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

IM-03 UPDATES TO ADMINISTRATIVE DISQUALIFICATION HEARING FORMS IM-160, IM-161 AND IM-161 INSTRUCTIONS

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATES TO ADMINISTRATIVE DISQUALIFICATION HEARING FORMS IM-160, IM-161 AND IM-161 INSTRUCTIONS
UPDATE

FORM REVISION #
IM-160
IM-161

DISCUSSION:

The Advance Notice of your Administrative Disqualification Hearing (IM-160) and The Waiver of Administrative Disqualification Hearing Consent Agreement (IM-161) forms were revised with the following:

  • Clarification to contact the Administrative Hearing Office,
  • Updated terminology,
  • Updated DSS logo, and
  • The optional Veteran service questions were added with a web address and Quick Response (QR) code to the MO Veteran’s Commission survey.

The Instructions for the IM-161 were updated to reflect the revision to contact the Administrative Hearing Office, as well. The newest version of the IM-160 and IM-161 have a revision date of 1/2025. Older versions should be destroyed immediately, and only the new version should be offered to participants.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Discard any old versions of the IM-160 and IM-161.
  • Begin using the new versions (01/2025) immediately.

 

 

 

KE/se

 

 

IM-02 HEARINGS MANUAL UPDATE AND OBSOLETING THE APPLICATION FOR STATE HEARING IM-87

FROM: KIM EVANS, DIRECTOR

SUBJECT: HEARINGS MANUAL UPDATE AND OBSOLETING THE APPLICATION FOR STATE HEARING IM-87

MANUAL REVISION #

0130.020.20.25 0130.005.10.25
0130.020.20.30 0130.020.20.15
0130.020.60 0130.020.70.30
0130.020.70.10 0130.020.90.10
0130.020.70.15 1105.035.50
0240.020.05 1130.040.00
  1840.030.15

 

DISCUSSION:

The IM-87 Application for State Hearing form is now obsolete. Any link or reference to the IM-87 has been removed from the policy manuals and replaced with the IM-85 Hearing Request. If a completed IM-87 is received, continue to accept as a request for a hearing, but destroy all printed versions of the IM-87.

The hearing manual was updated to reflect current terminology, the correct processes regarding the handling of a hearing request, and if a participant reports a change to the Family Support Division (FSD) on a case with a hearing pending.

Review the following manual sections:

The manual sections below had the IM-87 replaced with the IM-85, along with terminology updates and removal of obsolete processes no longer utilized by the IMHU and local county FSD staff.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Destroy all paper IM-87’s.

 

 

 

KE/ch

 

IM-01 OBSOLETING SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) MANUAL SECTIONS MID-CERTIFICATION REVIEW FOR SNAP ONLY CASES AND FOR SNAP/IM COMBINATION CASES

FROM: KIM EVANS, DIRECTOR

SUBJECT: OBSOLETING SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) MANUAL SECTIONS MID-CERTIFICATION REVIEW FOR SNAP ONLY CASES AND FOR SNAP/IM COMBINATION CASES

MANUAL REVISION #
1140.020.05 (Obsolete)
1140.020.10 (Obsolete)

 

DISCUSSION:

The following manual sections contain outdated and/or redundant information:

  • 1140.020.05 Mid-Certification Review for SNAP Only Cases
  • 1140.020.10 Mid-Certification Review SNAP/IM Combination

Relevant information regarding the Mid-Certification review is outlined in 1140.020.00 Mid-Certification Reviews.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

KE/tl

IM-68 2025 AFFORDABLE INSURANCE QUOTES UPDATED ON FAMILY MO HEALTHNET (MAGI) APPENDIX G

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2025 AFFORDABLE INSURANCE QUOTES UPDATED ON FAMILY MO HEALTHNET (MAGI) APPENDIX G

MANUAL REVISION #
APPENDIX G

 

DISCUSSION:

The CHIP Affordability Test Calculator, Appendix G, has been updated with 2025 insurance quotes from the Federally Facilitated Marketplace (FFM). Affordable insurance determinations for Children’s Health Insurance Program (CHIP) premium children must still be completed.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using the updated CHIP Calculator (MAGI Appendix G) January 1, 2025.

 

 

 

KE/bl

IM-67 EXPIRATION OF ELECTRONICALLY STOLEN BENEFITS (ESB) REPLACEMENT FUNDING

FROM: KIM EVANS, DIRECTOR

SUBJECT: EXPIRATION OF ELECTRONICALLY STOLEN BENEFITS (ESB) REPLACEMENT FUNDING

 

DISCUSSION:

The authority to replace SNAP electronically stolen benefits ended December 20, 2024. The Family Support Division (FSD) will continue to process these benefits if they were stolen on or before December 20, 2024. Staff must continue to accept all ESB replacement requests, however, ESB replacement requests received after December 20, 2024, cannot be processed and benefits will not be replaced.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/lp

IM-66 JANUARY 2025 COLA ADJUSTMENT OF SSA/SSI/VA/RR INCOME FOR ALL INCOME MAINTENANCE PROGRAMS EXCEPT MAGI MO HEALTHNET

FROM: KIM EVANS, DIRECTOR

SUBJECT: JANUARY 2025 COLA ADJUSTMENT OF SSA/SSI/VA/RR INCOME FOR ALL INCOME MAINTENANCE PROGRAMS EXCEPT MAGI MO HEALTHNET

MANUAL REVISION #
APPENDIX B
APPENDIX D
APPENDIX E
APPENDIX J
APPENDIX K

 

DISCUSSION:

In January 2025, all Social Security Administration (SSA), Supplemental Security Income (SSI), Veterans Administration (VA), and Railroad Retirement (RR) participants will receive a 2.5% Cost of Living Adjustment (COLA).

