Category: 2022

IM-151 2023 AFFORDABLE INSURANCE QUOTES UPDATED ON FAMILY MO HEALTHNET (MAGI) APPENDIX F AND G

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FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 AFFORDABLE INSURANCE QUOTES UPDATED ON FAMILY MO HEALTHNET (MAGI) APPENDIX F AND G

MANUAL REVISION #
APPENDIX F
APPENDIX G

 

DISCUSSION:

The CHIP Affordability Test Calculator, Appendix G, has been updated with 2023 insurance quotes from the Federally Facilitated Marketplace (FFM) as well as including insurance quotes for married couples. Affordable insurance determinations for Children’s Health Insurance Program (CHIP) premium children must still be completed. The CHIP Affordability Test Calculator Instructions, Appendix F, are updated to include instructions for couples.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using the updated CHIP Affordability Test Calculator Instructions (MAGI Appendix F) and CHIP Calculator (MAGI Appendix G) January 1, 2023.

 

 

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IM-150 PRESUMPTIVE ELIGIBILITY (PE) MANUAL UPDATED WITH NEW QUALIFIED ENTITIES (QE), REMOVAL OF ESTIMATED DUE DATE FOR TEMP, AND PROGRESSION OF PE DETERMINATIONS

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: PRESUMPTIVE ELIGIBILITY (PE) MANUAL UPDATED WITH NEW QUALIFIED ENTITIES (QE), REMOVAL OF ESTIMATED DUE DATE FOR TEMP, AND PROGRESSION OF PE DETERMINATIONS

MANUAL REVISION #
1900.020.10
1900.020.40
1900.020.60
1900.020.80
1900.030.00
1900.030.10

FORM REVISION #
PE-1SSL
PE-2 Worksheet
PE-3
PE-3PW

 

DISCUSSION:

The PE Manual has been updated to add the following facilities as QEs:

  • Community Mental Health Centers (CMHCs); and
  • Comprehensive Substance Treatment and Rehabilitation (CSTAR) facilities.

CMHCs and CSTARS, along with Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs), can begin making PE determinations once the Family Support Division (FSD) has received a new executed Memorandum of Agreement (MOA) and QE staff have completed the revised training. These facilities are now allowed to determine PE for all PE programs, with the exception of BCCT-PE.

When determining PE for adults, the following order must be followed when screening:

  1. PE for Pregnant Women (TEMP or SMHB-PE),
  2. PE for Parents/Caretaker Relatives (MHF-PE),
  3. PE for Former Foster Care Youth (FFCY-PE), and
  4. PE for Adult Expansion Group (AEG-PE).

For Temporary MO HealthNet During Pregnancy (TEMP) coverage, estimated due date is no longer required.

PE policy and forms have been updated to show the new QE facilities, the progression of PE determinations, and removal of the estimated due date.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

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IM-149 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) SHELTER EXPENSE CHANGES NOT REPORTED WITH ADDRESS CHANGE MANUAL UPDATE

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FROM: KIM EVANS, DIRECTOR

SUBJECT: SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) SHELTER EXPENSE CHANGES NOT REPORTED WITH ADDRESS CHANGE MANUAL UPDATE

MANUAL REVISION #
1105.005.00
1115.035.25.20

 

 

DISCUSSION:

When a SNAP household reports a new address, if the new shelter expense information was not reported with the address change the agency must investigate changes in the shelter costs. Manual Section 1115.035.25.20 Utility Decision Period has been updated to reflect this requirement.

Manual section 1140.005.50 Address Changes was previously updated in regards to this as announced in memo IM-64 dated May 24, 2022. Refer to that memo for the steps that are to be taken when new shelter expense information was not provided with the new address.

NOTE: A change of address is not required to be reported by the household.

Manual section 1105.005.00 Residency has been updated to remove the reference to the FAMIS User Guide, updated terminology, and removed FAMIS specific references.

See manual sections 1115.035.25.20 Utility Decision Period and 1140.005.50 Address Changes for more information.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Send questions through normal supervisory channels.

