MO HealthNet for the Aged, Blind, and Disabled

0840.015.10 REOPENING CLOSED CASES

IM#115 August 06, 2019,  IM#98 July 3, 2019

MHABD 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 by FSD in a timely manner, but not entered into the eligibility 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
  • real or personal property information

EXAMPLE: Mr. Smith is active MO HealthNet for the Aged, Blind, and Disabled (MHABD) Non-Spend Down and reports he has gotten married.  Mr. Smith also reports his spouse is working and receives $1500.00 monthly earnings.  Mr. Smith provided acceptable verification of his marriage, but did not provide the name of spouse’s employer or her wage verification.  FSD staff was unable to verify the new income or employer via IMES, but sent a request for information notice regarding changes reported.  Mr. Smith failed to submit the information in ten days, and the case is closed.

Seven days after the closing is completed, Mr. Smith submitted one paystub, but did not provide the pay frequency bi-weekly or twice monthly. Staff will make a comment in the eligibility system regarding the information provided, but does NOT reopen the case since the pay frequency is unknown and still outstanding.

Twenty days after the closing is completed, Mr. Smith submits the additional paystubs which verify the frequency of pay. Staff make a comment in the eligibility system regarding the wage 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 review or during the 90 day reconsideration period, refer to Medical Assistance for the Aged, Blind, and Disabled manual section 0840.005.05 Reconsideration Period.

The MO HealthNet Division Stakeholder Services Unit (formerly the Premium Collections Unit) must be notified when a MHABD Spend Down or Ticket to Work (TWHA) case is reopened for any reason. The MHD Medicare Buy-In Unit must be notified when a QMB/SLMB case is reopened for any reason.  Refer to the MHABD Cancel Close/Cancel Reject Chart for the current procedure for reopening Spend Down, TWHA, and QMB/SLMB cases.