IM-066 – MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) WHEN RECEIVING MEDICARE DUE TO END STAGE RENAL DISEASE

FROM:  PATRICK LUEBBERING, DIRECTOR

SUBJECT:  MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) WHEN RECEIVING MEDICARE DUE TO END STAGE RENAL DISEASE

MANUAL REVISION #44

1060.005.00 

 

DISCUSSION:

Receipt of Medicare due to end stage renal disease (ESRD) is sufficient to establish disability for MHABD programs without a Medical Review Team (MRT) determination in most instances.

The manual has been updated to clarify when an MRT decision is required for individuals receiving Medicare due to ESRD.

An MRT decision is required for participants receiving Medicare due to ESRD only when:

  • The individual’s earned income exceeds the Substanial Gainful Activity (SGA),
  • It has been more than 12 months since the individual received a kidney transplant, or
  • The individual is no longer receiving Medicare, unless approved for SSI, SSDI, or is age eligible for MHABD.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

PL/vb