Category: IM Memo

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  INDIVIDUALS ACTIVELY RECEIVING SSI/SSDI CAN RECEIVE MO HEALTHNET FOR FAMILIES

MANUAL REVISION #33

1810.020.00

FORMS MANUAL # 11

SSI/SSDI Transition Letter

DISCUSSION:

The purpose of this memorandum is to advise that participants who are actively receiving Supplemental Security Income (SSI) or Social Security Disability Income (SSDI) can receive MO HealthNet for Families (MHF) per guidance from Centers for Medicare and Medicaid Services (CMS). 

The Family MO HealthNet (MAGI) policy manual section 1810.020.00 Eligibility Requirements has been updated to reflect this change.   

For participants currently receiving MHF and SSI or SSDI: send the SSI/SSDI Transition Letter at annual review.  This letter will advise the participant they may be eligible for MO HealthNet for Aged, Blind, and Disabled (MHABD).  If the participant chooses not to complete the MHABD application and all other eligibility factors are met, continue MHF coverage. 

NECESSARY ACTION:

• Start sending participants receiving MHF and SSI or SSDI the SSI/SSDI Transition Letter at annual review.
• Review this memorandum with appropriate staff.

PL/al                                    

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  2019 MAGI COST OF LIVING ADJUSTMENT (COLA) FOR VETERANS ADMINISTRATION AND RAILROAD INCOME  

DISCUSSION:

This memorandum informs staff that Railroad Retirement (RR) and Veterans Administration (VA) participants received a 2.8% Cost of Living Adjustment (COLA) for MAGI programs effective January 2019.

Cases Adjusted

Cases that include MEDES income types of Railroad Retirement and/or VA Benefits were subject to an automatic increase of 2.8% for those income types.  MEDES end dated the previous income and added a new piece of income evidence that reflects the adjusted income amount.

Cases That Did Not Adjust

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

Notices

For case updates made as a result of COLA, MEDES finalized the decision(s) and send out the appropriate notices. The reasons and notices that were sent are as follows:

• Cases with no change were sent the IM-33C.
• Cases that resulted in benefit reduction were sent an IM-80 allowing 10 days for the individual to respond to the proposed case action. The IM-33C was sent after the IM-80 expired.
• Cases that resulted in individuals who no longer qualify were sent an IM-80 PRE allowing 10 days for the individual to respond to the proposed case action. An IM-80PRE and IM-80 were sent, followed by the IM-33C.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/ers

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  2019 MAGI COST OF LIVING ADJUSTMENT (COLA) FOR SSA/SSI INCOME                       

DISCUSSION:

Thi memorandum informs staff that Social Security Administration (SSA) and Supplemental Security Income (SSI) participants will receive a 2.8% Cost of Living Adjustment (COLA) for MAGI programs effective April 2019.

Cases Expected to Adjust

Cases that include MEDES income types of 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 Supplemental Security Income, will be subject to an automatic increase of 2.8% for those income types.  MEDES will end date the previous income and add a new piece of income evidence that reflects the adjusted income amount.

Cases Not Expected to Adjust

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

Notices

For case updates made as a result of COLA, MEDES will propose and finalize the decision(s) and send out the appropriate notices. The reasons and notices that will be sent are as follows:

• Cases with no change will be sent the IM-33C.
• Cases that result in benefit reduction will be sent an IM-80 allowing 10 days for the individual to respond to the proposed case action. After the IM-80 period expires, the IM-33C will be sent.
• Cases that result in individuals who no longer qualify will be sent an IM-80 PRE allowing 10 days for the individual to respond to the proposed case action. After the IM-80 PRE expires, an IM-80 will be sent allowing an additional 10 days. After the IM-80 expires, the IM-33C will be sent.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/ers

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  UPDATED PRESUMPTIVE ELIGIBILITY INCOME GUIDELINES

MANUAL REVISION #32

APPENDIX A (1900.000.00)

DISCUSSION:

The purpose of this memorandum is to update the income guidelines for Presumptive Eligibility due to the increase in the Federal Poverty Level (FPL). These guidelines are effective from April 1, 2019 through March 31, 2020. Appendix A, found in the Presumptive Eligibility Manual has been updated to reflect the new FPL. 

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/df

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  INCREASE IN RESOURCE LIMITS FOR QUALIFIED MEDICARE BENEFICIARY (QMB), SPECIFIED MEDICARE BENEFICIARY (SLMB), AND QUALIFYING INDIVIDUALS (QI-1 OR SLMB2) PROGRAMS

MANUAL REVISION #31

0865.010.00
0865.010.15

APPENDIX J

DISCUSSION:

Effective January 1, 2019, the QMB, SLMB, and SLMB2 resource limits increased.  For a single individual, the resource limit increased from $7,560 to $7,730.  For a married couple, the resource limit increased from $11,340 to $11,600.  Resource maximums have been updated in the Family Assistance Management Information System (FAMIS).  There is no change in policy regarding how to determine available resources.

Income Maintenance Manual Sections Eligibility Requirements 0865.010.00 and Resources (QMB) 0865.010.15 have been updated to include the increase in resource limits.  The MO HealthNet Program Description Aged, Blind, and Disabled Chart and MO HealthNet Aged, Blind and Disabled Income Chart have been updated on the Intranet and Internet to show the increased resource limits.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/vb

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  REASONABLE COMPATIBILITY CLARIFICATION

MANUAL REVISION #28

1805.030.15                          

DISCUSSION:

The purpose of this memorandum is to advise the 1805.030.15 Reasonable Compatibility section of the Family Healthcare Manual- MAGI has been updated.   

The manual has been updated to clarify that when the self-attested income is above the MO HealthNet eligibility threshold and the Electronic Data Source (EOI) is below the threshold that a reasonable explanation must be provided or additional verification must be requested.

Income is still considered reasonable compatibility when:

• Both the self-attested income and the EOI fall within the same MO HealthNet program eligibility threshold or
• The self-attested income is below the MO HealthNet program eligibility threshold and EOI falls in a different MHN program category above the threshold, but the EOI is within 10% or less of the self-attested income.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

PL/al