SUBJECT:
ELIMINATION OF GENERAL RELIEF STATE MEDICAL BENEFITS
DISCUSSION:
Missouri House Bill 11 (2005) did not provide funding for General Relief (GR) State Medical benefits effective July 1, 2005. RSMo 208.162 requires that benefits be eliminated when appropriated funds are not sufficient to pay for the benefits.
Effective July 1, 2005, GR State Medical benefits end, the last day of coverage is June 30, 2005. This does not apply to Refugee Assistance, MA-GR or MPW-GR cases as those categories provide federally-funded Medicaid rather than state-only funded GR Medical.
State Office will send an adverse action notice to GR cases that are active on June 4, 2005. On June 8 2005, the notice will be mailed to the recipients informing them of their ineligibility for continued coverage and their hearing rights. The notice gives the recipient until June 20, 2005 to request a hearing. The notice specifies the date and time the hearing will be held. The hearings are scheduled for 8:30 a.m. and 1:00 p.m. on June 22, 23, 24 and 27, 2005. A copy of the notice is attached to this memo. Fax and mail the Application for State Hearing (IM-87) form to the Hearings Unit the same day the request is received. Notate on the IM-87 that the hearing is concerning the change in the law eliminating GR State Medical benefits. If a claimant states that they have special needs or require other special accommodations to be able to participate in the hearing, ask the individual to call the Hearing Unit at 573-526-5240 by June 20, 2005.
The notice also instructs GR recipients who feel they are disabled and need medical coverage to contact the local Family Support Division office for information on other programs. If a recipient contacts your office, inform them of the eligibility requirements for our other healthcare programs (MA, MPW, etc.). If the recipient would like an eligibility determination for another program, inform them they will have to make a new application.
Medicaid ex-parte requirements do not apply, as General Relief is not a federally funded Medicaid program.
County offices will receive a report of all cases notified of the termination of General Relief Medical Benefits and a copy of the each recipient’s individual notice.
ACTION ON CASES AFTER JUNE 4, 2005
For cases approved beginning June 6, 2005, on the approval letter (IM-32) include the following statement:
“You are not eligible for medical coverage after June 30, 2005, as House Bill 11 (2005) did not provide funding for General Relief State Medical benefits after June 30, 2005 (RSMo 208.162)”.
Enter this statement in Box 4 (other) of the IM-32.
On June 25, 2005 the system will close all active General Relief cases. For cases approved beginning June 27, 2005, the system will automatically enter a coverage end date of June 30, 2005. The system will adjust all active MA-GR cases from LOC “A” to LOC “T”.
For GR applications taken through July 31, 2005, process in the same manner as you currently do, except benefits must end June 30, 2005.
MPW-GR cases will be manually adjusted by state office.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- On approval letters after June 4, 2005, include the statement contained in this
memorandum concerning General Relief Medical Coverage ending on June 30, 2005.
GLS
ATTACHMENTS:
Advance Notice of GR Medical Ineligibility
Closing Notice for GR Medical