IM-115 UPDATED CANCEL CLOSE INSTRUCTIONS FOR FAMIS CASES

FROM:  REGINALD E. McELHANNON, INTERIM DIRECTOR

SUBJECT:  UPDATED CANCEL CLOSE INSTRUCTIONS FOR FAMIS CASES

MANUAL REVISION #81

0840.015.10

 

DISCUSSION:

The purpose of this memorandum is to notify staff of the correct process for cancel closing Temporary Assistance (TA), Adult MO HealthNet (MHN), Child Care (CC) and Food Stamp (FS) cases in FAMIS. This email memorandum will replace Email IM-#42 from June 20, 2017 with new information pertaining to the Food Stamp program.

An Agency error closing is defined as a closing that occurs after all necessary, requested information was provided by the participant. This includes:

  • Information/verification is received timely but not acted on by the agency        before the case closes;
  • The agency incorrectly budgets income or enters resources causing a case to close incorrectly.
  • The review form was received during the adverse action period, but the closing was not voided in time.

For ALL programs, an agency error closing should be cancel closed as soon as the error is found regardless of how much time has passed since the case closed. If the action is no longer on ACTRES:

  • For TA and CC Cases, create a new application using the original application date.
  • For FS Cases contact FAMIS to complete the cancel close.
  • For MHN Cases follow the MO HealthNet Special Instructions at the end of this memo.

A Participant error closing is defined as a closing that occurs due to the direct action or inaction of the participant. This includes:

  • Required or requested information/verification is not received in a timely manner.

ONLY for TA, MHN, and CC Cases, participant error closings may be cancel closed if the participant provides all missing information that caused the closing within 30 days of the date the closing action was completed. The action is considered completed on the date listed on the EU Action Log (EULOG) screen under STATUS DATE, for the closing action.

For FS Cases, participant error closings may be cancel closed if the participant provides all missing information that caused the closing by the end of the month in which the participant last received benefits. The case cannot be cancel closed in any month after benefits have ended.

EXAMPLE 1:  Ms. Carter’s FS, TA, and CC cases closed January 15, 2019 because she failed to return the requested verification of her income. She last received FS benefits on January 7, 2019. On February 10, 2019, Ms. Carter turned in the requested verification.  

The missing verification was provided less than 30 days after the closing.  The TA and CC cases should be cancel closed and adjusted based on the verified income. The FS case should NOT be cancel closed because the verification was received after the end of the month Ms. Carter last received her FS benefits. She will need to reapply for FS.

EXAMPLE 2:  Mr. Ford’s FS, TA, and MHN cases closed January 15, 2019 because he failed to return the requested verification of his income. On February 22, 2019, Mr. Ford turned in the requested verification.

It is more than 30 days since the cases closed (January 15). It is also after the end of the month Mr. Ford last received his FS benefits. Mr. Ford will need to reapply for FS, TA, and MHN, if he wishes to continue receiving benefits.

For special instructions on cancel closing Adult MO HealthNet cases, please refer to 0840.015.10 Reopening Close Cases.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

RM/hrp

IM-113 VERIFICATION OF APPLICATION FOR OTHER BENEFITS AT APPLICATION FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAMS, AND SUPPLEMENTAL NURSING CARE (SNC)

FROM:  REGINALD E. McELHANNON, INTERIM DIRECTOR

SUBJECT:  VERIFICATION OF APPLICATION FOR OTHER BENEFITS AT APPLICATION FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAMS, AND SUPPLEMENTAL NURSING CARE (SNC)

MANUAL REVISION #79

1000.005.00 APPLICATION FOR OTHER BENEFITS

0840.005.00.05 APPLICATION FOR OTHER BENEFITS AT ANNUAL REVIEW

 

DISCUSSION:

Application for other benefits is a requirement for all MHABD programs per Federal Regulations in 42 CFR-435.608.  This memorandum is to inform staff of a change in the verification requirement at application for MHABD, and SNC programs, which states participants not currently receiving SSI/SSDI or other benefits they may be entitled to receive, must verify status of application for those benefits.         

Effective immediately, self-attestation is acceptable evidence to verify agreement to apply for, and/or application is currently pending for other benefits.  IM Manual Section 1000.005.00 Application for Other Benefits has been updated to reflect this change. 

