Category: MoHealthNet Home

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  EMERGENCY MO HEALTHNET FOR INELIGIBLE ALIENS (EMCIA) FORMS UPDATE

FORM REVISION #

IM-365
IM-365D

DISCUSSION:

Updates have been made to forms used for EMCIA determinations.

The Emergency MO HealthNet for Ineligible Aliens (IM-365) form was updated to add MO HealthNet Adult Expansion Group (AEG), update contact information for the Medical Review Team (MRT) Processing Center, allow additional dates of service (up to 6), and change to PDF format.

The Emergency MO HealthNet for Ineligible Aliens Determination (IM-365D) was created to document the MRT physician’s determination of qualified coverage dates for EMCIA emergency medical conditions as outlined in Section 1903(v) of the Social Security Act.

These forms are available for staff use in the FSD Intranet Income Maintenance (IM) Forms Manual.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Use the forms with the revision date of 10/2021.
• Discard any forms with older revision dates.

KE/cj

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  PRIOR QUARTER (PQ) UPDATES TO THE FAMILY MO HEALTHNET (MAGI) AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAM MANUALS

MANUAL REVISION #

0420.000.00
0515.005.00
0620.005.00
0810.015.00
0810.015.05
0810.015.10
0815.045.00
0815.050.05
1030.035.40
1810.030.10
1830.020.00
1850.030.00
1865.030.10

DISCUSSION:

Updated policy information regarding PQ requests have been made to the MAGI and MHABD program manuals. Individuals may apply or reapply for PQ for up to one year after the application date. They may apply for PQ in person, by telephone, or in writing.

The PQ months must be the three consecutive months prior to the date of application.

EXAMPLE: Ms. B applied and was approved for MHABD in May 2021. In August 2021, Ms. B contacted FSD stating she had outstanding medical bills from March 2021. Ms. B can apply for PQ because it has not been over a year since she submitted her initial application for MHABD.

Note: Adult Expansion Group (AEG) PQ coverage shall not start prior to the implementation month of July 2021.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/kg

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  APPENDIX B UPDATED TO INCLUDE ADULT EXPANSION GROUP (AEG)

MANUAL REVISION #
APPENDIX B

DISCUSSION:

Appendix B of the Family MO HealthNet (MAGI) Manual has been updated to include the AEG program.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/al

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) POLICY MANUAL APPENDICES J AND K UPDATE AND OBSOLETE APPENDIX L AND M

MANUAL REVISION #
APPENDIX J
APPENDIX K

DISCUSSION:

The MO HealthNet for the Aged, Blind, and Disabled (MHABD) policy manual has several appendices that contain useful information for staff, participants, and other community stakeholders. Updates to these appendices are described below.

Appendix J is now Appendix J: Eligibility Standards for MHABD. The information provided in this appendix is only used for MHABD eligibility determinations. Appendix J includes information for all MHABD programs with related programs grouped together. An asset maximum effective date column was added.

Appendix K is now Appendix K: MO HealthNet eligibility for people who are Aged (65 and Over), Blind, Disabled, or need treatment for Breast or Cervical Cancer. It contains basic eligibility information, including all income and asset information, about all MHABD programs and the Breast and Cervical Cancer Treatment (BCCT) program.

Appendix L is now obsolete. Appendix L contained income and asset information only and was combined with Appendix K.

Appendix M is now obsolete. Appendix M contained information for Medicare Cost Savings Programs, Qualified Medicare Beneficiary and Specified Low Income Medicare Beneficiary. The policy information for QMB is in 0865.010.00 Eligibility Requirements and for SLMB is in 0870.010.00 Eligibility Requirements. The resource limits and income limits can be found in Appendix J and Appendix K.

NECESSARY ACTION:

• Discard any printed or saved appendices.
• Immediately use versions showing a 10/2021 revision date.
• Review this memorandum with appropriate staff.

KE/cj

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  LUMP SUM SECTION ADDED TO THE DECEMBER 1973 ELIGIBILITY REQUIREMENTS MANUAL

MANUAL REVISION #
1030.015.05

DISCUSSION:

1030.015.05 Lump Sum Payments has been added to the December 1973 Eligibility Requirements manual. This section clarifies how lump sum payments are to be considered when determining initial and/or ongoing eligibility for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs.

For MHABD programs, lump sum payments received are counted as income in the month of receipt. The amount of funds retained until the first of the following month, are then counted as a resource.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/sh

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  SALE OF HOMESTEAD SECTION ADDED TO THE DECEMBER 1973 ELIGIBILITY REQUIREMENTS MANUAL

MANUAL REVISION #
1030.010.35

DISCUSSION:

1030.010.35 Sale of Homestead as an Excluded Resource has been added to the December 1973 Eligibility Requirements manual. This section provides guidance to help staff determine if the sale of a homestead is an excluded resource when determining initial or ongoing eligibility for MO HealthNet for the Aged, Blind, and Disabled (MHABD) programs.

When a participant sells an excluded home, the proceeds of the sale are an excluded resource if the participant:

• plans to use the funds to buy another excluded home, and
• does so within 3 full calendar months of receiving them. “Within 3 full calendar months” means by the end of the last day of the third month after the month in which the funds are received.

NECESSARY ACTION:

Review this memorandum with appropriate staff.

KE/sh

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  APPENDIX H UPDATED TO INCLUDE ADULT EXPANSION GROUP (AEG)

MANUAL REVISION #
APPENDIX H

DISCUSSION:

Appendix H of the MAGI Manual has been updated to include information on the newly implemented AEG program.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/al