IM-14 INCREASE IN AVERAGE PRIVATE PAY NURSING RATE FOR TRANSFER OF PROPERTY PENALTIES

FROM: KIM EVANS, DIRECTOR

SUBJECT: INCREASE IN AVERAGE PRIVATE PAY NURSING RATE FOR TRANSFER OF PROPERTY PENALTIES

MANUAL REVISION #
APPENDIX J
APPENDIX N

 

DISCUSSION:

The average private pay nursing care rate increased to $7,909 per month effective April 1, 2025. For applications taken on or after April 1, 2025, use $7,909 to determine the number of months of ineligibility for vendor level services for a transfer of assets penalty.

Eligibility Standards for Non-MAGI Programs (Appendix J) of the MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual lists the current average private pay nursing care rate.

Note: Maximum MMMNA was incorrect on the 12/2024 revision of the Eligibility Standards for Non-MAGI Programs appendix and has been corrected. The correct monthly amount is $3948 effective 1/1/2025.

Average Private Pay Nursing Home Rates (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/cj

IM-13 NON-MAGI FEDERAL POVERTY LEVEL ADJUSTMENT

FROM: KIM EVANS, DIRECTOR

SUBJECT: NON-MAGI FEDERAL POVERTY LEVEL ADJUSTMENT

MANUAL REVISION #
Appendix J
Appendix K

 

DISCUSSION:

Effective April 1, 2025, 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)

The weekend of March 8, 2025, 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.

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 Non-MAGI Policy Manual is updated to include the change in FPL income limits.

Income Standards

Appendix J in the Non-MAGI policy Manual is updated with the updated FPL income limits.

All FPL income guidelines are effective from April 1, 2025, through March 31, 2026. These standards may be referenced as needed for historical purposes.

MHABD income standards

Assistance Group Size Non-Spend Down OAA/PTD (85% FPL) Non-Spend Down AB (100% FPL)
1 $1109 $1305
2 $1499 $1763

QDWI income standards

Assistance Group Size QDWI (200% of FPL)
1 $2609
2 $3525

Medicare Savings Programs income standards

Assistance Group Size QMB (100% FPL) SLMB1 (120% FPL) SLMB2 (135% FPL)
1 $1305 $1565 $1761
2 $1763 $2115 $2380
3 $2221 $2665 $2999

Blind Pension sighted spouse monthly income maximum

Sighted Spouse (500% FPL) $8813

TWHA Income Standards and Premiums

Percent of FPL Type of Case Monthly Income Premium Amount
Less than 100% FPL Single $1305.00 or less non premium
  Couple $1763.00 or less non premium
100% FPL up to but not including 150% FPL Single $1305.01-1956.99 $52
  Couple $1763.01-2643.99 $71
150% FPL up to but not including 200% FPL Single $1957.00-2608.99 $78
  Couple $2644.00-3524.99 $106
200% FPL up to but not including 250% FPL Single $2609.00-3260.99 $130
  Couple $3525.00-4406.99 $176
250% FPL up to 300% FPL Single $3261.00-3913.00 $196
  Couple $4407.00-5288.00 $264

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using the new FPL income guidelines for eligibility determinations effective April 2024 and ongoing.
  • Follow the staff user guides in IM Resources to resolve conflicting actions related to FPL.
  • Review this memorandum with appropriate staff.

 

 

 

KE/st

 

IM-12 MULTI-LANGUAGE INTERPRETER SERVICES (IM-4 MLIS) ADDED TO SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) NOTICES – RELEASE NUMBER 2

FROM: KIM EVANS, DIRECTOR

SUBJECT: MULTI-LANGUAGE INTERPRETER SERVICES (IM-4 MLIS) ADDED TO SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) NOTICES – RELEASE NUMBER 2

 

DISCUSSION:

Beginning March 3, 2025, the IM-4 MLIS (FA650) form will be included in the mailings of the following SNAP notices:

  • FA150 Claimant Action Notice
  • FA510 Adverse Action Notice
  • FA544 SNAP Change Report Form
  • FA601 Claimant Information Notice

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/vb

IM-11 CITIZENS OF MICRONESIA, THE MARSHALL ISLANDS, AND PALAU ELIGIBLE FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) AND TEMPORARY ASSISTANCE (TA)

FROM: KIM EVANS, DIRECTOR

SUBJECT: CITIZENS OF MICRONESIA, THE MARSHALL ISLANDS, AND PALAU ELIGIBLE FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) AND TEMPORARY ASSISTANCE (TA)

MANUAL REVISION #

1105.010.05 0205.040.05.05
1105.010.10 0205.040.05.15
1105.010.10.40 0205.040.05.25
1105.097.00  
1105.099.00  

DISCUSSION:

Micronesia, The Marshall Islands, and Palau have a Compact of Free Association (COFA) with the United States, meaning citizens of these nations are allowed to enter, leave, and reside in the United States at will. Per the Consolidated Appropriations Act of 2024, effective 3/9/2024, citizens of COFA nations residing in the United States are now eligible for SNAP and TA. They do not have a waiting period and are not subject to sponsor deeming.

