MEMORANDUM

DISCUSSION:

The purpose of this memo is to introduce a new Family Support Division (FSD) Spend Down Calculator. This is a tool to assist the eligibility specialists (ES) in determining spend down. ES should use this calculator to enter and track bills submitted by MO HealthNet Aged, Blind and Disabled spend down participants.

Complete a separate calculator for every spend down participant or couple case with incurred medical expenses, using out-of-pocket expenses, or using a combination of pay-in and incurred medical expenses. The worksheet calculates the date the spend down is met based on the data entered by the ES.

This calculator will track:

• date(s) of service;
• service code(s);
• participant's  provider(s);
• the total medical expense(s);
• Third Party Liability;
• the participant's personal liability;
• a summary of all the above for each month;
• and, a summary of the liability by the participant throughout the year by month.

A drop down window provides the ES with options for how each expense is applied to meet the participant's spend down amount. The options are:

1. Incurred
2. Not covered by MO HealthNet
3. Paid by customer
4. Check received

The calculator tracks transactions by date of service and displays the date the participant is eligible for MO HealthNet coverage with the liability the participant owes the provider(s). This is the information that must be entered on the MO HealthNet Division Add Spenddown Coverage (MSPA) screen. Print a copy of the completed spreadsheet each month that an entry is made and retain in the participant's file.

A statewide shared drive labeled "FSD-Spenddown-Users" was created to store the spend down calculator spreadsheets. All ES, ES supervisors and managers that attended the January 2012 spend down training have been given access to the FSD-Spenddown-Users shared drive.

Create a separate spreadsheet for each participant and their spouse. Save each participant's spreadsheet on the FSD-Spenddown-Users drive by the 10 digit DCN, followed by the last name, first name of the Head of Household as listed on the FAMIS Program Participation (FAMISPAR/FM0D) screen.

Save the work sheets in the folder of the participant's residence county – NOT the FSD office that maintains the case. The residence county is indicated in the Co (county) field on the Supercase Address/Supercase Transfer (ADDRESS/FM0A) screen in FAMIS. SETTING UP A NEW CALCULATOR gives step-by-step instructions on how and where to save each individual calculator.

To request access to the FSD-Spenddown-Users drive, the local office security officer must submit an Automated Security Access Processing (ASAP) form and state in the comments "please add fsd-spend down-users" To remove access to the drive, submit an ASAP form and  state, "please remove fsd-spend down-users".

The Spend Down Calculator is available in the Medical Assistance manual as Appendix G. The Spend Down Calculator and Expense Log Instructions are Appendix H. The "Setting Up a New Calculator" is Appendix I.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Immediately begin using the Spend Down Calculator to track incurred medical expenses and to determine the date spend down is met.
• Submit ASAP forms as needed for staff to have access to the FSD-Spenddown-Users drive.

ATTACHMENTS:

• Appendix G
• Appendix H
• Appendix I

AC/dbh jm