IM-043 – INCREASE IN RESOURCE LIMITS FOR QUALIFIED MEDICARE BENEFICIARY (QMB), SPECIFIED MEDICARE BENEFICIARY (SLMB), AND QUALIFYING INDIVIDUALS (QI-1 OR SLMB2) PROGRAMS

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  INCREASE IN RESOURCE LIMITS FOR QUALIFIED MEDICARE BENEFICIARY (QMB), SPECIFIED MEDICARE BENEFICIARY (SLMB), AND QUALIFYING INDIVIDUALS (QI-1 OR SLMB2) PROGRAMS

 

MANUAL REVISION #31

0865.010.00
0865.010.15

APPENDIX J

 

DISCUSSION:

Effective January 1, 2019, the QMB, SLMB, and SLMB2 resource limits increased.  For a single individual, the resource limit increased from $7,560 to $7,730.  For a married couple, the resource limit increased from $11,340 to $11,600.  Resource maximums have been updated in the Family Assistance Management Information System (FAMIS).  There is no change in policy regarding how to determine available resources.

Income Maintenance Manual Sections Eligibility Requirements 0865.010.00 and Resources (QMB) 0865.010.15 have been updated to include the increase in resource limits.  The MO HealthNet Program Description Aged, Blind, and Disabled Chart and MO HealthNet Aged, Blind and Disabled Income Chart have been updated on the Intranet and Internet to show the increased resource limits.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

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IM-042 – TRUST SUBMISSION ON REQUEST FOR INTERPRETATION (IM-14)

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  TRUST SUBMISSION ON REQUEST FOR INTERPRETATION (IM-14)

 

MANUAL REVISION #30

1025.015.04

1025.015.04.01.01

1025.015.04.01.02 

 

DISCUSSION:

Income Maintenance manual sections have been updated with new instructions for submitting trusts for review by Program & Policy.

Submit each Trust to Program & Policy, on a separate IM-14 through proper supervisory channels.   Supervisors will submit through SharePoint.

Do not send to FSD.IM14@dss.mo.gov, as this email is no longer monitored. 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

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IM-040 – IRS NOTICE LOG and IRS NOTICE LOG INSTRUCTIONS

FROM: REGINALD E. McELHANNON, INTERIM DIRECTOR

SUBJECT:  IRS NOTICE LOG and IRS NOTICE LOG INSTRUCTIONS 

 

DISCUSSION:

Requests for Interpretation of Policy (IM-14), or policy clearances, were originally forms sent to Program and Policy staff regarding the application of program policy to specific cases. This is now an electronic process.

  • General: For MAGI programs only
  • Case Specific: For all Income Maintenance programs

General requests for interpretation are meant to address trends of case issues that staff are seeing or questions about how to apply policy to MEDES system functionality.  These clearances often include a “team” approach with MAGI Program and Policy staff working with the Training Unit and MEDES system subject matter experts to come up with responses that may be applied across similar cases or system issues.

Case specific requests for interpretation are submitted when field staff have questions on how to apply policy to a specific case situation. These are reviewed only by Program and Policy staff and only regard how policy impacts a specific case. Because the responses to these Requests for Interpretation are based on the information for a specific case and policy that is in place at the time the case is reviewed, these clearances must NOT be applied to other cases.

Keep the following items in mind when submitting a Request for Interpretation:

  • Specific references to the policy manuals and system user guides are always included in a policy clearance request. With the exception of trusts and annuities, staff must ALWAYS consult available resources before submitting a Request for Interpretation.
  • All pages of all relevant documents must be attached to the clearance request in order to receive a policy response.
    • Policy staff cannot provide a response when pages of submitted documents are missing or some documents are not submitted at all.
    • Policy staff will not search through the SharePoint or the Electronic Content Management System (ECM) to find missing information.
  • Requests for Interpretation of Policy must always be submitted through supervisory channels to the Policy and Procedure Collaboration Portal. Only supervisors or managers may submit new general or case specific Requests for Interpretation of policy.
  • Requests for Interpretation are always sent for:
    • Trusts: These clearances are assigned a “T” number
    • Annuities: These clearances are assigned a “A” number
    • In cases when the reasonable opportunity exceeds 90 days
    • MO HealthNet Undue Hardship Waiver Requests
  • Subject lines for Requests for Interpretation of policy should include information about the topic of the clearance, such as, but not limited to:
    • Participant’s last name
    • “Income Counting” for income questions
    • “QIT” for Medicaid Qualifying Income Trusts
    • “MSNT” for MidWest Special Needs Trusts
    • “ARCare” for ARCare Trusts
    • “Spend Down” for clearances regarding spend down expenses
  • Requests for Interpretation are internal documents and not to be shared with participants or other outside entities. Case comments must only include a brief summary of the clearance response, and the clearance number.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Refer to Policy and Procedure site instructions for information on how to enter Requests for Interpretation of Policy.

 

EMAIL-IM-#40

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IM-039 – REASONABLE COMPATIBILITY CLARIFICATION

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  REASONABLE COMPATIBILITY CLARIFICATION

MANUAL REVISION #28

1805.030.15                          

 

DISCUSSION:

The purpose of this memorandum is to advise the 1805.030.15 Reasonable Compatibility section of the Family Healthcare Manual- MAGI has been updated.   