 

 

 

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IM-148 UPDATES TO THE MISSOURI LONG-TERM CARE PARTNERSHIP PROGRAM SECTION OF THE DECEMBER 1973 ELIGIBILITY REQUIREMENTS MANUAL

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FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATES TO THE MISSOURI LONG-TERM CARE PARTNERSHIP PROGRAM SECTION OF THE DECEMBER 1973 ELIGIBILITY REQUIREMENTS MANUAL

MANUAL REVISION #
1030.055.00
1030.055.05
1030.055.10
1030.055.15
1030.055.20

 

DISCUSSION:

The Missouri Long-Term Care Partnership Program sections of the December 1973 Eligibility Requirements manual were updated to reflect current terminology, replace broken links, update contact information, and remove duplicated information. References to the Department of Insurance, Financial Institutions, and Professional Registration (DIFP) were replaced with the updated name Department of Commerce and Insurance (DCI).

The following sections are revised and replace all previously released policy and memorandums:

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Replace any previously saved contacts with the updated contact information.

 

 

 

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IM-147 BLIND PENSION (BP) MANUAL UPDATES

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FROM: KIM EVANS, DIRECTOR

SUBJECT: BLIND PENSION (BP) MANUAL UPDATES

MANUAL REVISION #
0500.005.00
0505.025.00
0505.025.05
0505.050.00
0505.060.00
0505.060.05
0525.005.00
0530.000.00
0535.000.00 obsolete
0535.005.00 obsolete

 

DISCUSSION:

Multiple sections of the BP Manual were updated to reflect current terminology, replace an incorrectly linked memo, obsolete outdated processes, and remove information that was duplicated from another manual section.

The following sections are revised and replace all previously released policy and memorandums:

The following manual sections are obsolete, the processes described are no longer used for BP case management:

  • 0535.000.00 Location of BP Case Records
  • 0535.005.00 Separation of Spouse Cases

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

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IM-146 UPDATES TO THE ALLOWABLE DEDUCTIONS SECTION OF THE FAMILY MO HEALTHNET (MAGI) MANUAL

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATES TO THE ALLOWABLE DEDUCTIONS SECTION OF THE FAMILY MO HEALTHNET (MAGI) MANUAL

MANUAL REVISION #
1805.030.20.15

 

DISCUSSION:

MAGI Manual section 1805.030.20.15 Allowable Deductions is revised with the following:

  • The Maximum Annual Health Savings Account (HSA) Contributions chart is updated with 2022 data.
  • Images of IRS form Schedule 1 are updated to the 2021 version.
  • Reference to an incorrect line number was removed.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/kb

IM-145 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT) PROVIDER CHANGE

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FROM: KIM EVANS, DIRECTOR

SUBJECT: NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT) PROVIDER CHANGE

 

DISCUSSION:

Effective December 1, 2022, Medical Transportation Management (MTM) is the NEMT provider. The reservation phone line and the Where’s My Ride line have not changed.

A postcard was mailed to MO HealthNet Participants informing them of the change and giving them the following information.

Participants can request MTM services by:

  • calling 866-269-5927 (TTY: 711) or
  • visiting the MTM website.

Additional phone numbers for participants:

  • If the ride is late, call 866-269-5944 (TTY: 711).
  • To file a complaint or grievance, call 866-436-0457.
  • To talk to an interpreter, call 888-561-8747.

Important NEMT reminders:

  • All rides must be for a MO HealthNet covered service with a MO HealthNet provider.
  • Participants must have no other way to get to and from their covered service.
  • Participants can schedule a ride Monday through Friday from 7am to 6pm.
  • Participants should call MTM at least 2 days before their appointment if they live in an urban county and 3 days before their appointment if they live in a basic or rural county; hospital discharges or trips to urgent care can be scheduled same day.
  • Participants should have their trip information ready when they call.
  • Participants should be ready at least 15 minutes before their ride is scheduled to arrive.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Information in Email Memo #163 dated November 8, 2005 is now obsolete.
  • Discontinue distributing any material that refers participants to LogistiCare Solutions, LLC or ModivCare Solutions, LLC.

