Category: IM Memo

IM-32 2023 MO HEALTHNET OUTREACH PROJECT WITH DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION, LICENSED CHILDCARE PROVIDERS, AND FAMILY SUPPORT DIVISION

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FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 MO HEALTHNET OUTREACH PROJECT WITH DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION, LICENSED CHILDCARE PROVIDERS, AND FAMILY SUPPORT DIVISION

 

DISCUSSION:

Senate Bill 583 (2010) requires the Department of Social Services (DSS) to collaborate with the Department of Elementary and Secondary Education (DESE) and licensed childcare providers in an effort to reach the uninsured children of Missouri.

Each year, to comply with Senate Bill 583, the Family Support Division (FSD) provides DESE and licensed childcare providers with a flyer that informs parents how to apply for MO HealthNet (MHN) as follows:

  • Online at mydss.mo.gov. Please send an email to Cole.MHNPolicy@dss.mo.gov with subject line “SCHOOL” or “FACILITY OUTREACH” to let us know to watch for your application. Include the parent’s name, child’s name, and child’s date of birth.
  • By telephone at 1-855-373-9994. When speaking with a representative please tell them this is a “School Application” or “Facility Outreach Application”.
  • Request an application from 1-855-FSD-INFO (1-855-373-4636). Please write “SCHOOL” or “FACILITY OUTREACH” at the top of the application.
  • Print an application online at https://dssmanuals.mo.gov/wp-content/uploads/2020/09/IM-1SSL-Fillable-Secured-6-24-21.pdf. Please write “SCHOOL” or “FACILITY OUTREACH” at the top of the application.

The attached flyers below will be distributed to schools and childcare facilities:

  • Two for DESE – one in English and one in Spanish
  • One for Childcare Facilities in English

FSD is required to track these applications for reporting. Each Family MO HealthNet (MAGI) office, Resource Center, and Customer Service Center is asked to document the receipt of these applications on the attached spreadsheets. School and Facility Outreach spreadsheets should be kept separate. Management should enter all information on the appropriate spreadsheet and submit monthly to Cole.MHNPolicy@dss.mo.gov.

 

NECESSARY ACTIONS:

  • Review this memorandum with appropriate staff.
  • Offices should begin tracking immediately and submitting documentation on the first week of each month.

 

ATTACHMENTS:

 

 

 

KE/kg

IM-31 APRIL 2023 – QUARTERLY FORMS UPDATE

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FROM: KIM EVANS, DIRECTOR

SUBJECT: APRIL 2023 – 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 forms show a revision date of 4/2023. Revised forms with older revision dates are now obsolete. Family Support Division (FSD) will accept obsolete forms until 6/30/2023.

 

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

Form Number Form Name New or Revision:
CARS-8 Request for Reduction of Claim Revised to update terminology and remove unnecessary fields.
CARS-8 Instructions Instructions for Request for Reduction of Claim Revised to update terminology and remove unnecessary fields.
IM-1MAC

Addendum to MO HealthNet Application: Request for optional cash benefits

 Revision to allow electronic signatures. New PDF format.
IM-1MAC (Spanish) Complemento de la Solicitud de MO HealthNet: Solicitud de Beneficios Opcionales en Dinero en Efectivo Revision to allow electronic signatures.

IM-6AR

IM-6AR (Large Print)

 Appointing an Authorized Representative Revision to change MO HealthNet (MHN) terminology to annual renewal.
IM-6AR (Spanish) Designacion de un Representante Autorizado Revision to change MHN terminology to annual renewal.
IM-31F Applying for SNAP Benefits Revision to clarify that Residency verification is only required when questionable.
IM-31F (Spanish) Solicite beneficios del SNAP Revision to clarify that Residency verification is only required when questionable.
IM-110 Statement of Loss/Replacement Request Revision to use central mail address.

 

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

Form Number  Form Name New or Revision:
FSD/SMH Cover MO HealthNet Application for DMH Consumers in a State Mental Hospital Form was revised by DMH to provide updated application processes and information for DMH staff. This form has a revision date of 9/2022.
IM-1U90 Annual Renewal Received Outside Reconsideration Period Revision to change form name and MHN terminology to annual renewal.

 

Obsolete forms should no longer be used by FSD staff and will NOT be accepted after 6/30/23. These forms are no longer in use with current FSD processes. In addition to forms listed above with older revision dates, the following forms are also obsolete:

Form Number Form Name
CARS-7 Food Stamp Repayment Agreement
IM-34 AEG MO HealthNet Informational Notice
  MRT Checklist
IM-115 Request for Food Stamp Household Report

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using revised forms immediately.
  • Discard and recycle blank obsolete forms.
  • Share with community partners.

