Category: MoHealthNet Home

IM-72 REVISIONS TO WAIVER OF 10-DAY ADVANCE NOTICE (IM-80A)

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISIONS TO WAIVER OF 10-DAY ADVANCE NOTICE (IM-80A)

FORM REVISION #
IM-80A

DISCUSSION:

The IM-80A was updated with current Family Support Division (FSD) terms. Other changes were made to allow streamlined use for all FSD programs.

The FSD Staff section, at the bottom of the form, allows staff to provide their name and title and removes the requirement to witness the participant’s signature. This allows the IM-80A to be used by FSD staff interacting with participants by methods other than in person.

The IM-80A shows a revision date of 6/2022 and is available in the public and internal forms manuals.

NECESSARY ACTION:
• Review this memorandum with appropriate staff.
• Begin using the revised IM-80A immediately.

KE/cj

IM-71 INTRODUCING THE SIGNATURE REQUEST FORM (IM-2SR)

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING THE SIGNATURE REQUEST FORM
(IM-2SR)

MANUAL REVISION #
0105.010.00
0203.020.05
1120.010.00
1802.020.05

FORM REVISION #
IM-2SR
IM-2SR Spanish
Signature Request Letter obsolete
Signature Request Letter (Spanish) obsolete

DISCUSSION:

The Signature Request Form (IM-2SR) and Signature Request Form Spanish (IM-2SR Spanish) have replaced the English and Spanish versions of the Signature Request Letter, which are now obsolete. The IM-2SR has fewer fillable fields, one return address for all program types, and is available in the internal forms manual.

The following manual sections were updated to include a link to the IM-2SR:

• General Information Manual Section 0105.010.00 Signing the Application
• Temporary Assistance/Case Management Manual Section 0203.020.05 Application with No Signature
• Supplemental Nutrition Assistance Program (SNAP) Manual Section 1120.010.00 Applications Received by the Agency
• Family MO HealthNet (MAGI) Manual Section 1802.020.05 Application with No Signature

When registering an application, be sure to review for a signature.

• If there is no signature, follow the Unsigned Applications instructions located in ECM Resources.
• Do not register the application.
• Return all pages of the original unsigned application with the IM-2SR to the participant within three business days.
• If staff find an unsigned application has been scanned to the Electronic Content Management (ECM) system, submit a ticket to have the unsigned application removed.
o The ECM team will reach out to the individual that scanned the paper unsigned application and they will be instructed to return all pages of the original application to the participant along with the IM-2SR.

If the document was received digitally (e.g., by FSD Upload Portal or by email), the staff member that has encountered the unsigned application must print and return all pages of the unsigned application to the participant along with the
IM-2SR.

NECESSARY ACTION:
• Review this memorandum with appropriate staff.
• Use the new forms immediately and discard all previous versions.

KE/sh

IM-70 FAMILY MO HEALTHNET (MAGI) APPLICATIONS, FORMS AND NOTICES UPDATED TO REPLACE FSD.DOCUMENTS WITH MYDSSUPLOAD.MO.GOV

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: FAMILY MO HEALTHNET (MAGI) APPLICATIONS, FORMS AND NOTICES UPDATED TO REPLACE FSD.DOCUMENTS WITH MYDSSUPLOAD.MO.GOV

FORM REVISION #
IM-1REQ
IM-1SSL
IM-1SSL Ongoing
IM-1U
IM-5
IM-7
IM-10
IM-13
IM-31A
IM-39
IM-108
IM-FTI

 

DISCUSSION:

Effective May 29, 2022 MAGI applications, forms and notices have been updated to replace references to the FSD.Documents email address with mydssupload.mo.gov (FSD Upload Portal). MAGI forms located in the internal and public forms manuals and system generated documents have been updated to reflect the change.

Individuals can use mydssupload.mo.gov to submit a variety of documents to the Family Support Division including, but not limited to, applications, reviews, changes, or supporting documents.

Additional form and notice updates to replace the email address with the upload portal information are forthcoming.

NECESSARY ACTION:
• Review this memorandum with appropriate staff.

KE/bl

 

IM-69 FORM USED FOR INCARCERATED PARTICIPANTS WHO HAVE AN INPATIENT EVENT (IM-151) REVISED AND RENAMED

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FROM: KIM EVANS, DIRECTOR

SUBJECT: FORM USED FOR INCARCERATED PARTICIPANTS WHO HAVE AN INPATIENT EVENT (IM-151) REVISED AND RENAMED

FORM REVISION #
IM-151

DISCUSSION:

Revisions were made to the IM-151 to allow incarcerated applicants and suspended participants to use the form for an inpatient event. The form was renamed Inpatient Coverage for Incarcerated Participants (IM-151).