Application for other benefits must be verified at annual review.  If evidence is not provided, or is unavailable to FSD staff at annual review, staff must request verification from the participant.  Refer to 0840.005.00.05 APPLICATION FOR OTHER BENEFITS AT ANNUAL REVIEW for additional information.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

RM/vm

 

 

 

 

 

 

 

 

 

 

 

IM-112 NEW IM-1MAC ADDENDUM TO REQUEST CASH BENEFITS FOR MO HEALTHNET FOR THE AGED, BLIND AND DISABLED PARTICIPANTS

FROM:  REGINALD E MCELHANNON, ACTING DIRECTOR

SUBJECT:  NEW IM-1MAC ADDENDUM TO REQUEST CASH BENEFITS FOR MO HEALTHNET FOR THE AGED, BLIND AND DISABLED PARTICIPANTS

FORM REVISION #25
IM-1MAC

DISCUSSION:

The purpose of this memorandum is to inform Family Support Division staff of a new form that has been added to the forms manual.  The IM-1MAC ADDENDUM TO MO HEALTHNET APPLICATION:  REQUEST FOR OPTIONAL CASH BENEFITS should only be used for MO HealthNet for the Aged, Blind and Disabled (MHABD) program participants who request the following cash benefits in addition to the MHABD benefits they have applied for or are already receiving:

  • Supplemental Nursing Care (SNC)
  • Supplemental Aid to the Blind (SAB)
  • Blind Pension (BP)

Because the form itself is NOT a stand-alone application, the only individuals who may use this form are participants who:

  • already have active MHABD coverage; OR
  • have previously submitted a complete application and are still in application status.

NOTE:  Staff should no longer require an active or application status MHABD participant to complete a new application to have eligibility explored for the SNC, SAB or BP MHABD cash programs.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

PL/kp

IM-111 LOSS OF TRANSITIONAL MO HEALTHNET (TMH) ELIGIBILITY AND SUSPENDED TMH UPDATES

FROM:  REGINALD E. McELHANNON, ACTING DIRECTOR

SUBJECT: LOSS OF TRANSITIONAL MO HEALTHNET (TMH) ELIGIBILITY AND SUSPENDED TMH UPDATES

MANUAL REVISION #
1820.050.30
1820.050.40

DISCUSSION:

The purpose of this memorandum is to advise staff of updates to sections 1820.050.30 Loss of TMH Eligibility after First Six Months and 1820.050.40 Suspended TMH Eligibility in Second Six Month Period of the Family Healthcare Manual – MAGI.

The following has been updated:

  • If the second quarterly report is not returned by the 21st day of the 7th month, the parent/caretaker relative will be suspended on the 1st day of the 8th
  • If the third quarterly report is not returned by the 21st day of the 10th month, the parents/caretaker relative will be suspended on the1st day of the 11th
  • Manual processes have been removed due to system functionality.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

RM/al

 

IM-110 CHIP AFFORDABLE INSURANCE DEFINITION – CALCULATOR APPENDIX G UPDATE

MISSOURI DEPARTMENT OF SOCIAL SERVICES
FAMILY SUPPORT DIVISION
P.O. BOX 2320
JEFFERSON CITY, MISSOURI

 

TO:  ALL FAMILY SUPPORT OFFICES

FROM:  REGINALD E. McELHANNON, ACTING DIRECTOR

SUBJECT:  CHIP Affordable Insurance Definition – Calculator Appendix G Update

MANUAL REVISION #77
Appendix G
Appendix F

 

DISCUSSION:

This memorandum introduces updates to the CHIP Affordability Calculator. The updates reflect the 2019 Federally Facilitated Marketplace (FFM) premium changes. The new calculator is effective immediately. Use the 2019 CHIP Affordability Calculator (Appendix G) when processing all new or pending applications dated 4/1/2019 or after.

To use the calculator review Appendix F – CHIP Affordability Test Calculator Instructions

NECESSARY ACTION:

  • Review this memorandum and policy revisions with appropriate staff.

RM/ag

IM-109 INTRODUCING MO HEALTHNET CHART FOR INFORMATION REQUESTS

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  INTRODUCING MO HEALTHNET CHART FOR INFORMATION REQUESTS

DISCUSSION:

The purpose of this memo is to introduce the new MO HealthNet Chart for Information Requests. This chart provides information for staff to use to determine if authorized representatives, or other entities that are requesting information about a participant’s case, are valid and if the representative can receive case information.

