July 2019 and later. The revised guidelines effective July 2019 are:
Minimum Maintenance Standard: $2,114
Shelter Standard: $634
CASES ADJUSTED DURING MASS ADJUSTMENT
FAMIS uses the current standards for the allotment and surplus determinations completed prior to the mass adjustment.
If a case contains a community spouse, minor or eligible dependent, FAMIS determines the proposed new allotment amount using the revised standards. The new allotment for a community spouse, minor or eligible dependent displays on the Allotment Information (ALLOT, FMJ6) screen in FAMIS. The new allotment for a minor not living with the community spouse displays on the Minor Living Outside Allotment Information (MINOR, FMJ2) screen.
If there is a change in the surplus amount, the cases are adjusted during the mass adjustment and a notice is sent to the participant. The change in the surplus amount displays on the Adult MO HealthNet Vendor Budget Summary (FMD8) screen.
To access the Adult MO HealthNet Vendor Budget Screen:
• Go to the EU Action Log (EULOG/FM40) screen;
• Select a Budget Month;
• Enter F17=INQAUTH;
• Select F16=MHABD;
• Select Coverage Type VEND and press F16=AGBUDSUM
After the adjustment, FAMIS determines allotments and surpluses for July 2019 and later using the new standards.
NOTICES
Cases resulting in no change from the mass adjustment do not receive an action notice. The following notices are sent depending upon the action:
• Adult MO HealthNet Benefit Action Notice (FA460) is sent for cases that result in an increase in benefits from the mass adjustment.
• Adult MO HealthNet Adverse Action Notice (FA420) is sent for cases that result in a decrease in benefits due to the adjustment.
• Adult MO HealthNet Benefit Notice (FA460) is sent once the adverse action notice expires.
• Adult MO HealthNet Provider Notice (FA-465) is sent to the facility for cases that result in any change in benefits.
MANUAL UPDATES
The following sections of the Medical Assistance for the Aged, Blind and Disabled, Vendor Eligibility have been updated to include this change:
• 0815.030.10.10.10 Determining the Allotment of the Community Spouse,
• 0815.030.10.10.20 Allotments for Minors and Dependants living with the Community Spouse, and
• Vendor Eligibility APPENDIX B
FAIR HEARING REQUEST
If the EU requests a fair hearing, send the request to the Administrative Hearings Unit (AHU) the same day. The IM Hearings Unit will send all Agency evidence to the AHU as soon as possible. All available evidence should be sent to the AHU with the original request for hearing. Do not wait until a few days before the hearing to send the evidence.
For budget adjustments, evidence includes, but is not limited to:
• FA-420 Adverse Action Notice
• FA-460 Action Notice
• Comments Screens
• Manual sections/legal references
• Adult MO HealthNet AG Budget Summary (FMD8) screen
Provide a copy of the evidence to the EU asking for the hearing and schedule a pre-hearing conference. If the EU designates an attorney or authorized representative for the hearing, send a copy of all notices and evidence for the hearing to the EU and the designated individual.
NECESSARY ACTION:
• Review this memorandum with appropriate staff.
RM/vb
