Category: MoHealthNet Home

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 FAMILY MO HEALTHNET (MAGI) COST OF LIVING ADJUSTMENT (COLA) FOR VETERANS ADMINISTRATION (VA) AND RAILROAD (RR) INCOME

DISCUSSION:

Effective January 2023, VA and RR participants will receive an 8.7% COLA. System updates will be made the weekend of December 10, 2022. 

Note: The Families First Coronavirus Response Act of 2020 (FFCRA) requires that MO HealthNet (MHN) coverage for individuals be maintained at the same level or better for the duration of the COVID-19 Public Health Emergency (PHE). The eligibility system will not reduce or end MHN coverage due to the COLA changes until the PHE is ended and a review of the case has been completed.

Cases Adjusted

Cases that include income types VA and/or RR benefits in the eligibility system are subject to an automatic increase of 8.7% for those income types. The eligibility system will end date the previous income and add a new piece of income evidence that reflects the adjusted income amount.

Note: Actions to reduce benefits will not be taken until the COVID-19 PHE has ended and a review of the case has been completed.

Cases That Did Not Adjust

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

Notices

For case updates made as a result of COLA, the eligibility system will finalize the decision(s) and send out the appropriate notices.

Note: Adverse Action notices will not be issued until the COVID-19 PHE has ended and a review of the case has been completed.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/kg

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISED BREAST AND CERVICAL CANCER TREATMENT MO HEALTHNET APPLICATION (IM-1BC)

FORM REVISION #
IM-1BC

DISCUSSION:

The IM-1BC is used by Show Me Healthy Women providers to assist participants applying for Breast and Cervical Cancer Treatment coverage.

The IM-1BC was revised to use updated terms and remove outdated information. The IM-1BC has a revision date of 10/2022. Providers should begin using the updated form with a 10/2022 revision date immediately, but outdated forms may still be accepted as valid applications through 1/31/2023.

The IM-1BC is available in the public and internal forms manuals.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Begin using the revised form (10/2022) immediately.
• Discard outdated forms.
• Provide updated form to community partners.

KE/cj

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING A NEW FORM AND REVISED FORMS FOR MO HEALTHNET (MHN) PARTICIPANTS WHO ARE INCARCERATED AND SUSPENDED

FORM REVISION #
IM-150
IM-151
IM-152
IM-153

DISCUSSION:

When MHN participants are incarcerated, benefits must be suspended. If an incarcerated participant goes to the hospital or other medical facility where they are admitted for an inpatient period of more than 24 hours, the suspended benefits are restored. When an incarcerated participant is released, the suspended benefits are redetermined and restored.

Family Support Division (FSD) has several existing forms that are used in the course of work for suspended participants. These forms have been revised as explained below:

• Suspending Incarcerated Participants (IM-150)
  • Revised form name
  • Provided new email address for submitting the form
  • Added fields:
    • to indicate that a new application was submitted
    • for DOC/Offender ID
    • for reporter’s contact information details.
• Inpatient Coverage for Incarcerated Participants (IM-151)
  • Updated the email address for submitting the form
  • Added fields to indicate that a new application was submitted
• Restoring a Suspended Participant Change Report (IM-152)
  • Revised form name
  • Provided new email address for submitting the form
  • Added fields for:
    • DOC/Offender ID
    • Additional contact information
    • Additional pregnancy details
    • The report’s contact information details.

A new form, Applying for Incarcerated Participants in Department of Corrections (IM-153) was created specifically for new applicants who are being assisted by Department of Corrections (DOC) staff and/or their medical provider, Centurion. Participants assisted by DOC or Centurion are managed by a specialized unit and the coversheet is used to identify these participants.

If any of these forms are received by staff, notify the specialized unit by sending an email to FSD.SuspendedDOC@dss.mo.gov. The email should include:

• Subject line: Incarceration information received
• The participant’s name
• The participant’s DCN
• What was received and when
• Any other relevant information

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/cj

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATED AGED, BLIND, AND DISABLED SUPPLEMENT (IM-1ABDS)

FORM REVISION #
IM-1ABDS
IM-1ABDS (Spanish)
IM-1ABDS (Large Print)

DISCUSSION:

The IM-1ABDS has been updated for clarity and to request additional information needed by Family Support Division (FSD) staff to complete an eligibility determination for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs.

Changes to the IM-1ABDS include:

• Updated instructions advising that applicants under the age of 18 years old must also include their parent’s information.
• Added fields for the name of the participant and spouse, Departmental Client Number (DCN), Social Security number, and date of birth.
• Updated all questions to clarify that information is requested for the applicant and their spouse.
• Updated all questions to have consistent Yes or No responses.
• Added fields identifying household members receiving Social Security Disability, Supplemental Security Income, or neither.
• Added a field identifying household members requesting assistance to pay their Medicare premiums.
• Added a field to provide a nursing home or residential care facility’s address.
• Added fields to provide shelter expense amounts.
• Moved the question about household members who are blind/visually impaired to appear immediately above the Blind Pension (BP) and Supplemental Aid to the Blind (SAB) declaration questions.
• Added a field for BP/SAB participants to provide their doctor’s information.
• Added additional fields to list assets.
• Updated question regarding life insurance and prepaid burial policy.
• Added a field for additional information.
• Added information regarding how to return the form to FSD.

