IM-94 NEW CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) NON-PREMIUM LEVEL OF CARE, 4M

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  NEW CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) NON-PREMIUM LEVEL OF CARE, 4M

MANUAL REVISION #
1800.000.00
1805.030.15
1805.040.00
1840.010.00
1840.010.05
1840.015.00
1880.010.00
1885.000.00
MAGI Appendix A
MAGI Appendix D
MAGI Appendix H

 

DISCUSSION:

CHIP 4M Non-Premium is a new level of care (LOC) effective July 1, 2022 created for MO HealthNet Division (MHD) reporting requirements. CHIP 4M provides non-premium MO HealthNet coverage for uninsured children who meet the requirements at 1840.010.00 Eligibility Requirements in addition to the following:

Income

  • Children ages 1 through 5: Gross income of 148% up to and including 153% FPL
  • Children ages 6 through 18: Gross income of 110% up to and including 153% FPL

Family MO HealthNet (MAGI) Manual Appendix A and Appendix D are updated with this change.

Uninsured

  • Children must be uninsured with no access to health insurance through a family member’s employment with a public agency.
  • Children with disabilities who qualify for MO HealthNet for Disabled Children (MHDC) non-spend down are considered insured.

Children are eligible for MO HealthNet for Kids (MHK) Non-CHIP if they meet all eligibility factors for CHIP 4M, other than the uninsured requirement. Explore MHK coverage if a child on CHIP 4M becomes insured or otherwise fails to meet the uninsured requirements for the CHIP 4M group.

EXAMPLE: Shari, age 13, receives CHIP 4M coverage. Her household’s income is at 117% of FPL. Her mother reports that Shari is now receiving health insurance coverage through an employer. Shari’s coverage transitions to MHK Non-CHIP.

Do not close or reject CHIP 4M coverage for failure to provide information about insurance status for a child.

EXAMPLE: June is uninsured and is eligible for CHIP 4M coverage. Her father submits two applications, one on 7/1 and the other on 7/2. On the 7/1 application he declares that June has insurance through his employer. On the 7/2 application he declares that she is uninsured. Clarification of insurance status for June is requested, but her father does not respond. June remains eligible for CHIP 4M.

Eligibility for CHIP 4M begins the first day of the application month or in prior quarter if all eligibility requirements are met. Children eligible for CHIP 4M are eligible for Non-Emergency Medical Transportation (NEMT).

MXIX will display 4M in the LOC column, when applicable. MAGI Appendix H: ME Codes Chart is updated with CHIP 4M.

NOTE: Although 4M is CHIP, because its income guidelines overlap with non-CHIP, the assignment of medical support is mandatory. A Referral/Information for Child Support Services (CS201) is required unless good cause for refusal to cooperate is established. Refer to 1805.040.00 Cooperation in Pursuit of Medical Support.

The MAGI manual is updated with these changes.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ers

IM-93 REPLACEMENT OF MO HEALTHNET ELIGIBILITY CODES (ME) FOR CERTAIN SHOW ME HEALTHY BABIES (SMHB) NEWBORNS

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  REPLACEMENT OF MO HEALTHNET ELIGIBILITY CODES (ME) FOR CERTAIN SHOW ME HEALTHY BABIES (SMHB) NEWBORNS

MANUAL REVISION #
1855.030.05

 

DISCUSSION:

To simplify funding procedures for the SMHB program, the following ME codes for SMHB Newborns are updated, effective July 1, 2022:

  • ME 62 with a Federal Grant Indicator (FGI) of 8 is replaced with ME 6S.
  • ME 74 and 75 with an FGI of 8 are replaced with ME 9S.

SMHB Newborn eligibility requirements have not changed. These ME code changes apply to SMHB levels of care only.

Non-SMHB levels of care, including MHK Under 1 (ME 62) and CHIP Premium Groups 74 and 75 (ME 74 and 75), are not affected. ME 97, the ME code for SMHB Newborns born to mothers denied MO HealthNet for Pregnant Women (MPW) due to excess income, is not replaced or affected.

Appendix H is updated with this change.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ers

IM-89 ALL PROGRAM UPDATE TO POLICY WHEN NO DATA IS SHOWN ON IMES AND “NO DATA” DEFINITION

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  ALL PROGRAM UPDATE TO POLICY WHEN NO DATA IS SHOWN ON IMES AND “NO DATA” DEFINITION

MANUAL REVISION #
0110.025.05
0110.025.10
1805.030.05

 

DISCUSSION:

Policy for all programs is updated to explain necessary actions when an Income Maintenance and Employment Security interface (IMES) returns “no data.” The General Information Manual and Family MO HealthNet (MAGI) Manual policy are revised with this change; content in policy manuals for programs other than MO HealthNet does not require an update at this time.

