0630.000.00 REINVESTIGATIONS AND INTERIM ACTIVITIES

0630.020.05 PRE-CLOSING EX-PARTE REVIEW

IM-#30 April 4, 2008,  IM-#193 December 28, 2000

If a change in circumstances results in a determination of ineligibility for SNC, ineligibility for all MO HealthNet categories must be established prior to taking action to close the case. All available information must be carefully reviewed. If potential eligibility exists under another category, change the case address if necessary, and continue MO HealthNet under SNC while exploring the other eligibility. Action may be taken to discontinue the cash grant while not affecting the MO HealthNet eligibility.

Do not ask the participant to provide new information that is available to the agency or to re-verify current case information. In some situations it may be necessary to obtain additional information from the participant to determine eligibility in another category. Do not close while attempting to complete the new eligibility determination.

If the participant is determined eligible under another category, switch the individual to the appropriate category (an IM-1 is not necessary). Process both closing and approval transactions on the same day in order to prevent any disruption in healthcare coverage.

If the category the participant is eligible is MHABD spenddown send an advance notice of adverse action (IM-80) notifying the participant they will become spenddown the month after the IM-80 expires. After the IM-80 expires, register an MHABD spenddown application and:

  1. Close the SNC MO HealthNet at the end of the current month.
  2. Approve the MHABD spenddown case with a Title XIX begin date of the first date of the next month.
  3. Send the participant a Notification of Approval for MHABD Spenddown (IM-32SPND).

If no other eligibility exists, initiate action to close the case by sending an advance notice of adverse action (IM-80). If a hearing is not requested close the active SNC case once the IM-80 expires and notify the participant in writing (IM-33) confirming the closing.