The manual has been updated to clarify that when the self-attested income is above the MO HealthNet eligibility threshold and the Electronic Data Source (EOI) is below the threshold that a reasonable explanation must be provided or additional verification must be requested.

Income is still considered reasonable compatibility when:

  • Both the self-attested income and the EOI fall within the same MO HealthNet program eligibility threshold or
  • The self-attested income is below the MO HealthNet program eligibility threshold and EOI falls in a different MHN program category above the threshold, but the EOI is within 10% or less of the self-attested income.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

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IM-037 – IM-4 MO HEALTHNET HEALTH CARE BROCHURE

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  IM-4 MO HEALTHNET HEALTH CARE BROCHURE

FORMS MANUAL UPDATE: #9

 

 

DISCUSSION:

This memo introduces the new IM-4 MO HealthNet Health Care brochure.  The brochure is available in English and Spanish, and is located in the Forms Manual (VOLUME 1).   The IM-4 MO HealthNet Health Care brochure is also available in the E-store to order.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Order the appropriate supply for Resource Centers

 

ATTACHMENTS:

 

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IM-036 – UPDATED HEALTH INSURANCE PREMIUM PAYMENT PROGRAM FORMS (HIPP)

FROM:    PATRICK LUEBBERING, DIRECTOR

SUBJECT:    UPDATED HEALTH INSURANCE PREMIUM PAYMENT PROGRAM FORMS (HIPP)

FORMS MANUAL REVISION #8

HIPP-1

HIPP-A

 

DISCUSSION:

The purpose of this memorandum is to replace the outdated Application for Health Insurance Premium Payment Program form (HIPP-1) in the Forms Manual and to add a second version, HIPP-A, which is used for HIV and AIDS participants.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using these forms immediately

 

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IM-035 – UNABLE TO LOCATE WILL NOT CLOSE INITIAL TMH

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  UNABLE TO LOCATE WILL NOT CLOSE INITIAL TMH 

MANUAL REVISION #26

1820.030.30

DISCUSSION:

The purpose of the memorandum is to clarify the 1820.030.30 Ineligibility in the First Six Months section of the Family Healthcare Manual – MAGI

The Transitional MO HealthNet (TMH) section of the MAGI manual has been updated to clarify that unable to locate will not cause close of TMH in the initial six months. 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

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IM-034 – CLARIFICATION OF ELIGIBILTY FOR THE INITIAL SIX MONTHS FOR TRANSITIONAL MO HEALTHNET (TMH)

FROM: PATRICK LUEBBERING, DIRECTOR

SUBJECT: CLARIFICATION OF ELIGIBILTY FOR THE INITIAL SIX MONTHS FOR TRANSITIONAL MO HEALTHNET (TMH)

MANUAL REVISION #
1820.030.00

DISCUSSION:
The purpose of this memorandum is to clarify the 1820.030.00 Eligibility For Initial Six Months section of the Family Healthcare Manual- MAGI.

The Transitional MO HealthNet (TMH) section of the MAGI manual has been updated to clarify that when a parent or caretaker relative who has earned income is added to the household and puts the household over the limit to stay on MO HealthNet for Families (MHF), that the original MHF household is allowed to move to TMH as long as the other eligibility factors to initially qualify for TMH are met.

NECESSARY ACTION:
• Review this memorandum with appropriate staff.

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IM-033 – UPDATE OF 1619 THRESHOLD AMOUNT

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  UPDATE OF 1619 THRESHOLD AMOUNT

MANUAL REVISION #24

0850.005.20

Appendix J

 

DISCUSSION:

The threshold amount established by the Social Security Administration (SSA) to determine eligibility under Section 1619 of the Social Security Act has increased from $3,099 monthly to $3,141 monthly, effective January 1, 2019.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

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IM-032 – CLARIFICATION ON WHO MAY APPOINT AN AUTHORIZED REPRESENTATIVE FOR MAGI APPLICATIONS

 

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  CLARIFICATION ON WHO MAY APPOINT AN AUTHORIZED REPRESENTATIVE FOR MAGI APPLICATIONS

 

MANUAL REVISION #23

1802.020.30

 

DISCUSSION:

The purpose of this memorandum is to clarify the 1802.020.30 Signing by an Authorized Representative section of the Family Healthcare Manual – MAGI

 

The  Signing by an Authorized Representative section of the MAGI manual has been updated to clarify who may appoint an authorized representative:

  • An applicant age 19 or older
  • An applicant younger than 19 meeting the criteria to apply on their own behalf, which includes the following conditions:
  • The minor is pregnant;
  • The minor has been lawfully married;
  • The minor is a parent;
  • The minor is homeless, as defined by section 167.020.1, RSMo 2015, or a victim of domestic violence, as defined by section 455.010.5, RSMo 2015, and meets all the criteria in section 431.056.1, RSMo 2014; or
  • The minor is legally emancipated.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Immediately allow minors who meet the criteria to apply on their own behalf appoint an authorized representative if requested.

 

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