Vendor payments may only be made on behalf of MO HealthNet for the Aged, Blind, and Disabled (MHABD) participants who meet the following requirements:
- Have received an initial assessment (DA-124 A/B) (see 0815.020.00 Initial Assessment and Medical Certification) and:
- have been medically certified for NF or IMR level of care, or
- are age 65 or older or under age 21 and medically certified for MHC level of care
Note: An individual who is certified for MHC level of care when s/he is under the age of 21 may continue to qualify for vendor payments until age 22.
- If certified for NF level of care and entering a nursing facility, have received a preadmission screening (DA-124C) (see 0815.025.00 Preadmission Screening for Entry Into Nursing Facilities).
- Qualify for MHABD based on December 1973 eligibility requirements, or as a child under age 18 based on MHF (see 1810.000.00 MO HealthNet for Families (MHF)) or MHK criteria for poverty level children (see 1830.000.00 MO HealthNet for Kids (MHK) – Non-CHIP Coverage).
- Note: A child in acute care called inpatient on a temporary stay for less than 30 days, is left on whatever level of care he/she is currently receiving. MHD will dis-enrolled the (MHF) or (MHK) Poverty Level child from the managed care plan. These children are anticipated to have a short stay at this level of care and will either be discharged, or transitioned into residential care.
- Reside in a MHN certified bed (T19) if in a Missouri nursing facility, or a MHN certified bed if (T19) if in a facility out of state.
A surplus determination must be made to determine the portion of an eligible participant’s income that is available to pay toward the cost of his/her care.