Category: 2023

FROM: KIM EVANS, DIRECTOR

SUBJECT: END OF CONTINUOUS ENROLLMENT CONDITION; TRANSITION PERIOD MANUAL SECTIONS ADDED TO MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED [MHABD (NON-MAGI)] AND FAMILY MO HEALTHNET (MAGI) MANUALS

MANUAL REVISION #
0890.010.00
1895.010.00

DISCUSSION:

On December 29, 2022, the Consolidated Appropriations Act, 2023 (CAA, 2023) was enacted. Under the CAA, 2023, expiration of the continuous enrollment condition is no longer linked to the end of the Public Health Emergency (PHE). The continuous enrollment condition ends on March 31, 2023.

Effective April 1, 2023, annual renewals will resume for all MO HealthNet (MHN) programs. Family Support Division (FSD) will attempt to complete an ex-parte (not requiring information from the individual) renewal for each participant prior to sending a paper renewal form. An annual renewal must be completed before a determination of ineligibility or lesser coverage can be made.

Participants that are found to no longer qualify for MHN will be referred to the Federally Facilitated Marketplace (FFM).

Participants who receive a paper renewal form can return it or other documents in the following ways:

• Uploading a document: Visit mydssupload.mo.gov to upload the document
• Fax: 573-526-9400
• Mail: Family Support Division
             PO Box 2700
            Jefferson City, MO 65102
• Visit your local Resource Center (check the map for office hours before visiting)

Review Renewing Your Medicaid Eligibility for additional information.

Future memorandums will be released regarding returned mail, electronic verification, MAGI and Non-MAGI annual renewal processes and annual renewal waivers.

Manual Updates

The MHABD (Non-MAGI) and MAGI Manuals have been updated to add sections regarding the Transition Period. The Transition Period manual sections house links to related memos.

Note: Transition period refers to the conclusion of the Continuous Enrollment Condition and restart of annual renewals. Missouri’s transition period is from April 1, 2023 through May 31, 2024.

The following manual sections have been added:

• MHABD Manual section 0890.010.00 Transition Period
• MAGI Manual section 1895.010.00 Transition Period

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Share with community partners.

KE/sh

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATE TO ANNUAL RENEWAL POLICY IN THE MAGI MANUAL

MANUAL REVISION #
1870.025.00
1880.000.00
1880.005.00
1880.010.00 obsolete
1880.015.00
1880.020.00
1880.025.00
1885.000.00

DISCUSSION:

Annual renewal policy in the Modified Adjusted Gross Income (MAGI) Manual is revised to update terminology, obsolete floating renewal policy, add ex parte renewal language, and for easier readability and understanding.

Effective, March 25, 2023, floating renewals are discontinued. MAGI Manual section 1880.010.00 Floating Renewal is obsolete as of this date. Annual renewals are completed once every 12 months. Do not complete a renewal when a change in circumstance is reported.

Note: If the participant returns an annual renewal form, it must be signed. Telephonic signatures are allowed for MHN annual renewals if the participant contacts the Customer Service Center and is transferred to complete the renewal with the Family Support Division (FSD) vendor by phone.

The following MAGI Manual sections are revised:

• 1870.025.00 Annual Renewals (UWHS)
• 1880.000.00 Annual Renewals
• 1880.005.00 Pre-populated Renewal Form
• 1880.015.00 CHIP Annual Renewal
• 1880.020.00 Reconsideration Period
• 1880.025.00 Annual Renewal Case Action Notifications
• 1885.000.00 Change in Circumstance

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Refer to MEDES Resources for information on processing an annual renewal.

KE/sh

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATE TO ANNUAL REVIEW/REINVESTIGATION POLICY IN THE NON-MAGI MANUALS

MANUAL REVISION #

DISCUSSION:

Annual renewal policy in the Non-Modified Adjusted Gross Income (Non-MAGI) Manual is revised to update terminology from review/reinvestigation to annual renewal, add ex parte renewal language, add the requirement for annual renewal forms to be signed, and for easier readability and understanding.

An ex parte renewal (not requiring information from the individual) must be attempted before a renewal form is sent. Ex parte renewals are completed using reliable information available to the agency without requiring information from the participant. If staff are able to verify all necessary eligibility factors by accessing available electronic data sources, do not send a renewal form.