New applicants should submit the IM-151 at the same time as their application. Suspended participants who were receiving MO HealthNet prior to incarceration should submit the IM-151 within 10 days of the end of the inpatient event.

Medical facility staff, jail/prison staff, or the participant (or their representative) may submit the IM-151 to Family Support Division (FSD) by email to FSD.inmatehospapp@dss.mo.gov.

FSD reviews the information provided and makes a determination if the inpatient event qualifies for MO HealthNet coverage. FSD will notify MO HealthNet Division (MHD), the participant, and their authorized representative (if applicable) of the eligibility decision.

Department of Corrections (DOC) may also receive information regarding eligibility during an inpatient event as allowed by agreements between DOC, FSD, and MHD.

Policy revised to reflect the updated name of the form:

• MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual section 0840.020.00 Suspending Incarcerated Participants
• Family MO HealthNet (MAGI) Manual section 1802.010.80.15 MO HealthNet Applications for Incarcerated Individuals

The IM-151 was updated in the public and internal forms manuals.

NECESSARY ACTION:
• Review this memorandum with staff.
• Begin using the updated form immediately.
• Share with any relevant community partners and stakeholders.

KE/cj

 

IM-68 NEW HEARING REQUEST AND CANCEL HEARING REQUEST FORMS DEVELOPED FOR PUBLIC USE

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: NEW HEARING REQUEST AND CANCEL HEARING REQUEST FORMS DEVELOPED FOR PUBLIC USE

FORM REVISION #
IM-85
IM-85 Instructions
IM-86
IM-86 Instructions

DISCUSSION:

The Online Hearing Request (IM-85) and Online Cancel Hearing Request (IM-86) forms are now available online to request a hearing or cancel a previously requested hearing. There are also instructions available for each form.

The forms and instructions are available on myDSS.mo.gov website for participants and their authorized representatives by using the quick links: Know Your Rights and Resources for Providers.

NOTE: When the Family Support Division receives a hearing request form, staff must follow the Hearing E-Referral Hand-Off process (see IM Email Memorandum #22 dated 4/29/21).

IM-85 and IM-86 are also available in the public forms manual and internal forms manual.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
KE/bh

IM-66 REVISION OF FAMILY MO HEALTHNET (MAGI) POLICY MANUAL SECTIONS REGARDING SIGNING THE APPLICATION

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISION OF FAMILY MO HEALTHNET (MAGI) POLICY MANUAL SECTIONS REGARDING SIGNING THE APPLICATION

MANUAL REVISION #
1802.020.00
1802.020.10
1802.020.35
1802.020.40
1802.020.45

DISCUSSION:

The MAGI Policy Manual has been updated in several sections to update language and Family Support Division (FSD) terminology to be inclusive of all MO HealthNet programs.

Updated sections:

• 1802.020.00 Signing the Application
• 1802.020.10 Signing by Mark
• 1802.020.35 Signing by a Relative
• 1802.020.40 Signing by a Legal Guardian or Conservator
• 1802.020.45 Signing on behalf of a Deceased Participant

 

NECESSARY ACTION:
• Review this memorandum with appropriate staff.
• Any obsolete MAGI policy held in memos or manuals should be disregarded.

KE/cj

 

IM-60 OBSOLETING EMPLOYER AND STUDENT INCOME VERIFICATION FORMS

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FROM: KIM EVANS, DIRECTOR

SUBJECT: OBSOLETING EMPLOYER AND STUDENT INCOME VERIFICATION FORMS

MANUAL REVISION #

1102.015.05
1102.015.45

FORM REVISION #

FA-311 obsolete
FA-321 obsolete
IM-12 obsolete
IM12A obsolete
IM-108 obsolete

DISCUSSION:

Effective 5/28/2022, the following employer and student income verification forms are obsolete for all Income Maintenance (IM) programs:

• Manual forms removed from the internal and external forms manuals: IM-12, IM-12A, and IM-108
• System forms removed as options to send by the eligibility systems: FA-311, FA-321, IM-12, and IM-108

The following Supplemental Nutrition Assistance Program (SNAP) policy sections are updated to remove references to the obsoleted forms:

• 1102.015.05 Gross Income
• 1102.015.45 Number of Hours Worked by Able Bodied Adults Without Dependents

To assist participants in obtaining verification staff should do the following:

• Complete a telephone call with the employer and/or participant
• Use electronic sources when applicable
• Communicate what are acceptable documents to be used as verification
     o Language should be clear and concise

When generating a request for information (FA325 or IM31A), the form should be edited to include clear and concise details of the required verification as well as the specific time period needed.

