Category: MoHealthNet Home

IM-79 SEPTEMBER 2023 – FORMS UPDATE

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: SEPTEMBER 2023 – FORMS UPDATE

 

DISCUSSION:

Income Maintenance (IM) forms and documents are reviewed and revised periodically, as necessary. New forms and documents are created as required or requested.

Note: Supplemental Nutrition Assistance Program (SNAP) replacement benefit forms are updated due to new replacement policies and procedures related to electronically stolen benefits. Refer to New and Revised internal forms for revisions to IM-112 and new form IM-112RB.

All new and revised IM forms show a revision date of 9/2023; previous versions of these forms with other revision dates are now obsolete. Family Support Division (FSD) will accept obsolete forms until 12/31/2023.

New and Revised Forms available in the public and internal forms manuals:

Form Number  Form Name New or Revision:
FSD-4 Customer Service Revision to add DSS logo and electronic signature attestation.
FSD-4 (Spanish) Servicio Al Cliente New form translating the FS-4 to Spanish.
IM-100RWC Request to Withdraw or Close Revision to add new form number, AEG program option, and non-discrimination statement.
IM-100RWC Solicitud de Suspension o Cierre Revision to IM-100RWC Spanish.
IM-110 Replacement Request Revision to add non-discrimination statement and remove office use only section.
IM-110 (Spanish) Solicitud de Substitucion New form translating the IM-110 to Spanish.
IM-145  Change Report Revision to add new question regarding pregnant household members and additional instructions for active MO HealthNet (MHN) participants requesting a different MHN program.
IM-145 (Spanish) Informe de Cambios New form translating the IM-145 to Spanish.

 

New and Revised Forms available only to FSD staff in the internal forms manual:

Form Number Form Name New or Revision: 
IM-112 Action Taken On Your Supplemental Nutrition Assistance Program (SNAP) Case Revision to remove replacement benefit language and add non-discrimination statement.
IM-112 (Spanish) Acción Implementada en su Caso del Programa de Asistencia Nutricional Suplementaria (SNAP) Revision to IM-112 (Spanish).
IM-112RB Action Taken on Your Request for Replacement Benefits New form to notify participants who have requested replacement benefits due to household misfortune, stolen EBT card, or electronically stolen benefits.
IM-112RB (Spanish) Medida Adoptada en su Solicitud de Sustitucion de Beneficios New form translating IM-112RB to Spanish.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using revised forms immediately.
  • Discard and recycle blank obsolete forms.
  • Share with community partners.

 

 

 

KE/cj

IM-78 INTRODUCING ONLINE APPLICATION FOR MEDICARE SAVINGS PROGRAMS (MSP) AND REVISIONS TO THE APPLICATION FORM

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING ONLINE APPLICATION FOR MEDICARE SAVINGS PROGRAMS (MSP) AND REVISIONS TO THE APPLICATION FORM

FORM REVISION #
IM-1MSP
IM-1MSP (SPANISH)
IM-1MSP (LARGE PRINT)

 

DISCUSSION:

The MSP application (IM-1MSP) can now be completed and submitted online. MSP’s are available for certain individuals to get assistance with paying their Medicare premium and for some participants to also receiving assistance with coinsurance and deductibles.

Additional information about MSP’s and the link to the online application is located on the Department of Social Services webpage, Programs for Seniors & Individuals with Disabilities.

Note: The IM-1MSP is NOT an application for MO HealthNet (MHN). A participant can apply for MSP and MHN or MHN only online, by calling 855-373-9994, or by completing an Application for Health Care & Help Paying Costs (IM-1SSL).

The IM-1MSP is also available as a paper form in local offices and as a PDF that participants, community agencies, and advocates can access online and print.

The IM-1MSP is a stand-alone application and must be registered and processed without requiring the Application for Health Coverage & Help Paying Costs (IM-1SSL) or the Aged, Blind, and Disabled Supplement (IM-1ABDS). When registering or processing an IM-1MSP, always explore prior quarter coverage.