The following Non-MAGI Manual sections are revised:

Supplemental Aid to the Blind (SAB) Manual

• 0430.000.00 Annual Renewals and Change in Circumstance
• 0430.005.00 Annual Renewal

Blind Pension Manual

• 0525.000.00 Annual Renewals and Change in Circumstance
• 0525.005.00 Annual Renewal

Supplemental Nursing Care (SNC) Manual

• 0630.000.00 Annual Renewals and Change in Circumstance
• 0630.005.00 Annual Renewal

Supplemental Payments Manual

• 0745.000.00 Annual Renewals and Change in Circumstance
• 0745.005.00 Annual Renewal

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

• 0820.040.05 Annual Renewal for HCB was added for consistency
• 0825.040.05 Annual Renewal for MOCDD cases
• 0840.000.00 Annual Renewals and Change in Circumstance
• 0840.005.00 Annual Renewal
• 0840.005.00.05 Application for Other Benefits at Annual Renewal
• 0850.015.00 Annual Renewal for Section 1619 Status cases
• 0855.015.00 Annual Renewal for TWHA cases
• 0865.025.00 Annual Renewal for QMB cases
• 0870.025.00 Annual Renewal for SLMB cases

December 1973 Eligibility Requirements Manual

• 1030.000.00 Available Resources (OAA and PTD)

Breast or Cervical Cancer Treatment (BCCT) Manual

• 1320.000.00 Annual Renewals and Change in Circumstance
• 1320.020.00 Annual Renewal was added for consistency

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Refer to FAMIS Resources for information on processing an annual renewal.

KE/sh

FROM: KIM EVANS, DIRECTOR

SUBJECT: MAGI MANUAL APPENDIX H UPDATE

MANUAL REVISION #
APPENDIX H

DISCUSSION:

MAGI Appendix H is updated. MO HealthNet Eligibility Codes (ME) Codes 07 (Foster Care), 36 (MHD IV-E Adopt-FFP Adoption Subsidy), and 56 (Adoption Subsidy) have been moved to the Newborn qualifying ME Codes side of Appendix H as they are Title XIX funded.

In addition, the appendix wording was corrected to show ME Code 83 as BCCT-PE and ME Code 84 as BCCT.

NECESSARY ACTION:

• Grant automatic newborn coverage to children born to women receiving (or retroactively eligible for) ME Codes 07, 36 and 56.
• Review this memorandum with appropriate staff.

KE/bl

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 MAGI COST OF LIVING ADJUSTMENT (COLA) FOR SSA/SSI INCOME

DISCUSSION:

Effective April 1, 2023, MAGI cases will be updated to reflect an 8.7% COLA for Social Security Administration (SSA) and Supplemental Security Income (SSI) participants.

Note: Due to the Continuous Eligibility Condition, no cases will have coverage closed or reduced to a lower level of care until an annual renewal has been completed.

Cases Adjusted

Cases that include income types Social Security Adult (disability or received off disabled/deceased spouse), Social Security Adult (retirement), Social Security Child (disability or received off disabled/deceased parent), and SSI are subject to an automatic increase of 8.7%. The eligibility system will end date the previous income and add a new piece of income evidence that reflects the adjusted income amount.

Cases That Did Not Adjust

Some cases will not adjust during 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. Adverse Action notices will not be acted upon until an annual renewal has been completed on the case.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/kg

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATE OF 1619 THRESHOLD AND INCREASE IN AVERAGE PRIVATE PAY NURSING RATE FOR TRANSFER OF PROPERTY PENALTIES

MANUAL REVISION #
Appendix J
Appendix N

DISCUSSION:

The threshold amount established by the Social Security Administration (SSA) to determine eligibility under Section 1619 of the Social Security Act has increased to $4,134 effective January 1, 2023. Additional information regarding 1619 eligibility is available in manual section 0850.005.20 Financial Need.

The average private pay nursing care rate increased to $6,983 per month effective. For applications taken on or after April 1, 2023, use $6,983 to determine the number of months of ineligibility for vendor level services.

Appendix J of the MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual lists the current average private pay nursing care rate and current 1619 threshold.

