| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | CANCEL CLOSING PROCESS FOR MC+ FOR CHILDREN CHIP PREMIUM CASES |
DISCUSSION:
Effective immediately, MC+ for Children CHIP Premium cases can only be cancel closed by Family Support Division's Income Maintenance Program and Policy Unit. This applies to both Legacy and FAMIS cases. This policy is implemented to prevent loss of coverage for the child(ren). When a CHIP premium case is cancel closed it only restores eligibility, it does not provide coverage to the child(ren). Program and Policy staff must coordinate with MO HealthNet Division (MHD) to ensure that the child(ren) receive coverage once a CHIP premium case has been cancel closed. All requests for cancel closings must be submitted by e-mail to Program and Policy staff through normal Supervisory channels to Jessie Maupin at Jessie.F.Maupin@dss.mo.gov. The case will be approved for cancel closing only if certain requirements are met as discussed later in this memorandum. Program and Policy will review each request, inform supervisory staff of the outcome, and make any necessary adjustments.
Cancel Closings of CHIP Premium Eligibility Units in FAMIS
A block in FAMIS prevents cancel closing on CHIP Premium Eligibility Units when at least one member of the EU was eligible as a CHIP73, CHIP74 or CHIP75. A Family Support Division Supervisor will receive the following message, “Premium level of care CCL action, restricted to Program and Policy” when attempting to cancel close a CHIP Premium EU. An eligibility specialist will receive the message, “Security profile not found” when attempting to cancel close a CHIP premium EU.
Cancel Closings of CHIP Premium Cases in Legacy
A block is added to Legacy which prevents cancel closing for all CHIP Level of Care (LOC) 2 and LOC 3 cases. The error message, “cancel close of premium case only allowed by Prog & Policy” displays on the individual update screen of IMU5 when action is entered to cancel close a case and coverage for any child is entered as a LOC 2 or 3.
Cancel Close Requests and Review Process
CHIP Premium cases may be approved for cancel closing if the following conditions are met:
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Request to cancel close must be e-mailed by supervisory staff to Program and Policy within five (5) working days of the original closing,
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The premium case must have been closed due to a worker error or valid circumstance, and
- The request to cancel close must explain the reason for cancel closing.
Program and Policy reviews the request for cancel closing, informs the supervisory staff of the outcome of the review and makes adjustments to the case as necessary.
Premium cases that have been closed for over five working days, but in need of cancel closing review, may still be submitted for review. Cancel closings for these cases require additional attention to insure coverage.
Examples of Cancel Closing requests:
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Adverse Action due to failure to supply information expires 9/22. Participant brings information to office receptionist as office is closing on 9/22. FAMIS closes CHIP Premium eligibility unit during overnight processing. Cancel closing request sent to Program and Policy 9/24. Case is cancel closed for a valid circumstance as participant provided information by the date requested.
- CHIP Premium case is closed for failure to cooperate with annual reinvestigation. Participant brings in reinvestigation form and information after case is closed. Case is not eligible for cancel closing.
Closing a CHIP Premium case ends coverage for the child(ren). Cancel closing the case only results in eligibility being restored; it does not provide coverage. Program and Policy must coordinate invoicing and payment processing with several MO HealthNet Division units to restore healthcare coverage. Refer to Income Maintenance Memo IM-44, April 18, 2006 for more information regarding CHIP Premium invoicing.
NECESSARY ACTION:
- Send all MC+ CHIP Premium cancel closing requests to Income Maintenance Program and Policy for approval review.
- Review this memorandum with appropriate staff.