IM-78 June 11, 2020; IM-143 November 22, 2017
Family MO HealthNet cases may be reopened or cancel closed under the following circumstances:
- When the case was closed in error, such as:
- incorrect data entry; or
- information was received in local office in a timely manner, but not entered into system in time to stop the case closing
- When the participant provides ALL missing information that caused the case to close within 30 days of the date the closing action is complete. This information may include, but is not limited to:
- income information
- tax filing status
- current mailing address
- employer-sponsored insurance information
EXAMPLE: Mr. Patrick has a CHIP 73 case and reports that he has a new job that offers employer-sponsored insurance. FSD staff sent a request for information notice regarding income and employer-sponsored insurance information. Mr. Patrick fails to submit the information in ten days, and the case is closed.
Seven days after the closing is completed, Mr. Patrick submits the income verification, but not the employer-sponsored insurance information. Staff make a comment in the eligibility system regarding the income verification received but do NOT reopen the case or process the new evidence since the insurance information is still outstanding.
Twenty days after the closing is completed, Mr. Patrick submits the employer-sponsored insurance information. Staff make a comment in MEDES regarding the insurance information received and take action to reopen the case now that FSD has received all outstanding verification.
NOTE: When reopening a case due to the annual renewal or the 90-day reconsideration period, refer to MAGI manual section 1880.020.00 Reconsideration Period.
Restore coverage to the same level of care it was prior to closing. See MEDES Resources for additional information.
The MO HealthNet Division Stakeholder Services Unit (formerly the Premium Collections Unit) must be notified when a CHIP premium case is reopened for any reason. Staff should refer to the MEDES Resources for the current procedure for reopening CHIP premium cases.