IM-71 06/14/02 CHANGES
TO MC+ COVERAGE FOR EXTENDED WOMENS' HEALTH SERVICES AND NON-CUSTODIAL
FAMILY HEALTHCARE REVISION #22
SECTIONS: 0925.005.00, 0925.050.00, 0925.050.10, 0925.050.20, 0925.050.25, 0935.000.00 - 0940.025.00
|CHANGES TO MC+ COVERAGE FOR EXTENDED WOMENS'
HEALTH SERVICES AND NON-CUSTODIAL PARENTS
FAMILY HEALTHCARE REVISION #22
SECTIONS: 0925.005.00, 0925.050.00, 0925.050.10, 0925.050.20,
0925.050.25, 0935.000.00 - 0940.025.00
|House Bill 1111 reduced the time limit
for the Extended Women's Health Services program from twenty-four (24)
to twelve (12) months. This bill also eliminated MC+ healthcare coverage
for non-custodial parents effective July 1, 2002. This includes both
the MC+ for non-custodial parents with income under 125% of poverty (NCP)
program and the MC+ for Parents' Fair Share participants (PFS) program.
All active MC+ for NCP and PFS cases and EWHS cases active twelve (12) or more months will be closed by the system on June 29, 2002. MC+ healthcare coverage for these recipients will end June 30, 2002. Advance notice of the change (copies attached) will be mailed to NCP and PFS cases on June 17, 2002. Advance notice will be sent to EWHS recipients on June 18, 2002. The advance notice informs the recipients they may remain eligible if they are blind, disabled, and pregnant or have a change in income. If the recipient responds to the Advance Notice indicating other possible eligibility, register the appropriate (MA, MC+ for Pregnant Women, MAF) application in IAPP.
Advance notices (see attached) are being sent June 18, 2002 to the remaining active EWHS cases notifying the women of the reduction in the time limit and advising them of the new ending date of eligibility.
HEARING PROCEDURES FOR NCP AND PFS CASES
The recipients have a right to appeal the loss of healthcare coverage. The caseworker must screen hearing requests to determine if the change in state law is the sole reason for the request, however the Hearing Unit will make the final decision on this issue. The advance notice gives NCP and PFS recipients until June 27, 2002, to request a hearing. The Advance Notice will inform the NCP and PFS recipients of the date and time a hearing will be held, if requested. Hearings for NCP and PFS recipients will be held June 28, 2002 at 8:00 a.m. This allows the Hearing Unit to make a decision prior to June 29th.
If a hearing is requested by June 27th, staff must determine if the request is due to the change in state law or for another reason. Staff must clearly indicate on the Application for State Hearing (IM-87) form whether the reason for the hearing is the change in state law or something else. The IM-87 must be faxed to the Hearing Unit on the date the request is received. The original IM-87 must still be mailed to the Hearing Unit.
If the reason for the hearing request is for a reason other than the change in state law, benefits must continue pending the outcome of the hearing. Normal hearing procedures will apply to these requests. Advise the claimant to disregard the hearing date shown on the advance notice because they will be notified by the Hearing Unit of a new hearing date. To prevent the system from closing the case send an e-mail to the IM Program and Policy unit (F051XIX). The e-mail should state that the NCP or PFS recipient listed has requested a hearing for a reason other than the change in State law and give the recipient's stated reason.
HEARING PROCEDURES FOR EWHS RECIPIENTS
EWHS recipients have until June 28, 2002, to request a hearing. Hearings for proposed closing and shortening of the eligibility period of EWHS are to be handled using normal hearing procedures. Staff must clearly indicate on the Application for State Hearing (IM-87) form whether the reason for the hearing is the change in state law or something else.
For hearings requested on EWHS cases to be closed on June 29th due having received for over 12 months, send an e-mail to the IM Program and Policy unit (F051XIX) to prevent the system from closing the case. The e-mail should state that the EWHS recipient listed has requested a hearing for a reason other than the change in State law and give the recipient's stated reason.
NEW EWHS CONVERSIONS FROM MPW:
Effective July 2002 MPW cases converted to EWHS will be given a 12-month eligibility period. The system generated ex-parte notices have been revised to reflect this change.
NCP AND PFS APPLICATIONS TAKEN PRIOR TO 7/1/02:
Through June 28, 2002, all NCP and PFS applications should be approved (if eligible) following normal procedures. However, for new approvals completed after June 15, 2002, the approval notice must state that the eligibility will end June 30, 2002, due to the elimination of the program by House Bill 1111. It should also cite 13CSR 70-4.090 effective July 1, 2002.
Effective July 1, 2002, IMU5 will no longer allow approvals of MC+ for NCP and PFS (type of assistance X) cases. If eligibility dates for prior to July 1, 2002, is established after June 28, 2002, it will be necessary to contact State Office for entry of the approval.
NCP and PFS Advance Notice (pdf)
EWHS Recipients Advance Notice (pdf)
Remaining Active EWHS Cases Advance Notice (pdf)