Family Healthcare (FAMIS)

0925.050.15 No Longer in Need of Family Planning Services

IM-#54 June 4, 2013

If the Eligibility Specialist (ES) becomes aware that the participant is sterilized, take action to close after the 60 days postpartum has expired. Send the participant a Pre-closing Notice (IM-80PRE) stating the reason for the proposed action and giving the participant 10 days to respond. When the IM-80PRE expires, enter an action of adverse action worker close (AAWC) in FAMIS with the reason code APE – application approved in error and send the participant an Adverse Action Notice (IM-80) stating the correct reason for closing. A copy of this corrected letter must be filed in the case record.

EXAMPLE:  Ms. Jones delivers her child 03/25 by C-Section and notifies her ES that during her C-Section, she had her tubes tied. On 05/01 the ES sends Ms. Jones an IM-80PRE notifying her that her 60 days post partum coverage is coming to an end. On 05/11 the ES sends Ms. Jones an IM-80 informing Ms. Jones that her 60 days post partum will end on 05/31 and she was not found eligible for an additional MO HealthNet program.