 

 

 

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IM-144 REVISIONS TO POLICY SECTIONS TO REPLACE OBSOLETE LINKS

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISIONS TO POLICY SECTIONS TO REPLACE OBSOLETE LINKS

MANUAL REVISION #
0110.000.00
0110.060.15
0210.005.05
0815.010.00
0820.020.00
0855.010.00
1020.005.00
1802.020.45.10

 

DISCUSSION:

Several policy sections in various policy manuals have been revised to remove links to obsolete policy sections.

The revisions include corrected links or policy updates to remove outdated processes. Sections were also revised with updated terminology if necessary.

The following sections were updated and replace all other versions of policy previously released:

General Information Manual:

Temporary Assistance Manual

MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual:

December 1973 Eligibility Requirements Manual

Family MO HealthNet (MAGI) Manual

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

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IM-143 JANUARY 2023 COLA ADJUSTMENT OF SSA/SSI/VA/RR INCOME FOR ALL INCOME MAINTENANCE PROGRAMS EXCEPT FAMILY MO HEALTHNET (MAGI)

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: JANUARY 2023 COLA ADJUSTMENT OF SSA/SSI/VA/RR INCOME FOR ALL INCOME MAINTENANCE PROGRAMS EXCEPT FAMILY MO HEALTHNET (MAGI)

MANUAL REVISION #

0410.010.15 APPENDIX B
0805.020.15 APPENDIX D
0865.010.15 APPENDIX E
1030.010.05 APPENDIX J
1030.035.10 APPENDIX K
1030.035.20  
1030.035.25  

 

 

DISCUSSION:

In January 2023, all Social Security Administration (SSA), Supplemental Security Income (SSI), Veterans Administration (VA), and Railroad Retirement (RR) participants will receive an 8.7% Cost of Living Adjustment (COLA).

The weekend of December 10, 2022, a mass adjustment will be completed in the eligibility system for Child Care (CC), Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance (TA), and MO HealthNet for the Aged, Blind, and Disabled (MHABD) cases. Income increases for SSA, SSI, VA, and/or RR and other adjustments will be completed. Medicare Premium amounts and federal eligibility standards will also be updated.

Note: The 2023 COLA will have the following effect on SNAP cases:

  • Increase in SNAP benefit reductions for January 2023
  • Increase in SNAP closures for December 2022

SSI Increases

SSI TABLE 2022 AMOUNT 2023 AMOUNT INCREASE
SSI Individual maximum (in own household) $841 $914 $73
SSI Couple maximum (in own household) $1,261 $1,371 $110
SSI Individual in household of another $561 $609 $48
SSI Couple in household of another $841 $914 $73
SSI Essential person/own home $421 $458 $37

 

MHABD Standards Adjustments

NEW MHABD STANDARDS 2022 AMOUNT 2023 AMOUNT
Maximum Allotment of Community Spouse $3,435 $3,716
Minimum Maintenance Standard for Allotments $2,289 $2,289
Maximum Allocation to a child $420 $457
Maximum Allotment to a child $726 $763
Minimum Spousal Share $27,480 $29,724
Maximum Spousal Share $137,400 $148,620
Maximum Home Equity $636,000 $688,000
HCB Maximum $1,470 $1,598
SAB Standard $908 $987

 

Supplementary Medical Insurance (SMI) Premium Adjustment

The standard SMI, commonly known as Medicare Part B, premium will decrease for 2023 to $164.90. The SMI premium for those who begin receiving Medicare in 2023 will be $164.90. Premiums for Medicare participants who pay less than the standard premium amount will not have an increase of more than the amount of the increase in Social Security benefit the individual received.

 

Additional MHABD Program Increases

Resource Limits for Medicare Savings Programs (QMB/SLMB/QI-1)
For a single individual, the resource limit increases to $9,090 for a married couple, the resource limit increases to $13,630. There is no change in policy regarding how to determine available resources.

Vendor Maximum Monthly Maintenance Standard
The 2023 Maximum Monthly Maintenance Standard is $3,716.