Revisions were made to the IM-1MSP to add preferences for opting out of automated calls and texts and some minor formatting changes to add clarification.

The revised IM-1MSP is available in English, Spanish, and large print with a revision date of 7/2023. All other versions of these applications should be removed and only the 7/2023 version should be distributed by FSD staff. FSD will accept the 1/2023 version until 12/31/23.

The applications are available in the public forms manual and internal forms manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Distribute 7/2023 revision as requested.
  • Remove obsolete forms (any other revisions date).
  • Share with community partners.

KE/cj

 

IM-76 DETERMINING CORRECT APPLICATION DATES FOR ALL PROGRAMS

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: DETERMINING CORRECT APPLICATION DATES FOR ALL PROGRAMS

 

DISCUSSION:

In a recent Program Access Review (PAR), the Food and Nutrition Service (FNS) found Supplemental Nutrition Assistance Program (SNAP) applications registered with incorrect application dates. This memo provides clarification in determining correct application dates for all programs.

Incorrect application dates can result in:

  • benefit payment errors,
  • incorrect eligibility begin dates,
  • improper processing timeframes, and
  • increases to the agency’s error rates for accuracy and timeliness, potentially impacting federal funding.

Application dates must be carefully evaluated during both registration and processing to ensure that the correct date is used.

Application Date vs Agency Received Date

Application dates are determined by the date and time that an application with the minimum required information is received by the agency. (See policy for program-specific requirements.)

  • Applications received before 5:00 p.m. Monday – Friday are considered as received on that date.
  • Applications received outside of business hours (after 5:00 p.m., on a weekend, or on a holiday) are considered as received on the next business day.

Note: MO HealthNet (MHN) applications received by phone or online, including applications from the Federally Facilitated Marketplace (FFM), are an exception. Regardless of the time of day or day of the week received, online and FFM applications are dated the day the application was successfully submitted and phone applications are dated the day that the telephonic signature was captured.

Identifying Date/Time of Receipt

With the exception of applications received through the Upload Portal, applications must be opened and viewed in order to see the received date.

Received date location examples:

  • Upload Portal: Added On date in the Electronic Content Management system (ECM)

  • Online/AEM (not MHN): Submitted Date Time on bottom of each page

 

  • Mail: Date stamp

  • Resource Center: Date stamp

  • Fax: Receiving information on bottom or side of page

  • MHN – Online, phone, FFM: MHN Application Case tab

 

When Multiple Applications are Received:

If more than one application is received for the same program, the first application received is the application to be registered.

Example: Two Temporary Assistance applications are found in the ECM, dated 9/12 and 9/14. The eligibility system shows that neither has yet been processed.

    • The 9/12 application is registered but both applications are reviewed during processing.

Registering the Correct Applicant:

Care must be taken to ensure that applications are registered under the correct applicant. Applications registered under an incorrect head of household cause delays for the applicant and could result in a breach of confidentiality for either party.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Review content and resources in the Application Registration row of FAMIS Resources.

 

 

 

KE/mn

IM-75 FSD.DOCUMENTS UPCOMING EMAIL ADDRESS DEACTIVATION

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: FSD.DOCUMENTS UPCOMING EMAIL ADDRESS DEACTIVATION

 

DISCUSSION:

As of October 1, 2023, FSD.Documents@dss.mo.gov will be deactivated and the sender will receive a bounce back response. Currently, an automatic response informs the sender beginning October 1st, 2023 documents will no longer be accepted through FSD.Documents@dss.mo.gov and provides additional resources to the sender.