IMES Used to Support an Income Determination

IMES is required in the record if it is accessed to review income information and reflects something other than “no data”. An IMES is considered to contain “no data” when the IMES:

  • is completely blank

or

  • has no earned income data for the last 12 months, and displays no unemployment compensation received for the last 12 months

When IMES displays “no data”, document in the eligibility system the date the IMES was viewed and why the IMES was not considered useful in an income determination.

IMES Used to Support Non-Financial Eligibility Requirements

Retain a copy in the case record if IMES is used to confirm non-financial information, such as, but not limited to:

  • Application status for other benefits such as unemployment compensation
  • Missouri residency or address information

FAMIS Resources guides are updated to include this information.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ers

IM-88 UPDATE TO CLARIFY MO HEALTHNET FOR FAMILIES (MHF) ELIGIBILITY FOR 18-YEAR-OLDS

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATE TO CLARIFY MO HEALTHNET FOR FAMILIES (MHF) ELIGIBILITY FOR 18-YEAR-OLDS

MANUAL REVISION #
1810.020.20.20

 

DISCUSSION:

Family MO HealthNet (MAGI) Manual section 1810.020.20.20 Eligibility for 18-Year-Olds is updated to clarify educational requirements for children who have reached the age of 18, but have not reached the age of 19.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ams

IM-87 REVISIONS TO NOTICE OF ELIGIBILITY FOR NURSING FACILITY AND OTHER VENDOR SERVICES (IM-62)

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  REVISIONS TO NOTICE OF ELIGIBILITY FOR NURSING FACILITY AND OTHER VENDOR SERVICES (IM-62)

FORM REVISION #
IM-62
IM-62 (Spanish)

 

DISCUSSION:

The IM-62 and IM-62 (Spanish) were updated to add the participant’s Managed Care Health Plan. Other changes were made for participant clarity and to remove information no longer utilized by staff.

The Managed Care Health Plan information in the middle of the form allows staff to enter the managed care name and date of enrollment for easy identification by vendors.

The IM-62 shows a revision date of 6/2022 and is available in the internal forms manual.

 

NECESSARY ACATION:

  • Review this memorandum with appropriate staff.
  • Begin using the revised IM-62 immediately.

 

KE/sh

IM-86 GATEWAY TO BETTER HEALTH (GTBH) PARTICIPANTS TO TRANSITION TO MO HEALTHNET ADULT EXPANSION GROUP (AEG)

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  GATEWAY TO BETTER HEALTH (GTBH) PARTICIPANTS TO TRANSITION TO MO HEALTHNET ADULT EXPANSION GROUP (AEG)

 

DISCUSSION:

In May 2022, FSD requested a waiver from Centers for Medicare & Medicaid Services (CMS) under 1902(e)(14)(A) of the Social Security Act. CMS approved the waiver until October 31, 2022. This waiver allows FSD to use the most recent non-MAGI GTBH eligibility determination to determine eligibility for AEG, a MAGI based program, without requiring additional information or verification from the participant.

From now until October 31, 2022, FSD will take action to move all GTBH participants to AEG using available information. FSD will utilize information provided by the participant at the last application, review, or change of circumstance. Once found eligible, participants will receive an approval notice for AEG benefits, and a separate closing notice for GTBH benefits.

Due to the COVID-19 Public Health Emergency (PHE), some current MO HealthNet (MHN) participants may not be eligible for any MHN program, but continue to receive benefits due to the continuous coverage requirement. GTBH participants who are not eligible for AEG (or any other MHN program) will remain on GTBH until they are found eligible for another MHN program, the end of the PHE, or the expiration of the GTBH program, whichever occurs first.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/cj

IM-84 UPDATED FORMS FOR APPOINTING AN AUTHORIZED REPRESENTATIVE (IM-6AR)

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATED FORMS FOR APPOINTING AN AUTHORIZED REPRESENTATIVE (IM-6AR)

FORM REVISION #
IM-6AR
IM-6AR (Spanish)
IM-6AR (Large Print)

 

DISCUSSION:

The IM-6AR has been updated and is to be used for all Family Support Division (FSD) programs.

Changes to the IM-6AR include:

  • Allowing a signed IM-6AR to be submitted within 90 days of the signature date according to MO HealthNet (MHN) policy
  • A new option for an authorized representative to apply for MHN with no ongoing authorized representative rights or responsibilities
  • Updated language for participant’s authorization to be represented
  • Updated language to allow the participant and the authorized representative to attest that an electronic signature has the same legal effect as a written signature
  • A new field for an authorized representative to provide an email address

The IM-6AR with a revision date of 11/2019 is now obsolete. FSD will accept the obsolete form until 9/30/2022. After 9/30/2022, all new authorized representatives must use the form with a revision date of 4/2022.

