Category: MoHealthNet Home

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MO HEALTHNET (MHN) POLICY CHANGES FOR AUTHORIZED REPRESENTATIVES

MANUAL REVISION #
0110.060.15.10
0803.000.00
1801.000.00
1801.005.00
1801.010.00
1801.010.10
1801.010.20
1801.020.00
1801.030.00
1802.020.30
0803.020.05 obsolete
0803.020.10 obsolete
0803.020.10.10 obsolete
0803.020.10.20 obsolete
0803.020.10.30 obsolete
0803.020.30 obsolete

DISCUSSION:

MHN policy has been updated to provide clarifications for authorized representatives. Updates include:

• Changes to terms to use updated FSD terms.
• Corrections to formatting including section headings and easier to navigate bullet lists.
• Updating examples to be relevant for common questions.
• Clarifying policy that arises with Family MO HealthNet (MAGI) households that contain a mixture of household compositions and people receiving different types of coverage.

The updated authorized representative policy has been added to the Family MO HealthNet (MAGI) Manual. New MAGI section 1801.000.00 Authorized Representative(s) for MO HealthNet provides a link and a brief description of each section.

Additional new MAGI policy sections are:

• 1801.005.00 – Legal Basis
• 1801.010.00 – Appointing an Authorized Representative
• 1801.010.10 – Appointing an Authorized Representative in a Household with Multiple Adults
• 1801.010.20 – Appointing Another Adult Member of the Household as an Authorized Representative
• 1801.020.00 – Duration of Appointment of Representative
• 1801.030.00 – Revoking an Authorized Representative Appointment

Updates were made to the existing MAGI section, 1802.020.30 Signing by an Authorized Representative, to update terminology and update links.

General Information Manual section 0110.060.15.10 FCRA Authorization for MO HealthNet for Disabled Children (MHDC) Cases was revised to update a link to a new MAGI section.

MO HealthNet for the Aged, Blind, and Disabled (MHABD) policy section, 0803.000.00 Authorized Representative(s) for MO HealthNet, provides links to the Family MO HealthNet (MAGI) Manual as authorized representative policy is the same for both programs.

The following MHABD policy sections are now obsolete:

• 0803.020.05 – Legal Basis
• 0803.020.10 – Appointment of an Authorized Representative
• 0803.020.10.10 – Appointment of an Authorized Representative When There is a Spouse or Second Parent in the Eligibility Unit
• 0803.020.10.20 – Duration of the Appointment of Representative
• 0803.020.10.30 – Authorized Representative Revocation
• 0803.020.30 – Signing by an Authorized Representative

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• These updates replace all previous policy and guidance regarding authorized representatives.
• Send questions regarding authorized representatives through normal supervisory channels.

KE/cj

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MO HEALTHNET (MHN) REVIEW FORMS UPDATED

FORM REVISION #
IM-1U
FA-402
FA-402 Spanish

DISCUSSION:

Effective July 10, 2022 the MO HealthNet Eligibility Review Information (FA-402), Información Sobre la Revisión de la Elegibilidad para Acceder a MO HealthNet (FA-402 Spanish), and the MO HealthNet Eligibility Review (IM-1U) were updated to add required and helpful information for participants. The public and internal forms manuals were updated with the revised forms and the eligibility system has been updated to send the revised FA-402.

Updates to the FA-402 include:

• Adding or updating return information to include the new Family Support Division (FSD) Upload Portal website, myDSSupload.mo.gov
  • Individuals can use mydssupload.mo.gov to submit a variety of documents to FSD including, but not limited to, applications, reviews, changes, or supporting documents
  • This portal replaces the email address, FSD.documents@dss.mo.gov
• Adding the FSD Nondiscrimination statement
• Removing fields for Collateral Information which is no longer required for MHN
• Adding military status questions to determine if participants may be eligible for and interested in receiving resources available to veterans and their families
  • Question 1: Have you or an immediate family member ever served in the U.S. Armed Forces?
  • Question 2: If yes, would you like information about military-related services in Missouri?

NOTE: Answering these questions is optional and will NOT affect any benefits received from FSD.

Revisions were made to the IM-1U to replace the existing email address with the website address to the FSD Upload Portal. The revised form is available on the public and internal forms manuals.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/mc

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  FAMILY MO HEALTHNET (MAGI) MANUAL UPDATED WITH HEALTHCARE SHARING MINISTRY PLANS

MANUAL REVISION #
1840.010.10

DISCUSSION:

MAGI Manual section 1840.010.10 Uninsured was updated to include Healthcare Sharing Ministry Plans. This type of plan was added to the list of insurances that are not considered to be health care coverage.