Documents will continue to be accepted via:

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/se

IM-74 UPDATED PROTECTED CASELOAD PROCESS

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FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATED PROTECTED CASELOAD PROCESS

 

DISCUSSION:

Protected Caseloads are established in the Family Assistance Management Information System (FAMIS) and Missouri Eligibility Determination and Enrollment System (MEDES) to protect Family Support Division (FSD) employees from inadvertently accessing or taking action on protected cases.
Protected loads serve participants who meet any of the following criteria:

  • A victim of domestic violence or human trafficking;
  • A participant in the Safe at Home program;
  • An employee of the Family Support Division (FSD) or a family member (spouse, parent or child) residing with an FSD employee;
  • A case on which the FSD employee is an Authorized Representative; or
  • A temporary employee currently assigned to FSD.

Effective immediately, IM-#66 Protected Caseloads dated 11/26/2018 is obsolete. For information about protected cases refer to MEDES or FAMIS Resources.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/pm

IM-72 REVISION TO AUTOMATIC WITHDRAWAL AUTHORIZATION FORMS FOR MO HEALTHNET (MHN) PROGRAMS

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISION TO AUTOMATIC WITHDRAWAL AUTHORIZATION FORMS FOR MO HEALTHNET (MHN) PROGRAMS

FORM REVISION #
2575-055
2575-056
2575-057

 

DISCUSSION:

MO HealthNet Division (MHD) has revised the Automatic Withdrawal Authorization forms to update contact information and change the form numbers. Participants must use the revised forms to start, change, or cancel an automatic withdrawal from their bank account to pay MHN Children’s Health Insurance Programs (CHIP) premiums, MHN Ticket to Work premiums, or MHN Spend Down pay-in.

The forms are located in the public forms manual and the internal forms manual. The forms all have an August 2023 revision date.

Form Number Form Name
2575-055 MO HealthNet for Kids Insurance Premium Payments Automatic Withdrawal Authorization
2575-056 Spend Down Pay-In Automatic Withdrawal Authorization
2575-057 Ticket to Work Health Assurance Withdrawal Authorization

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Share with community partners.

 

 

 

KE/cj

IM-69 INTRODUCING SYSTEM-GENERATED AGED, BLIND, AND DISABLED SUPPLEMENT FORM FOR NON-MAGI APPLICATIONS

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING SYSTEM-GENERATED AGED, BLIND, AND DISABLED SUPPLEMENT FORM FOR NON-MAGI APPLICATIONS

 

DISCUSSION:

The Aged, Blind, and Disabled Supplement (FAABD) is a new system-generated version of the Aged, Blind, and Disabled Supplement (IM-1ABDS).

Effective August 12, 2023, FAMIS will allow Family Support Division (FSD) staff to send an FAABD to any participant that has indicated that they are over the age of 65, blind, or disabled. If the supplement information is not provided, then the application will systematically reject for “failure to provide supplemental information” and a notice will be sent to the participant.

FSD staff cannot complete a Non-MAGI eligibility decision with only information provided on the MO HealthNet online application, or the Application for Health Coverage & Help Paying Costs (IM-1SSL). The FAABD and IM-1ABDS are used to collect the additional information required to determine eligibility for Non-MAGI programs such as:

  • MO HealthNet for Aged, Blind, and Disabled
  • Blind Pension
  • Supplemental Aid to the Blind
  • Supplemental Nursing Care

Note: If FSD is able to collect the required information by calling the participant or during a Supplemental Nutrition Assistance Program (SNAP) interview, a call to the FSD Information Center at 855-373-4636, or during any phone or in person interaction with FSD staff and certain contracted vendors, then a supplement form is not required for Non-MAGI applications.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Staff must review revised FAMIS Resources training materials regarding registering applications.

 

 

 

KE/cj

IM-68 NEED FOR FAMILY PLANNING IS NO LONGER REQUIRED FOR UNINSURED/EXTENDED WOMEN’S HEALTH SERVICES (UWHS/EWHS)

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: NEED FOR FAMILY PLANNING IS NO LONGER REQUIRED FOR UNINSURED/EXTENDED WOMEN’S HEALTH SERVICES (UWHS/EWHS)

MANUAL REVISION #
1850.040.40
1850.040.40.20 obsolete
1870.000.00
1870.005.00
1870.015.00

 

DISCUSSION:

Effective 8/1/2023, women who are aged 18-55, with family income at or below 201% FPL and who are not eligible for other MO HealthNet programs must be screened for UWHS regardless of the need for family planning services.

