42 CFR 435.403 requires individuals to be residents of Missouri to receive MO HealthNet. When FSD discovers an individual or a household has moved out of state, action must be taken to close the MO HealthNet (MHN) eligibility.
If the individual reports in writing they moved out of state, action is taken immediately to close the case; an adverse action period is not required. If the agency discovers the individual moved out of state by any other means (examples: by a telephone call or report from another individual), an adverse action period must be granted.
NOTE: When only the head of household has moved out of state, the entire household eligibility closes. If there are household members who remain residents of Missouri, someone else will need to apply for the household.
EXAMPLE: Tim and Kristen have an active MO HealthNet for Families (MHF) case open with their child, Scott. Tim is the head of the household. Kristen notifies FSD that Tim moved to Oklahoma to live with his family and does not intend to return to Missouri. Tim was the only household member who moved. The case with Tim as head of the household is closed. Kristen must reapply as the head of the household for herself and Scott.
Refer to MAGI Manual section 1885.015.00 Removing A Person to remove individuals from the household.
Additionally, PARIS matches are an indicator that a MO HealthNet participant may be receiving Medicaid services in another state. When a PARIS match is received, review sources available to FSD, such as FAMIS, for the current address or telephone number. Attempt to contact the household to confirm their state of residency, as well as physical and mailing address.
NOTE: Do not send a Request for Information (IM-31A), when a review of the individual’s case record or a telephone call cannot verify the state of residency.
If benefits are opened in another state after benefits in Missouri were opened, assume the participant(s) has(ve) moved out of state. Provide a 10 day adverse action period by sending the Adverse Action Notice (IM-80). If benefits are opened in another state after benefits in Missouri were opened, assume the participant(s) has(ve) moved out of state. Provide a 10 day adverse action period by sending the Adverse Action Notice (IM-80).
EXAMPLE: Angie applied and was approved for MO HealthNet benefits on October 1, 2016. FSD received a PARIS match showing Angie is in the State of Iowa. It was confirmed with the State of Iowa that Angie applied and was approved for Medicaid benefits in Iowa on February 1, 2017. Action is taken to close the case.
Missouri residency is a condition of eligibility; MO HealthNet for Pregnant Women (MPW) and Newborn cases are not be treated differently when the individual moves out of state or is unable to locate.
NOTE: A Newborn (a child born to a women who was covered by a Title XIX MO HealthNet program at the child’s date of birth) that moves out of Missouri and then move back within his/her first year of life, must have Newborn coverage reopened. Income does not have to be reviewed. The Newborn is guaranteed coverage for the first year of life when he/she is a resident of Missouri.