The revised IM-1ABDS shows a revision date of 8/2022. The IM-1ABDS with a revision date of 7/2021 is now obsolete. The obsolete form may still be accepted as valid, but staff should begin using the revised form and encourage community partners to do the same.

The updated IM-1ABDS is available in large print (IM-1ABDS-LP) and Spanish [IM-1ABDS (Spanish)] for participant and staff use. The IM-1ABDS, IM-1ABDS-LP, and IM-1ABDS (Spanish) have been updated in the public forms manual and the internal forms manual.

The IM-1ABDS and IM-1ABDS (Spanish) can be ordered by designated staff from the E-store.

The online Aged, Blind, and Disabled Supplement form has been edited to reflect the changes made to the IM-1ABDS.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Discard and destroy blank IM-1ABDS forms with 7/2021 revision date.
• Begin using IM-1ABDS with 8/2022 revision date immediately.
• Share with community partners and contacts.

KE/cj

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATES TO MO HEALTHNET POLICY REGARDING CERTAIN NATIVE AMERICAN (INDIAN) TRIBAL PROPERTIES AND INCOMES

MANUAL REVISION #
0805.015.10
1035.005.05.05
1805.030.20.10

DISCUSSION:

A new section, 1035.005.05.05 Native American (Indian) Tribal Lands and Property, is added to the December 1973 Eligibility Requirements Manual. This section describes treatment of certain tribal lands and other properties and incomes derived from those lands and properties.

Section 0805.015.10 Income Exclusions in the MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual is updated to exclude certain Native American incomes and to align with Family MO HealthNet (MAGI) policy section 1805.030.20.10 Income Excluded Under MAGI.

Information is added to both updated sections above to explain that payments issued to individual members of a tribe on a per capita basis, such as casino profits, are countable income in the month received.

NECESSARY ACTION:

•  Review this memorandum with appropriate staff.

KE/ers

FROM: KIM EVANS, DIRECTOR

SUBJECT: APPLICATION PROCESSING POLICY REVISIONS FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAMS

MANUAL REVISION #

DISCUSSION:

Application policy for MHABD has been revised as MO HealthNet (MHN) uses a single streamlined application and most application policies apply to all MHN programs.

A new section was created in the MHABD Manual, 0804.000.00 – Application Processing that explains which application policies apply to all applications and provides links to existing policy in the Family MO HealthNet (MAGI) Manual. This policy section also provides links to new MHABD policy sections that provide information for MHABD specific policy.

New MHABD specific policies include:
0804.005.00 – MHABD Application Timeframes
0804.010.00 – Voluntary Withdrawal
0804.015.00 – Rejection before the End of the Timeframe
0804.020.00 – Canceling a Rejection
0804.025.00 – MO HealthNet Application Concurrent with MHABD Cash Programs

The MHABD Manual has been revised to obsolete 0835.000.00 Application Timeframes for MO HealthNet for the Aged, Blind, and Disabled Programs as this information is now available in 0804.005.00 Application Timeframes. Section 0835.010.00 Canceling a Rejection has been revised and renumber and is now located at 0804.020.00 Canceling a Rejection.

The General Information Manual, Application Processing Manual (excluding SNAP, Family MO HealthNet Programs, Temporary Assistance, & Child Care) has numerous sections that are now obsolete. All relevant policy information has been replaced by the new MHABD policy sections above, or has been identified as following existing MAGI policy.

Obsolete sections:
0105.005.00 – Requests for Assistance
0105.010.00 – Signing the Application
0105.015.00 – Dating the Application
0105.030.00 – Voluntary Withdrawal of Application
0105.035.00 – Notification of Application Decision
0105.040.00 – Specialized Application Procedures
0105.040.10 – Re-Applications
0105.040.15 – Death After Application
0105.040.20 – Application for Deceased Persons
0105.040.25 – MO HealthNet Application Concurrent with Cash Programs
0105.040.30 – MO HealthNet Application for Inmates in Custody of Department of Corrections
0105.045.00 – Delays in Processing IM Applications
0105.045.05 – Reasons for Delay of Application Processing

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/cj

FROM: KIM EVANS, DIRECTOR

SUBJECT: MANAGED CARE PLANS ADDRESS UPDATE FLEXIBILITY APPROVED FOR MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
0895.005.00
1895.005.00

DISCUSSION:

The Centers for Medicare and Medicaid Services (CMS) has approved the Missouri Department of Social Services’ (DSS) request to implement the following address change flexibility to promote retention of eligible MHN individuals. This flexibility will remain in effect through the Public Health Emergency (PHE) unwinding period.

Partnering with Managed Care Plans to Update Beneficiary Contact Information

Accept updated participant in-state contact information received directly from managed care plans without additional confirmation from the participant. In-state address changes reported by a managed care plan should be updated without first sending a notice to the participant address on file.

Address changes due to Managed Care Plan reports will be handled by MO HealthNet Division (MHD) staff. Family Support Division (FSD) staff may see comments made by contracted staff in the eligibility system regarding an address change.

Note: This flexibility does not apply to out-of-state address changes. FSD will process out-of-state address changes using current procedures.

Managed care providers can go to the Information for Managed Care Health Plans website to update a participant-reported address change using a new online form. Participants and their representatives should continue to use the Report a Change online form.

The MO HealthNet for the Aged, Blind and Disabled manual section 0890.005.00 Unwinding the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE) and the Family MO HealthNet (MAGI) manual section 1895.005.00 Unwinding the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE) have been updated to add this memo.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/sh