Eligibility for Title-XIX MO HealthNet and Children’s Health Insurance Program (CHIP) was previously introduced in Memo IM-50 2021 and Memo IM-28 2024.

Verification of COFA citizenship is required. If verification has previously been entered into the system, the documentation must be located in the electronic case record (ECM) or confirmed by SAVE. If prior verification cannot be confirmed, then verification must be requested.

Acceptable forms of verification include:

  • Birth certificate from Micronesia, The Marshall Islands, or Palau
  • Passport issued by Micronesia, The Marshall Islands, or Palau
  • I-94 with the following Class of Admissions (COA) codes:
    • FSM or CFA/FSM (Federated States of Micronesia)
    • RMI or CFA/RMI (Republic of the Marshall Islands)
    • PAL or CFA/PAL (Republic of Palau)

Note: COFA individuals are not routinely issued an alien registration number and instead use their I-94 number, which can be used to run SAVE.

The eligibility system has been updated to determine participants eligible for SNAP and TA benefits during the following actions:

  • Application
  • Recertification
  • Add-a-person
  • Mid-certification review
  • Manually processed annual review

The system will not automatically reinstate participants of already-active cases during an interim change. This includes when one of the above actions is taken on one program but not another and system-completed reviews. COFA members must be manually reinstated if their status is confirmed or verified outside of application, review, or add-a-person processing.

The policy sections noted above, as well as the SNAP Guide to Immigrant Eligibility, have been updated to reflect this change in policy.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/mn

IM-10 UPDATE TO THE TEMPORARY ASSISTANCE APPLICATION (IM-1TA)

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATE TO THE TEMPORARY ASSISTANCE APPLICATION (IM-1TA)

FORM REVISION #
IM-1TA
IM-1TA SPANISH
IM-1TA DARI
IM-1TA PASHTO

 

DISCUSSION:

The IM-1TA has been updated to include a new link and Quick Response (QR) code informing veterans of resources available to them and their family.

Continue to accept the 02/2024 version of the IM-1TA as this question does not impact eligibility requirements.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using revised IM-1TA 01/2025 immediately.
  • Discard and recycle blank obsolete IM-1TA forms prior to 01/2025.
  • Share with community partners.

 

 

 

KE/hs

IM-09 FEBRUARY 2025 – QUARTERLY FORMS UPDATE

FROM: KIM EVANS, DIRECTOR

SUBJECT: FEBRUARY 2025 – QUARTERLY FORMS UPDATE

 

DISCUSSION:

Income Maintenance forms and documents are reviewed and revised quarterly, and as necessary. New forms and documents are created as required or requested.

All new and revised IM forms show a revision date of 01/2025, unless otherwise stated.

New and Revised Forms available in the public and internal forms manuals:

Form Number Form Name New or Revision:
IM-1MAC Addendum to MO HealthNet Application: Request for Optional Cash Benefits Revision to add information for SNC facility base rate, add Veterans information, update rights and responsibilities to match other MHN forms, and format form for digital processing.
IM-1MAC (Spanish) Complemento de la Solicitud de MO HealthNet: Solicitud de Beneficios Optionales en Dinero en Efectivo Spanish revision of IM-1MAC.
IM-29PROV MO HealthNet Spend Down Provider New form to allow medical providers to verify qualified medical expenses to meet spend down. Creation date 11/2024.
IM-29SDP MO HealthNet Spend Down Participant New form to allow participants to provide proof of medical expenses and identify which months to apply the expenses. Creation date 11/2024.

New and Revised Forms available only to FSD staff in the internal forms manual:

Form Number Form Name New or Revision:
PE-1SSL Application for Presumptive Eligibility Updated DSS logo and added Veterans information.
PE-2 Worksheet Qualified Entity Presumptive Eligibility Determination Worksheet Updated DSS logo.
PE-3 MO HealthNet Presumptive Eligibility Authorization Updated DSS logo.
PE-3PW MO HealthNet TEMP/SMHB Authorization Updated DSS logo.

New and Revised Online Forms

Form Name New or Revision:
MO HealthNet Spend Down Participant New form to allow participants to provide proof of medical expenses and identify which months to apply the expenses. Links to the form have been added to mydss.mo.gov webpages. Creation date 11/2024.
MO HealthNet Spend Down Provider New form to allow medical providers to verify qualified medical expenses to meet spend down. Links to the form have been added to mydss.mo.gov webpages. Creation date 11/2024.

Obsolete forms should no longer be used by FSD staff. These forms are no longer in use with current FSD processes. Staff should work with participants and community partners to ensure that the most current forms are being used. The following forms are obsolete:

Form Number Form Name
MO 886-4501 MO HealthNet Spend Down Provider

Some forms and documents require only small revisions and older versions of documents may be accepted as valid, if the information provided on the form is correct. FSD may accept documents that have been obsoleted if the information provided is current and necessary eligibility determinations.