NECESSARY ACTION:
• Review this memorandum with appropriate staff.

KE/ams

IM-58 GENERAL INFORMATION MANUAL UPDATE TO USE OF ELECTRONIC VERIFICATION SYSTEM (EVS) SOURCES

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: GENERAL INFORMATION MANUAL UPDATE TO USE OF ELECTRONIC VERIFICATION SYSTEM (EVS) SOURCES

MANUAL REVISION #
0110.060.10

DISCUSSION:

EVS Manual section 0110.060.10 Use of Electronic Verification System (EVS) Sources has been updated and no longer identifies adding vendor coverage to an active MO HealthNet case as an application.

When determining if an EVS source should be utilized, an application only refers to:
     • an initial application,
     • requesting benefits for a new or existing member of the household (such as adding a spouse), or
     • adding cash benefits (such as Blind Pension) to an active MO HealthNet case.

 

NECESSARY ACTION:
• Review this memorandum with appropriate staff.

KE/sh

IM-57 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) INFORMATION AND MANUAL UPDATE

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) INFORMATION AND MANUAL UPDATE

MANUAL REVISION #
0825.030.35
0830.000.00 Obsolete
1030.010.05
1040.030.00
1040.030.30

DISCUSSION:

Missouri has a new PACE provider in the Saint Louis area, New Horizons PACE. The Family Support Division (FSD) is not responsible for making eligibility determinations for the PACE program. The enrollment process begins with the PACE provider and is coordinated by the MO HealthNet Division (MHD).

The PACE program provides comprehensive health care services to eligible participants age 55 or older who live in the community of a PACE provider and need a nursing home (NF) level of care, but do not live in a nursing home. PACE participants receive Medicare and Medicaid covered services from their PACE provider team.

Requests for PACE Benefits

Individuals who are eligible for any level of care of MO HealthNet (MHN) can be evaluated for PACE eligibility. To find a local PACE provider, refer to PACE information on the Medicare.gov site.

Individuals interested in the PACE program begin the process by contacting the PACE provider.
PACE providers accept Medicare, Medicaid, and direct payments. An individual is not required to receive MHN coverage in order to receive services from a PACE provider.

Determination for PACE

MHD makes the determination for PACE benefits. Enrollment is identified in the Medicaid Management Information System (MMIS). Staff with access to MMIS can identify PACE participants by reviewing the “Lockin” information when completing a Participant Inquiry.

For questions regarding PACE eligibility, participants should contact New Horizons PACE directly by calling 833-654-7223.

FSD staff should send PACE eligibility questions to MHD.PACE@dss.mo.gov.

FSD Determination for MHN

There is no change to how FSD determines eligibility for MHN coverage.

FSD does not determine eligibility for PACE, therefore, manual section 0830.000.00 Program of All-Inclusive Care for the Elderly (PACE) is now obsolete.

The following manual sections have been updated to remove references to the PACE program:

0825.030.35 Income and Budgeting
1030.010.05 Homestead Exemption
1040.030.00 Determining the Penalty Period
1040.030.30 Required Documentation

The FSD eligibility system will no longer be used to authorize PACE eligibility. Until the PACE option in the Type field on the Home and Community Based/PACE Information (HCBINFO/FMJ7) screen can be deactivated, do NOT use the PACE type code.

PACE and Spend Down

The PACE organization will pay the participant’s spend down to MHD directly. PACE will bill the participant for the charges used to meet the spend down.

PACE and Vendor

There are no changes to FSD’s existing processes for vendor coverage. Participants will continue to pay their surplus to the nursing home.

Hearings

Hearings regarding MHN eligibility continue to be processed by FSD. MHD will conduct all hearings regarding PACE enrollment.

Hearing requests for a PACE enrollment determination must be forwarded to MHD using the following contact information:

• Email: statefairhearings@dss.mo.gov
• Phone: 800-392-2161
• Mail:  MO HealthNet Division
           Attn: Hearings
           PO Box 6500
           Jefferson City, MO 65109

 

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/rnr

IM-55 INTRODUCING THE IM-4 MO HEALTHNET REPORT A CHANGE FLYER

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING THE IM-4 MO HEALTHNET REPORT A CHANGE FLYER

FORM REVISION #
IM-4 MO HealthNet Report a Change

DISCUSSION:

The IM-4 MO HealthNet Report a Change flyer was created to stress the importance of MO HealthNet participants keeping their information up to date. The flyer also lists some of the changes participants must report and how to report those changes.

The IM-4 MO HealthNet Report a Change flyer is available in the public forms manual.

NECESSARY ACTION:
• Review this memorandum with appropriate staff.

KE/sh