Appendix N of the December 1973 Eligibility Requirements Manual lists the historical values for average private pay nursing care rates.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/rnr

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 UPDATE OF POVERTY INCOME GUIDELINES FOR MAGI PROGRAMS

MANUAL REVISION #
1805.030.20.10
APPENDIX A
APPENDIX A (PE)
APPENDIX B
APPENDIX D
APPENDIX E
APPENDIX I

FORM REVISION #
IM-4PRM

DISCUSSION:

Effective April 1, 2023, the Federal Poverty Level (FPL) income guidelines increase for all MAGI programs, including Presumptive Eligibility (PE).
MAGI cases will be adjusted on March 29, 2023 based on the new FPL income guidelines; however, due to the Continuous Eligibility Condition, no cases will have coverage closed or reduced to a lower level of care until an annual renewal has been completed.

Note: Change in circumstance or applications processed prior to April 1, 2023 will need to be authorized before the FPL change can be viewed.

PREMIUM REFUNDS

Premiums paid for April coverage will be refunded to the participant if the FPL causes the case to:

• become eligible as a non-premium case;
• go from CHIP75 to CHIP74; or
• go from CHIP74 to CHIP73.

The refund process will take approximately 8 weeks to complete.

MAGI MANUAL REVISION, PROGRAM DESCRIPTIONS, AND OTHER RESOURCES

MAGI Manual section 1805.030.20.10 Income Excluded Under MAGI has been updated to reflect an increase in the tax filer threshold for earned income from a child to $12,950 based on the 2022 IRS Publication 501.

NOTE: The tax filer threshold for unearned income from a child has not increased.

PRESUMPTIVE ELIGIBILITY

PE Manual Appendix A income standards are updated. These standards are effective from April 1, 2023 through March 31, 2024.

NECESSARY ACTION:

• Use the new FPL income guidelines beginning April 1, 2023.
• Review this memorandum with appropriate staff.

KE/kg

FROM: KIM EVANS, DIRECTOR

SUBJECT: CITIZENSHIP AND ALIEN STATUS SECTION OF THE BLIND PENSION (BP) MANUAL UPDATED

MANUAL REVISION #
0505.040.00

DISCUSSION:

An outdated link contained in manual section 0505.040.00 Citizenship and Alien Status in the BP Manual has been removed. Acceptable documentation for citizenship, and alien or immigrant status is the same for all MO HealthNet programs. Links were added to refer staff to the Family MO HealthNet (MAGI) manual sections below for acceptable documentation types.

• 1805.020.15 Documentation and Verification of Alien or Immigrant Status
• 1805.020.05.05 Documents to Verify Citizenship

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/mc

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATE OF POVERTY INCOME GUIDELINES FOR MO HEALTHNET NON-MAGI PROGRAMS

MANUAL REVISION #
Appendix J
Appendix K

DISCUSSION:

Effective April 1, 2023, the Federal Poverty Level (FPL) income guidelines increase for the following programs:

• MO HealthNet Non-Spend Down (MHNS)
• MO HealthNet Spend Down (MHSD)
• Ticket to Work Health Assurance (TWHA)
• Qualified Medicare Beneficiary (QMB)
• Specified Low Income Medicare Beneficiary (SLMB and SLMB2)
• Qualified Disabled Working Individuals (QDWI)
• MO HealthNet for Disabled Children (MHDC)
• Blind Pension (BP)

On the weekend of March 11, 2023, programs with income eligibility based on the federal poverty level will be adjusted in the eligibility system.

Note: All MO HealthNet cases will be adjusted based on the new FPL income guidelines. However, due to the continuous enrollment condition, participants will not have coverage reduced to a lower level of care or cases closed until after their next annual review is completed.

Premium Refunds
Premiums paid for April coverage will be refunded to the participant if the FPL causes the case to become eligible as a non-premium case. The refund process will take approximately 8 weeks to complete.

Program Descriptions
Appendix K in the MHABD Policy Manual is updated to include the change in FPL income limits. Appendix K is now named, MO HealthNet Eligibility for Non-MAGI Programs.

Income Standards
Appendix J in the MHABD Policy Manual is updated with the updated FPL income limits. Appendix J is now named, Non-MAGI Eligibility Standards.

All FPL income guidelines are effective from April 1, 2023 through March 31, 2024. These standards may be referenced as needed for historical purposes.

MHABD income standards

QDWI income standards

Medicare Savings Programs income standards

Blind Pension sighted spouse monthly income maximum

TWHA Income Standards and Premiums

NECESSARY ACTION:

• Begin using the new FPL income guidelines for eligibility determinations effective April 2023 and ongoing.
• Follow the staff user guides in FAMIS Resources to resolve conflicting actions related to FPL.
• Review this memorandum with appropriate staff.

KE/cj