Obsolete per IM-125 September 13, 2022
IM-125 September 13, 2022; IM-30 April 02, 2021; IM-98 July 3, 2019 MO HealthNet for the Aged, Blind, and Disabled (MHABD) applications rejected due to verification not provided or participant’s failure to cooperate may be cancel rejected when: The application was rejected in error, or ALL requested information is provided by the application due date. “Agency Errors” occur when staff fail to act promptly on information provided by the participant and/or verification provided, causing the application to be rejected. Applications rejected due to an agency error must be cancel rejected. See MHABD Cancel Close/Cancel Reject Chart for instructions. MHABD applications rejected for failure to provide information or failure to cooperate may be cancel rejected if ALL requested information is received by the application due date. Application due dates are referenced in MHABD manual section 0835.000.00 Application Processing Timeframes for MO HealthNet for the Aged, Blind, and Disabled Program. EXAMPLE: Bob Smith applied for MHABD on April 25, 2019. He is 72 years old, his application is due on June 9th, 45 days from the application date. On April 25, 2019, a Request for Information notification was generated requesting verification of his self-employment income and expenses. The notification expired on May 5, 2019. The information was not received. On May 6, 2019, staff checked the eligibility system to see if a second request went out. It did and expires May 16, 2019. On May 17, 2019, staff reviewed the electronic date sources and the eligibility system. The requested information was not received, and there were no comments that the participant had requested more time. Staff rejected the application. On May 25, 2019, the information was received. Staff cancel reject the application and process using the original application date of April 25, 2019. If the requested information had been provided after June 9th, the rejection could not be canceled. If all necessary information is not provided by the original due date of the application, no further action is necessary.
Cancel Rejections for Add a Person Requests: Add a person requests in which the individual being added is requesting coverage follow the same cancel rejection timeframes as an initial application. If ALL requested verification is provided within the cancel rejection timeframe, a cancel closing may be required in addition to the cancel rejection, even if the information is provided after the cancel closing timeframe has expired. NOTE: After the cancel closing has been authorized, a new add a person request must be registered using the original application date. Add a person requests in which the individual being added is not requesting coverage are considered a change in circumstance. If the case closes, only the cancel closing policy would apply, not the cancel rejection policy. EXAMPLE: On July 16, 2019 Mary Louis requested to add coverage for her spouse to her active MHABD case. Mr. Louis is applying under the permanent and total disability (PTD) requirements. Verification needed to process the “add a person” application was requested and the Request for Information Notice expired on July 30, 2019 with no response from the participants. An Adverse Action Notice was sent and the case closed and the “add a person” application was denied on August 10, 2019. According to the Application Timeframes section of the policy manual, an application based on PTD standards is due within 90 days. The 90th day is October 14, 2019. If ALL of the requested information is provided by October 14, 2019, the rejection of the application can be canceled. The closing of the case can be canceled even though the information was provided after the cancel closing timeframe if it was provided before the cancel rejection timeframe. Staff must authorize the cancel closing and then register an add a person request using the original application date.
Cancel Rejections for Add a Category Requests: Adding a category of coverage, such as Blind Pension or QMB/SLMB follows the application processing time frames for the cancel rejection policy. Changing a category of coverage is considered a change in circumstance and if the case closes, only the cancel closing policy would apply not the cancel rejection policy. NOTE: Adding a category for cash assistance such as Blind Pension or Supplemental Aid to the Blind is an application, not a change in circumstance.