MO HealthNet for the Aged, Blind, and Disabled

0815.030.15 Effective Date of Surplus

IM-#33, March 29, 2012

The effective date of the participant’s surplus must always be the first day of a month.

  • If the participant was in the facility on the first day of the month of request, the surplus is effective on the first day of that month.
  • If the participant was not in the facility on the first day of the month of request, the surplus is effective the first day of the following month.

EXAMPLE: Mr. B. was admitted to a MO HealthNet certified bed in a nursing facility on 7/5/06. He applied for MHABD vendor benefits on 7/10/06. He was determined eligible on all factors on 7/28/06. Mr. B’s surplus will be effective 08/01/06; because he was not in the facility on 7/1/06 (the first day of the month of request). MO HealthNet will pay the nursing facility for the entire cost of care for 7/5 through 7/31. MO HealthNet will pay the nursing facility the cost of care minus the participant’s surplus amount effective 8/1/06.

NOTE: If a participant enters the vendor home after the first day of the month, or leaves the vendor home before the last day of the month multiple WIBCAs will need to be completed. From the Select Worker Initiated Budget Calculation Area screen (SELWIBCA or FMXH) press F14=ADDWIBCA. The WIBCAs must be done to show the appropriate coverage type for the days when the participant was eligible for VEND VENDOR NURSING CARE, and for the days either prior to entering and/or after leaving the facility when the participant would be eligible for another coverage type such as SPNDN MA SPENDDOWN/NON-SPENDDOWN. Review the Medicaid Category History screen (MEDHIST or FM4L) to determine if WIBCAs were authorized appropriately to provide coverage to the participant for the entire month.