The updated IM-6AR is available in large print (IM-6AR-LP) and Spanish (IM-6AR (Spanish)) for participant and staff use. The IM-6AR, IM-6AR-LP, and IM-6AR (Spanish) have been updated in the public forms manual and the internal forms manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Discard and destroy blank IM-6AR forms with 11/2019 (or older) revision date.
  • Begin using IM-6AR with 4/2022 revision date immediately.
  • Share with community partners and contacts.

 

KE/cj

 

Correction (issued June 17, 2022): An earlier version of this memo stated “The IM-6AR can be ordered by designated staff from the E-store”. The IM-6AR (4/2022) cannot be ordered from the E-store. FSD staff and offices should print the updated versions from the public forms manual.

IM-78 INCREASE IN VENDOR MINIMUM MONTHLY MAINTENANCE NEEDS ALLOWANCE (MMMNA) AND SHELTER STANDARD ADJUSTMENTS FOR VENDOR CASES

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  INCREASE IN VENDOR MINIMUM MONTHLY MAINTENANCE NEEDS ALLOWANCE (MMMNA) AND SHELTER STANDARD ADJUSTMENTS FOR VENDOR CASES

MANUAL REVISION #
MHABD APPENDIX B
MHABD APPENDIX J

 

DISCUSSION:

Effective July 1, 2022, the MMMNA and Shelter Standard are increased for Vendor cases.

On the weekend of June 11, 2022, all Vendor cases will be adjusted in the eligibility system. Allotments for community spouses, minor children, and eligible dependents and the MMMNA and Shelter Standard are revised for actions effective the month of July 2022 and later.

Effective July 1, 2022:

Minimum Maintenance Standard $2,289
Shelter Standard $687

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/sh

IM-77 ANNUAL MO HEALTHNET FOR AGED, BLIND, AND DISABLED (MHABD) ASSET LIMIT INCREASE AND RELATED MANUAL SECTION UPDATES

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  ANNUAL MO HEALTHNET FOR AGED, BLIND, AND DISABLED (MHABD) ASSET LIMIT INCREASE AND RELATED MANUAL SECTION UPDATES

MANUAL REVISION #
MHABD APPENDIX J
MHABD APPENDIX K
0820.030.20
0855.005.35
1030.000.05

 

DISCUSSION:

As a result of HB1565 (2016), asset limits for MHABD programs will increase effective July 1, 2022. Appendices J and K have been updated with the new amounts.

The weekend of June 11, 2022, all MHABD cases will be adjusted in the eligibility system. The Individual Asset Limit and Couple Asset Limit will be updated for actions effective the month of July 2022 and thereafter.

Effective July 1, 2022:

Individual Asset Limit $5301.85
Couple Asset Limit $10603.70

 

Method of Calculation

The percentage increase is based on changes in the Consumer Price Index for All Urban Consumers (CPIU) between July of two (2) years prior to the year in which the current fiscal year (FY) begins and July of the immediately preceding year. The asset limit is rounded to the nearest five cents 13 CSR 40-8.020(4)(C).

Note: The calculation for FY 2023 is based on the unadjusted percent change from FY 2020 to FY 2021.

The following manual sections have been revised to update wording, remove references to specific resource amounts and instead, refer staff to Appendix J.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/mc

IM-76 APPLICATION DATE WHEN REGISTERING A MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) APPLICATION

FROM: KIM EVANS, DIRECTOR

SUBJECT: APPLICATION DATE WHEN REGISTERING A MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) APPLICATION

DISCUSSION:

When a MO HealthNet (MHN) participant reports they are disabled, an application for MHABD must be registered to explore if the participant is eligible for a mandatory MHN program.

A participant may report they are disabled by answering yes to any of the disability screening questions on a MHN online, phone, or paper application.

A participant may also report they are disabled on an annual review, change report, by returning an Aged, Blind, and Disabled Supplement form (IM-1ABDS), by telling FSD staff they are disabled during any interaction, or by an active participant requesting MHABD benefits.

When a participant reports that they are disabled, an MHABD application must be registered in Family Assistance Management Information System (FAMIS). The application date used in FAMIS is determined by when the request is received:

• If the participant is active on a Family MO HealthNet (MAGI) program:

o An MHABD application should be registered using an application date as of the date that disability is reported.

• If an MHN application was submitted and is pending, and the participant or authorized representative later reports a disability:

o An MHABD application is registered using the pending application’s date.

• If an MHN application with NO DISABILITY indicator is rejected for MAGI, but the participant contacts FSD after they receive the rejection letter:

o If within 90 days of initial application (still within application processing timeframes), register an MHABD application using the initial application date.
o If not within 90 days of initial application, the participant must reapply.

 

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/cj