Uninsured women transitioning from postpartum coverage are eligible for EWHS even if they no longer have a need for family planning. There is no change in the services covered under these programs.

The manual sections listed above are updated to reflect these changes. 1850.040.40.20 No Longer in Need of Family Planning Services is obsolete.

Refer to MEDES Resources for the mitigation to be used until system updates are completed.

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/rc

IM-63 JULY 2023 – QUARTERLY FORMS UPDATE

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: JULY 2023 – QUARTERLY FORMS UPDATE

 

DISCUSSION:

Income Maintenance forms and documents are reviewed and revised quarterly and as necessary. New forms and documents are created as required or requested.

All new and revised IM forms show a revision date of 7/2023, unless otherwise stated. Revised IM forms with older revisions dates are now obsolete. Family Support Division (FSD) will accept obsolete forms until 9/30/2023.

New and Revised Forms available in the public and internal forms manuals:

Form Number  Form Name New or Revision:
HIPP-1 Application for Health Insurance Premium Payment (HIPP) Program MO HealthNet Division (MHD) updated and revised the application. This form has a revision date of 2/2023.
HIPP-1 Solicitud para el Programa de Pago de Primas de Securos Medicos *(HIPP) MHD updated and revised the application. This form has a revision date of 2/2023.
HIPP-A Application for Health Insurance Premium Payment (HIPP) Program – Care Coordinator Version MHD updated and revised the application. This form has a revision date of 2/2023.
HIPP-A Solicitud para el Programa de Pago de Primas de Securos Medicos *(HIPP) – Coordinador de Cuidados MHD updated and revised the application. This form has a revision date of 2/2023.
IM-2SR Signature Request Revision to update terminology from review to renewal.
IM-6NF Authorization for Release of Medical/Health Information to Nursing Facilities, In-Home Nursing Care Providers, and Other Providers of Medical Services Revision to use official name, add electronic signature attestation, remove one year expiration date, and update formatting to improve readability.
IM-114 Voluntary Repayment Authorization Form Revision to update terminology, contact information, and processes.
MO 231-0167 Missouri Voter Registration Application Secretary of State revised to add optional political party affiliation and remove rural voters field. This form has a revision date of 5/2023.

New and Revised Forms available only to FSD staff in the internal forms manual:

Form Number Form Name New or Revision:
IM-33HCB Notice of Case Action for Home and Community Based Services Waiver New action notice for cases requesting or receiving Home and Community Based Services (HCB) Waiver benefits.
IM-54A Home and Community Based Services Referral Revision to correct a broken hyperlink.

Revised forms sent to participants by FAMIS or MEDES eligibility systems:

Form Number Form Name Revision:
HIPP-1 Application for Health Insurance Premium Payment (HIPP) Program Updated in MEDES to match revisions made by MHD. Released in MEDES 5/30/23.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using revised forms immediately.
  • Discard and recycle blank obsolete forms.
  • Share with community partners.

 

 

 

KE/cj

IM-62 2023 MO HEALTHNET CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) PREMIUMS AND RELATED APPENDIX UPDATES

Posted on

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2023 MO HEALTHNET CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) PREMIUMS AND RELATED APPENDIX UPDATES

MANUAL REVISION #
Appendix A
Appendix E

 

DISCUSSION:

CHIP premiums are required for families with income above 150% of the Federal Poverty Level (FPL). Each year, as required by state statute, the MO HealthNet Division (MHD) reviews and establishes the premium amounts. Effective dates on Appendix A and Appendix E have been updated, but there is no premium increase at this time.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

KE/bl