FROM: KIM EVANS, DIRECTOR
SUBJECT: INCREASE IN VENDOR MINIMUM MONTHLY MAINTENANCE STANDARDS AND SHELTER STANDARDS ADJUSTMENTS IN VENDOR
MANUAL REVISION #40
APPENDIX B
DISCUSSION:
Effective July 1, 2020, the Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Standard for Vendor cases are increased. FAMIS adjusts all Vendor cases on June 7, 2020.
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 2020 and later. The revised guidelines effective July 2020 are:
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Minimum Maintenance Standard:
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$2,155
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Shelter Standard:
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$ 647
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CASES ADJUSTED DURING MASS ADJUSTMENT
FAMIS uses the current standards for the allotment and surplus determinations completed prior to the mass adjustment.
If there is a community spouse, minor or eligible dependent, FAMIS determines the 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 institutionalized spouse’s coverage is adjusted during the mass adjustment and a notice is sent to the participant.
The coverage for the community spouse, minor or eligible dependent is NOT automatically updated. Manual update of the allotment amount on the Select Income (SELINC) screen is required. This will often result in an adverse action for the community spouse, minor or eligible dependent due to the increase in the allotment amount.
NOTE: Adverse actions are currently being suspended due to the COVID-19 emergency.
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 2020 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.
NOTE: Adverse actions are currently being suspended due to the COVID-19 emergency.
MANUAL UPDATES
The following sections of the Medical Assistance for the Aged, Blind and Disabled, Vendor Eligibility have been updated to include this change:
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.
KE/vb