 

 

KE/cj

IM-30 ALIGNING FAMILY MO HEALTHNET (MAGI) INCOME VERIFICATION POLICY WITH THE MAGI VERIFICATION PLAN

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FROM: KIM EVANS, DIRECTOR

SUBJECT: ALIGNING FAMILY MO HEALTHNET (MAGI) INCOME VERIFICATION POLICY WITH THE MAGI VERIFICATION PLAN

MANUAL REVISION #
1805.030.05
1805.030.15
1805.030.15.10

 

DISCUSSION:

MAGI Manual Sections 1805.030.05 Income Evidence, 1805.030.15 Reasonable Compatibility, and 1805.030.15.10 Reasonable Compatibility with More than One Income in the Household are updated to align MAGI policy with recent changes to the MAGI Verification Plan and related federal guidance.

Key changes are:

  • Attempt to resolve reasonable compatibility (RC) inconsistencies by first trying to contact the participant to ask for a clarifying statement. Obtain verification only if the clarifying statement cannot be obtained or does not resolve the inconsistency.
  • When self-attested income and electronically obtained information (EOI) are both within the same program threshold or the EOI is in a higher program threshold, but is within 10% of the self-attested amount, use the self-attested amount to determine the eligibility level.
  • After checking for income verified by another assistance program, such as Supplemental Nutrition Assistance Program (SNAP), accept the self-attested amount of income for self-employment and farming income, pensions, and short or long-term disability.

Refer to the updated sections for more information.

Note: Per federal requirements at 42 CFR 435.945(j), Family Support Division (FSD) is required to maintain a MAGI Verification Plan describing FSD’s MAGI verification policies and procedures.

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/ers

IM-29 UPDATED POLICY ALLOWING ELIGIBILITY CHANGES FOR SUSPENDED MO HEALTHNET (MHN) PARTICIPANTS

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FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATED POLICY ALLOWING ELIGIBILITY CHANGES FOR SUSPENDED MO HEALTHNET (MHN) PARTICIPANTS

MANUAL REVISION #
0840.020.00
1885.040.00

 

DISCUSSION:

MHN participants who become incarcerated, or are determined eligible while incarcerated, must have their MHN suspended until release. Policy is updated to allow all case actions for a suspended participant.

Suspended participants (or their household or authorized representative) must complete annual renewals and report changes in circumstance during incarceration. Family Support Division (FSD) will attempt to complete annual renewals without contacting the participant; however, if this is not possible, an annual renewal form will be sent to the participant’s mailing address, which may be the jail or prison, or their household address.

If an annual renewal or a change of circumstance causes a change to eligibility for a suspended participant, FSD will take action on these changes and send appropriate notices.

This may include, but is not limited to:

  • Changing the level of care.
  • Moving from MAGI to Non-MAGI programs.
  • Closing eligibility.

Revised MAGI policy is in Family MO HealthNet manual section, 1885.040.00 Suspension of MAGI Benefits for Incarcerated Individuals.

Revised Non-MAGI policy is in MO HealthNet for the Aged, Blind, and Disabled manual section, 0840.020.00 Suspending Incarcerated Participants.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/cj

IM-28 RECONSIDERATION PERIOD DURING THE TRANSITION PERIOD FOR ALL MO HEALTHNET (MHN) PROGRAMS

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FROM: KIM EVANS, DIRECTOR

SUBJECT: RECONSIDERATION PERIOD DURING THE TRANSITION PERIOD FOR ALL MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
0840.005.05
0890.010.00
1880.020.00
1895.010.00

 

DISCUSSION:

Effective April 1, 2023 through May 31, 2024, temporary reconsideration period policy is in effect for all MHN programs.

When a case has closed for failure to return the annual renewal form, cancel close/reopen the case when the signed annual renewal is received within 90 days of closing.

If the participant returns an annual renewal form, it must be signed. Telephonic signatures are allowed for MHN annual renewals, however, only the Family Support Division (FSD) vendor and specialized staff trained to accept and record telephonic signatures can complete annual renewals by phone. If the participant contacts the Customer Service Center and needs to complete the annual renewal, transfer the call to the FSD vendor.

Consider the annual renewal as received if the participant fails to return the annual renewal form but provides all information required to complete the annual renewal by phone, online, in-person, or through the mail within the 90-day reconsideration period. For example, the participant turns in a new application with all required information.

When the annual renewal is received 90 days or less after the case closed:

  • Cancel close/reopen the case.
  • Follow established procedures to complete the annual renewal.

When the annual renewal is received 91 days or more after the case closed:

Note: MEDES system changes to allow cases to be reopened up to 90 days will be in a future MEDES Release.

MO HealthNet for the Aged, Blind and Disabled (MHABD) Manual section 0840.005.05 Reconsideration Period and Family MO HealthNet (MAGI) Manual section 1880.020.00 Reconsideration Period were updated instructing staff to follow guidance in this memo during the transition period.

This memo has been added to the following MHABD and MAGI manual sections:

0890.010.00 Transition Period
1895.010.00 Transition Period

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/sh

IM-27 WAIVERS APPROVED BY CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) FOR ALL MO HEALTHNET (MHN) ANNUAL RENEWALS

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FROM: KIM EVANS, DIRECTOR

SUBJECT: WAIVERS APPROVED BY CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) FOR ALL MO HEALTHNET (MHN) ANNUAL RENEWALS

MANUAL REVISION #
0890.010.00
1895.010.00

 

DISCUSSION:

An increased number of eligibility and enrollment actions must be completed when MHN annual renewals resume on April 1, 2023. CMS has approved Missouri to use the following waivers to help expedite renewal processing, protect participants from inappropriate terminations, and reduce administrative burden. Headings shown below are the official CMS waiver titles.