An individual with a Healthcare Sharing Ministry Plan should be treated as uninsured when determining eligibility for CHIP, however, the plan should be reported for Third Party Liability (TPL).

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Review 1805.045.00 Third Party Liability (TPL).

KE/ams

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATE TO REASONABLE COMPATIBILITY POLICY IN THE FAMILY MO HEALTHNET (MAGI) MANUAL

MANUAL REVISION #
1805.030.15

DISCUSSION:

Effective immediately, when a participant attests to income above applicable program thresholds, the participant is ineligible. Participants determined to be ineligible are systematically referred to the Federally Facilitated Marketplace (FFM) to explore coverage.

MAGI Manual section 1805.030.15 Reasonable Compatibility is revised to add definitions of eligibility levels and program thresholds and to explain the distinction between the two.

For the duration of the Public Health Emergency (PHE), follow verification guidance in MEDES Resources.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  APPENDIX H UPDATED WITH NEW MEDICAID ELIGIBILITY (ME) CODES FOR CHILDREN’S DIVISION (CD)

MANUAL REVISION #
MAGI Appendix H

DISCUSSION:

Effective July 1, 2022, Appendix H of the Family MO HealthNet (MAGI) Manual is updated to include 2 new ME codes used by CD:

• 0F-Foster Care Title IV-E
• 5A-Adoption/Guardianship Subsidy Title IV-E

Neither coverage type is Title XIX funded; both are state funded.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  REASONABLE OPPORTUNITY, CITIZENSHIP, AND IMMIGRANT STATUS POLICY CONSOLIDATED FOR MO HEALTHNET (MHN) PROGRAMS

MANUAL REVISION #
1010.000.00
0110.020.00 obsolete
0110.020.01 obsolete
0110.020.02 obsolete
0110.020.03 obsolete
0110.020.05 obsolete
1010.005.00 obsolete
1010.010.00 obsolete

DISCUSSION:

Based on feedback recommendations, the 1973 Eligibility Requirements Manual has been updated to provide links to the Family MO HealthNet (MAGI) Manual sections regarding Reasonable Opportunity, Citizenship, and Immigration Status requirements that are the same for both programs. Links can be found in the renamed manual section, 1010.000.00 Reasonable Opportunity, Citizenship, and Immigrant Status (OAA, PTD, and AB).

Policy found in sections 1010.005.00 Documents to Verify Citizenship and 1010.010.00 Citizens of the Federated States of Micronesia, Republic of Palau, and Republic of Marshall Islands has been moved to 1010.000.00 Reasonable Opportunity, Citizenship, and Immigrant Status (OAA, PTD, and AB) and linked to the MAGI Manual; therefore, these section numbers are now obsolete.

The following Verification Requirements sections in the General Information manual are obsolete as the policy contained in these sections has also been moved to 1010.000.00 Reasonable Opportunity, Citizenship, and Immigrant Status (OAA, PTD, and AB) and linked to the MAGI Manual:

• 0110.020.00 Citizenship/Alien Status
• 0110.020.01 Documents to Verify Citizenship
• 0110.020.02 Reasonable Opportunity to Verify Citizenship
• 0110.020.03 Reapplication after Benefits are Discontinued for Failure to Provide Documentation of Citizenship
• 0110.020.05 Alien Status

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ers

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATES TO FAMILY MO HEALTHNET (MAGI) MANUAL SECTIONS ALLOWABLE DEDUCTIONS AND SPECIFIC TYPES OF INCOME

MANUAL REVISION #
1805.030.20.15
1805.030.25.15

DISCUSSION:

The Internal Revenue Service (IRS) has revised IRS Form-1040 and IRS Schedule 1 (Form-1040). MAGI manual sections 1805.030.20.15 Allowable Deductions and 1805.030.25.15 Specific Types of Income have been updated to remove references to the location of specific line items found on these forms.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/kg

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  CALCULATION OF THE FIVE PERCENT DISREGARD IN THE FAMILY MO HEALTHNET (MAGI) POLICY MANUAL REVISED

MANUAL REVISION #
1805.030.20.20.05

DISCUSSION:

Revisions were made to MAGI Manual section 1805.030.20.20.05 Calculation of the Five Percent Disregard. References to systematic calculations and examples containing these calculations have been removed.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/ams

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