Minimum and Maximum Spousal Share
The 2023 minimum spousal share is $29,724. The new maximum spousal share is $148,620. Both amounts become effective for any assessment completed on or after January 1, 2023.

Substantial Gainful Activity (SGA)
The SGA monthly amounts increase and are as follows:

  • $2,460 for statutorily blind individuals
  • $1,470 for non-blind individuals

 

Policy and Appendices Updates
The following appendices were updated to show the new amounts:

Manual sections 0410.010.15, 0865.010.15, 1030.010.05 and 1030.035.10 are revised to remove outdated information and reference Appendix J for current information.
Manual sections 0805.020.15, 1030.035.20 and 1030.035.25 are updated to specify that data contained in examples are for illustrative purposes only and do not contain current numbers.

 

Adjustments by Program and Mass Adjustment Process
All programs will be adjusted according to program. Review FAMIS Resources for further information about the mass adjustment process.

Senate Bill 577 (2007) authorized the disregard for Social Security COLA increases for certain MO HealthNet (MHN) programs with income eligibility based on federal poverty level (FPL) until the next FPL adjustment in April. All SSA, SSI, VA, and RR income sources will be updated with the new income amount and verification code “CO” for COLA adjustment.

Note: For budget months prior to January 2023, do not use the “CO” – COLA verification code.

Note: The Families First Coronavirus Response Action of 2020 (FFCRA) requires that MO HealthNet (MHN) coverage for individuals be maintained at the same level or better for the duration of the Public Health Emergency (PHE). There will be no adverse action to reduce or end MHN coverage due to COLA changes until the end of the PHE.

 

Reports with Actions Needed
Reports with action needed will be distributed to the SNAP, TA/CC, and MHN Program Managers for assignment. Follow the instructions in FAMIS Resources on how to process each type of report.

 

Request for Hearing/Continued Benefits
When a fair hearing is requested, follow current fair hearing request procedures.

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Search “COLA” or “Adjustment” in FAMIS Resources for processing guidance.
  • State Office will provide the SSA/SSI/VA/RR Needing Review report to designated staff.
  • Allow MHN Policy for “CO” income verification to disregard SSA and SSI COLA Adjustments until the Federal Poverty Level (FPL) Adjustment in April.

 

 

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IM-142 2023 FAMILY MO HEALTHNET (MAGI) COST OF LIVING ADJUSTMENT (COLA) FOR VETERANS ADMINISTRATION (VA) AND RAILROAD (RR) INCOME

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 FAMILY MO HEALTHNET (MAGI) COST OF LIVING ADJUSTMENT (COLA) FOR VETERANS ADMINISTRATION (VA) AND RAILROAD (RR) INCOME

 

DISCUSSION:

Effective January 2023, VA and RR participants will receive an 8.7% COLA. System updates will be made the weekend of December 10, 2022. 

Note: The Families First Coronavirus Response Act of 2020 (FFCRA) requires that MO HealthNet (MHN) coverage for individuals be maintained at the same level or better for the duration of the COVID-19 Public Health Emergency (PHE). The eligibility system will not reduce or end MHN coverage due to the COLA changes until the PHE is ended and a review of the case has been completed.

 

Cases Adjusted

Cases that include income types VA and/or RR benefits in the eligibility system are subject to an automatic increase of 8.7% for those income types. The eligibility system will end date the previous income and add a new piece of income evidence that reflects the adjusted income amount.

Note: Actions to reduce benefits will not be taken until the COVID-19 PHE has ended and a review of the case has been completed.

 

Cases That Did Not Adjust

Some cases will not adjust during the COLA. These cases will require manual intervention from staff to add the increased income amounts. As cases are reviewed, check the income on each case to determine if the current income is entered. Update and verify income as required using established procedures.

 

Notices

For case updates made as a result of COLA, the eligibility system will finalize the decision(s) and send out the appropriate notices.

Note: Adverse Action notices will not be issued until the COVID-19 PHE has ended and a review of the case has been completed.

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

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