Any representative with a current and valid IM-6AR meets the requirements to release case information. However, if a participant wants to release the information to an attorney, individual, or organization they can provide a different release (such as a release created by their attorney or the organization), but the signed request must include certain information. This required information varies depending on who is requesting the information. This chart includes the specific information that is required for attorneys, individuals, and organizations.

The MO HealthNet Chart for Information Requests was created using the following policy information. There was no change in policy.

Family MO HealthNet (MAGI): 802.020.30 Signing by an Authorized Representative

Medical Assistance for the Aged, Blind, and Disabled: 0803.020.10 Appointment of an Authorized Representative

Income Maintenance Manual: 0130.000.00 Legal Aspects

The chart is available for staff to reference on the FSD Training & Development page, click on the Income Maintenance tab at the top of the page, click on the Guides tab, and then the MO HealthNet Chart for Information Requests will be located on the Guides and Helpsheets page under Guides.

The chart is also available for staff to reference in the MEDES Resource Guide.

NECESSARY ACTION:

  • Staff must use this chart to determine if an information release is valid.
  • Review this memorandum with appropriate staff.

ATTACHMENT:
MO HealthNet Chart for Information Requested

RM/cj

IM-108 APPLICATION FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (IM-1MA) REVISION

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT: APPLICATION FOR MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (IM-1MA) REVISION

FORM REVISION #24

IM-1ABDS

 

DISCUSSION:

The purpose of this memorandum is to introduce changes to the IM-1MA Application for MO HealthNet (Medicaid).

Page (1) of the IM-1ABDS has been revised to include the Greene County Family Support Division (FSD) mailing address and fax number where MO HealthNet for the Aged, Blind, and Disabled (MHABD) applications should be submitted. The https://mydss.mo.gov/ website has also been added.

MHABD applications may now be submitted to FSD at:

  • Greene County FSD
    101 Park Central Square
    Springfield, MO 65806
    Fax: (417) 895-6080

The revised IM-1ABDS is available in the IM Forms Manual.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Destroy all previous paper versions of the IM-1MA and immediately begin using the 06/19 version.

PL/vm

IM-107 UPDATED TO THE GATEWAY TO BETTER HEALTH APPLICATION

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  UPDATED TO THE GATEWAY TO BETTER HEALTH APPLICATION                  

FORM REVISION #23

Gateway to Better Health Application (IM-1MAGW)

 

DISCUSSION:

The MO HealthNet/Gateway to Better Heath Application/Eligibility Statement has been updated to reflect the primary health care center’s name change to CareSTL Health (previously known as Myrtle Hilliard Davis Health Centers.) The updated form also removes the option to choose “None” as an option for a primary health center.

Use the updated version immediately and discard all previous versions.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

PL/cj

 

IM-106 MAGI FLOATING RENEWAL UPDATE

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  MAGI FLOATING RENEWAL UPDATE

MANUAL REVISION #75

1880.010.00

 

DISCUSSION:

The purpose of this memorandum is to advise on changes to the 1880.010.00 Floating Renewal section of the Family Healthcare Manual-MAGI.

The Floating Renewal section has been updated to remove tax filing status/tax filing relationship as a qualifying change in individual’s circumstances (CiC) that prompts a floating renewal.

Updates include:

  • Tax filing status/tax filing relationship change removed.
  • Clarification has been added that the certification period is extended from the date the CiC is finalized for another 12 months.
  • Example scenarios have been updated.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

PL/al/kg                                   

IM-105 MEDICAL REVIEW TEAM (MRT) PROCESS FOR MO HEALTHNET FOR THE AGED, BLIND AND DISABLED (MHABD) APPLICATIONS

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  MEDICAL REVIEW TEAM (MRT) PROCESS FOR MO HEALTHNET FOR THE AGED, BLIND AND DISABLED (MHABD) APPLICATIONS

MANUAL REVISION #74

1060.005.10

 

DISCUSSION:

The purpose of this memorandum is to inform staff of a change in the process for submitting medical records to MRT on new applications for MHABD.  There is no longer a separate email address for the St. Louis City area staff. 

All staff will send medical records to MRT at MRT.Personnel@dss.mo.gov.  IM Manual section1060.005.10 Submitting Information on New Applicants to MRT has been revised to reflect this change. 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

PL/vm