The weekend of December 14, 2024, a mass adjustment will be completed in the eligibility system for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance (TA), and Non-MAGI MO HealthNet 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 2025 COLA will have the following effect on SNAP cases:

  • Increase in SNAP benefit reductions for January 2025.
  • Increase in SNAP closures for December 2024.

SSI Increases

SSI Table 2024 AMOUNT 2025 AMOUNT INCREASE
SSI Individual maximum (in own household)  $943  $967  $24
SSI Couple maximum (in own household)  $1415  $1450  $35
SSI Individual in household of another  $629  $645  $16
SSI Couple in household of another  $943  $967  $24
SSI Essential person/own home  $472  $484  $12

Non-MAGI Standards Adjustments

NON-MAGI STANDARDS 2024 AMOUNT 2025 AMOUNT
Maximum Allotment of Community Spouse  $3,854  $3,948
Minimum Maintenance Standard for Allotments  $2,465  $2,555
Maximum Allocation to a child  $472  $483
Maximum Allotment to a child  $821  $852
Minimum Spousal Share  $30,828  $31,584
Maximum Spousal Share  $154,140  $157,920
Maximum Home Equity  $713,000  $730,000
HCB Maximum  $1,649  $1,690
SAB Standard  $1,019  $1,044

Supplementary Medical Insurance (SMI) Premium Adjustment

The standard SMI, commonly known as Medicare Part B, premium will increase for 2025 to $185.00. 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 Non-MAGI Program Increases

Resource Limits for Medicare Savings Programs (QMB/SLMB/QI-1)

For a single individual, the resource limit increases to $9,660. For a married couple, the resource limit increases to $14,470. There is no change in policy regarding how to determine available resources.

Minimum and Maximum Spousal Share

The 2025 minimum spousal share is $31,584. The new maximum spousal share is $157,920. Both amounts become effective for any Division of Assets completed on or after January 1, 2025.

Substantial Gainful Activity (SGA)

The SGA monthly amounts increase and are as follows:

  • $2,700 for statutorily blind individuals
  • $1,620 for non-blind individuals

Appendices Updates

The following appendices were updated to show the new amounts:

Note: Appendix J and Appendix K were updated to reference Resource Limits, instead of Asset Limits. Appendix K was updated to correct the Blind Pension and Supplemental Aid to the Blind grant amount to $828, as it was increased in 7/2024.

  • December 1973 Eligibility Requirements Manual
    • Appendix D – Substantial Gainful Activity

 

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 2025, do not use the “CO” – COLA verification code.

Reports with Actions Needed

Reports with action needed will be distributed to the SNAP, TA, 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.

 

 

 

KE/cj

IM-65 UPDATES FOR HANDLING OF FEDERAL TAX INFORMATION (FTI) AND INCIDENT RESPONSES FOR UNAUTHORIZED IRS DISCLOSURES

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATES FOR HANDLING OF FEDERAL TAX INFORMATION (FTI) AND INCIDENT RESPONSES FOR UNAUTHORIZED IRS DISCLOSURES

MANUAL REVISION #

0165.000.00
0165.000.05
0107.010.05

 

DISCUSSION:

There are new procedures for the handling of Federal Tax Information (FTI) and Incident Reponses for Unauthorized IRS disclosures.

Updates to the following policies:

0107.010.05 Email Policy

Emailing FTI (Federal Tax Information) is generally prohibited but should it be necessary, the following must be followed:

  1. The email recipient is authorized to receive FTI; and
  2.  The email subject line contains “FTI” to ensure the recipient is aware that the email contains FTI; and
  3. The email is encrypted; and
  4. The email subject line contains no confidential information, such as name or DCN, because the subject line displays even when the email is encrypted; and
  5. Any email attachment(s) that contain FTI are encrypted.

In the event FTI is incorrectly emailed/disclosed, notify Family Support Division, Income Maintenance Security Officer in Central Office at FSD.IMPRIVACY@DSS.MO.GOV and attempt to recall the email. If unsuccessful, contact ITSD to attempt to disable the email before the recipient tries to read the email.

0165.000.00 Safeguard Requirements for IRS Information:

All Management and Supervisory Staff have an ongoing responsibility for ensuring all staff are knowledgeable about the processing and handling of Personally Identifiable Information (PII) which includes FTI as found in DSS Policy 5-103.

View 0165.000.05 Incident Response for Unauthorized IRS Disclosures and follow steps to report Unauthorized IRS Disclosures.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/nw