These waivers are effective April 1, 2023 and will continue until further notice.

1. Renewal for Individuals Based on SNAP Eligibility

Renew MHN eligibility for participants under 65 years of age who are receiving Supplemental Nutrition Assistance Program (SNAP) benefits, despite the differences in household composition and income-counting rules.

Note: This waiver allows the “Targeted Enrollment SNAP Strategy” flexibility currently used for Modified Adjusted Gross Income (MAGI) applications to also be used for all MHN annual renewals.

2. Ex Parte Renewal for Individuals with No Income and No Data Returned

When using the ex parte (not requiring information from the individual) renewal process for non-CHIP cases, complete the income determination without requesting additional income information or documentation if:

  • An attestation of zero-dollar income was verified at an initial application or renewal completed no earlier than March 2019; and
  • No income information is reported on an electronic source, such as IMES, IIVE, or The Work Number.

Continue to take appropriate steps to complete a determination of non-financial eligibility requirements.

Note: This waiver does not apply to CHIP cases.

3. Facilitating Renewal for Individuals with no Asset Verification System (AVS) Data Returned within a Reasonable Timeframe

Assume there has been no change in resources and complete the ex parte (not requiring information from the individual) renewal process without any further verification of assets when:

  • No information is returned through Accuity; or
  • Accuity response is not returned within 15 days.

If information from Accuity indicating potential ineligibility is received after a renewal has been completed, treat the information as a change in circumstance.

4. Extended Timeframe to Take Final Administrative Action on Fair Hearing Requests

All participants must remain active on MHN pending the outcome of a fair hearing decision regardless of whether the participant has requested that their MHN benefits continue. This flexibility does not extend the timeframe to take final administrative action when benefits cannot be provided pending the outcome of a fair hearing, such as a denial of eligibility for a new applicant.

  • Staff who submit the hearing request must place both the Adverse Action Benefit Reduction (AABR) and No Change (NOCH) actions on hold before submitting the hearing request handoff. Information on how to change an adverse action status can be found in FAMIS Resources.
  • The Income Maintenance (IM) Hearing Unit is responsible for reinstating coverage back to the date of the action for any person who requests a fair hearing after the date of action.

Note: Missouri will not recoup the cost of MHN benefits provided to the participant while the fair hearing is pending, regardless of whether the fair hearing ultimately upholds the agency’s determination.

This memo has been added to the following MO HealthNet for the Aged, Blind, and Disabled (MHABD) and Family MO HealthNet (MAGI) manual sections:
0890.010.00 Transition Period
1895.010.00 Transition Period

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/sh

IM-26 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

Posted on

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:

 

NECESSARY ACTION:

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

 

 

 

KE/sh

IM-25 UPDATE TO ANNUAL RENEWAL POLICY IN THE MAGI MANUAL

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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:

 

NECESSARY ACTION:

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

 

 

KE/sh

IM-24 UPDATE TO ANNUAL REVIEW/REINVESTIGATION POLICY IN THE NON-MAGI MANUALS

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FROM: KIM EVANS, DIRECTOR

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

MANUAL REVISION #

0430.000.00  0840.000.00
0430.005.00  0840.005.00
0525.000.00     0840.005.00.05
0525.005.00 0850.015.00
0630.000.00 0855.015.00
0630.005.00 0865.025.00
0745.000.00  0870.025.00
0745.005.00  1030.000.00
0820.040.05 1320.000.00
0825.040.05 1320.020.00

 

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

Blind Pension Manual

Supplemental Nursing Care (SNC) Manual

Supplemental Payments Manual

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

December 1973 Eligibility Requirements Manual

Breast or Cervical Cancer Treatment (BCCT) Manual

 

NECESSARY ACTION:

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

 

 

KE/sh

IM-23 MILEAGE REIMBURSEMENT RATE INCREASE FOR ALL INCOME MAINTENANCE (IM) PROGRAMS

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FROM: KIM EVANS, DIRECTOR

SUBJECT: MILEAGE REIMBURSEMENT RATE INCREASE FOR ALL INCOME MAINTENANCE (IM) PROGRAMS

FORM REVISION #
APPENDIX J

 

DISCUSSION:

The state mileage rate used to calculate expenses for all IM programs increased from $.55 per mile to $.62 per mile effective 03/01/2023. Use the rate of $.62 per mile when calculating mileage expenses.

Effective 03/19/2023, the eligibility system is updated to reflect the rate increase. Appendix J of the MO HealthNet for the Aged, Blind, and Disabled manual has been updated to reflect the change.

Note: Final approval for the increased rate was received after March benefits were created. Affected cases have been adjusted to reflect this change for March 2023 and notices will be generated.

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/mc