Note: Program applications and documents used to release information are exceptions. These forms must be the current revision, except during the transition period allowed after a new revision is posted.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using revised forms immediately.
  • Share with community partners.

 

 

 

KE/cj

IM-08 APPLICATION FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) UPDATE

FROM: KIM EVANS, DIRECTOR

SUBJECT: APPLICATION FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) UPDATE

FORM REVISION #
FS-1
FS-1 (Spanish)
FS-1 (Dari)
FS-1 (Pashito)
FS-1 (Large Print)
AEM (Online) FS-1

DISCUSSION:

The “Application for SNAP (FS-1)” was updated with the following:

  • Formatting changes were made throughout the application;
  • A new field was added to the household member details to indicate who buys and cooks together;
  • The question, “Do you need a new Missouri EBT card?” was added;
  • A new field was added to the expenses section to capture how much is paid for an expense.
  • The DSS Non-Discrimination Statement was updated; and
  • The optional Veteran service questions were replaced with a web address and Quick Response (QR) code to the MO Veteran’s Commission survey.

The newest version of the FS-1 has a revision date of 1/2025. Older versions on hand should be destroyed immediately and only the new version should be offered to participants; however, any FS-1 must be accepted regardless of the revision date.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Discard any old versions of the FS-1 and begin using the new version (01/2025) immediately.

 

 

 

KE/tl

 

 

IM-07 FAMIS UPDATES FOR REQUESTS FOR INFORMATION (FA325) AND DIVISION OF ASSETS REQUEST FOR VERIFICATION (FA479)

FROM: KIM EVANS, DIRECTOR

SUBJECT: FAMIS UPDATES FOR REQUESTS FOR INFORMATION (FA325) AND DIVISION OF ASSETS REQUEST FOR VERIFICATION (FA479)

DISCUSSION:

Updates were completed to the FAMIS eligibility system to allow participants to see a relevant date for each type of requested verification.

As each program may request verification for one or more months to determine initial and ongoing eligibility, this modification allows for participants to see clearly what month the information is being requested for. This does NOT replace special instruction fields entered by staff.

Request for Information (FA325) used for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance (TA), and Non-MAGI MO HealthNet (MHN) was updated to display the month and year requested for all eligibility factors.

 

Division of Assets Request for Verification (FA479) used for Non-MAGI MHN was updated to display the month and year requested for any resources owned at the date of institutionalization. The date displayed is the last month and year entered in FAMIS for the resource before the date of institutionalization if it was not previously verified.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/cj

 

IM-06 NEW PRESUMPTIVE ELIGIBILITY (PE) EMAIL AND REMINDER TO CLOSE PE

FROM: KIM EVANS, DIRECTOR

SUBJECT: NEW PRESUMPTIVE ELIGIBILITY (PE) EMAIL AND REMINDER TO CLOSE PE

MANUAL REVISION #
1900.030.00
1900.030.10
1900.030.30

 

DISCUSSION:

Presumptive Eligibility (PE) is not consistently being closed upon approval or denial of ongoing full MO HealthNet (MHN) coverage. This causes duplicate coverage which can cause billing issues and be counted as an error on a Qualify Assurance/Quality Control (QA/QC) review. In order to ensure the PE is closed:

  • Check MXIX to view if a participant has active PE coverage status and end dates. Even when the status shows Closed (CLS), review the end date on the coverage.
  • Review the comments in MEDES on the Client Contact Notes.
  • When a participant with an active PE case is ready to be approved or denied for ongoing MHN, follow directions in the Closing PE Guide in IM Resources.

The contact email for PE closures and contacts has been updated to FSD.IM.Cole.PE@dss.mo.gov. Please begin using this email immediately to request PE closures.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/bl

IM-05 REVISION TO NON-MAGI DISABILITY VERIFICATION POLICY

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISION TO NON-MAGI DISABILITY VERIFICATION POLICY

MANUAL REVISION #
1060.005.00
1050.005.15

 

DISCUSSION:

MO HealthNet Non-MAGI disability policy was updated in the December 1973 Eligibility Requirements Manual.

  • 1060.005.00 Verification of Disability was revised to:
    • Add that a Social Security favorable decision letter or determination can be used as proof of disability in certain circumstances.
    • Clarify that a new MRT decision is not required when a case closes and the applicant reapplies within 90 days, if the MRT decision was previously waived.
    • Update the email contact information for MRT.
    • Update FSD terminology.
  • 1060.005.15 Submitting Information on Cases Previously Reviewed by MRT was revised to:
    • Clarify that a new MRT decision is not required when a case closes and the applicant reapplies within 90 days, if the MRT decision was previously waived.
    • Update FSD terminology.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Staff should reference IM Resources for updated guidance Non-MAGI disability.

 

 

 

KE/cj