MEMORANDUM

2013 Memorandums

IM-#130      12/31/13

DEPARTMENT OF SOCIAL SERVICES
FAMILY SUPPORT DIVISION
P.O. BOX 2320
JEFFERSON CITY, MISSOURI
TO:
ALL COUNTY OFFICES
FROM:
ALYSON CAMPBELL, DIRECTOR
SUBJECT:
RESPONSIBILITIES OF FAMIS OFFICES FOR MODIFIED ADJUSTED GROSS INCOME (MAGI) CASES

DISCUSSION:

The purpose of this memorandum is to explain roles and responsibilities of the Family Support Division (FSD) staff when the new rules for processing cases under the Modified Adjusted Gross Income (MAGI) rules become effective January 1, 2014.

The programs that are impacted by the new rules include:

GENERAL DISCUSSION:

Applications for the programs listed above that were received on or before December 31, 2013, must be entered and processed in the Family Assistance Management Information System (FAMIS), even if not yet registered in FAMIS. Staff should register the application in FAMIS with the appropriate received date.

Applications for the programs listed above that are received after January 1, 2014, must be entered and processed in the Missouri Eligibility Determination and Enrollment System (MEDES).

All FSD staff will continue to have access to FAMIS after January 1, 2014. Access to the caseworker portal in MEDES will be restricted to staff in the MAGI processing centers in the Jefferson City, Union, and Joplin offices.

For purposes of this memorandum:

FAMIS OFFICES – ROLES AND RESPONSIBILITIES

This section of the memorandum will explain roles and responsibilities of staff in a FAMIS office.

Changes on Active Cases in FAMIS Offices

FAMIS offices will continue to be responsible for active family MO HealthNet cases (not active in MEDES) and can act on changes such as changes of address or income for these cases in FAMIS until:

In one or more of the above circumstances, FAMIS offices must notify the MAGI processing center to enter the case in MEDES by scanning appropriate forms and documentation to the FSD WorkSite SharePoint at http://moteam.state.mo.us/dss03/FSD/WorkSite.

NOTE: Scanning instructions are forthcoming. Do not scan documents to the FSD WorkSite SharePoint until instructions are received.

The MAGI processing center will enter the case in MEDES and close the FAMIS case using the reason “MDS” when:

NOTE:  If the benefits would be better for the individual(s) under existing rules, the case will not be closed and the individual(s) will continue to receive benefits in FAMIS until the next annual review date.

EXAMPLE 1: A family of three has an active case in FAMIS. The family reports a new household member on February 1, 2014. The FAMIS office notifies the MAGI processing center by sending a completed IM-1UA SUPP to the FSD WorkSite SharePoint. The IM-1UA SUPP should be signed by the participant only when the report is made in-person.

The MAGI processing center determines the new household member's eligibility in MEDES. The other three household members are still active in FAMIS. In FAMIS, the children in the household were receiving MHK. In MEDES, the household is eligible for MHF. The MAGI processing center authorizes the benefit in MEDES and closes the case in FAMIS using the "MDS" code.

EXAMPLE 2: A family has an active case in FAMIS. A change is reported to add a new household member. The FAMIS office notifies the MAGI processing center by sending a completed IM-1UA SUPP to the FSD WorkSite SharePoint. The IM-1UA SUPP should be signed by the participant only when the report is made in-person.

The MAGI processing center determines the household is eligible for CHIP. In FAMIS, the children are receiving MHF. For this household, the benefit is better in FAMIS. The children currently active on MHF will continue to receive benefits in FAMIS until the next FAMIS review date. The new household member will receive CHIP benefits through the MEDES system.

If the FAMIS office receives a report of an additional change on the case, check MXIX field "SYS" for code "MS" to determine if the child is active in MEDES. If the child is in MEDES, scan the reported change to the FSD WorkSite SharePoint.

EXAMPLE 3:  A woman on UWHS with children on MHK in FAMIS reports she is pregnant. The FAMIS office notifies the MAGI processing center by sending a completed IM-1UA SUPP to the FSD WorkSite SharePoint. The IM-1UA SUPP should be signed by the participant only when the report is made in-person.

The MAGI processing center applies MAGI methodology to the case. The MPW will be approved in MEDES. The children's benefit using MAGI methodology is the same. The case will be entered in MEDES since the benefit is the same or better. The benefit in MEDES will be authorized and the case in FAMIS will be closed with reason code "MDS".

EXAMPLE 4:  A woman with 2 children is active on MHF. She reports she is pregnant. The FAMIS office notifies the MAGI processing center by sending a completed IM-1UA SUPP to the FSD WorkSite SharePoint. The IM-1UA SUPP should be signed by the participant only when the report is made in-person.

The MAGI processing center applies MAGI methodology to the case. The woman qualifies for MPW and the children continue to qualify for MHF. Since this is the same or better benefit under MAGI methodology, the benefit in MEDES will be authorized and the case in FAMIS will be closed with reason code "MDS".

EXAMPLE 5:  Mom is active in FAMIS on MPW. The child was born on December 28, 2013. The hospital notifies the FAMIS office of the birth. The FAMIS office must complete the newborn eligibility in FAMIS, using current procedures because the birth occurred prior to January 1, 2014.

Mom applied through the citizen portal at https://mydss.mo.gov on January 3, 2014. MEDES will complete an eligibility determination based on this application. The mother and child will be approved for MO HealthNet for Families. Since this is the same or better benefit under MAGI methodology, the benefit in MEDES will be authorized and the case in FAMIS will be closed with reason code "MDS".

Annual Reviews on Active Cases in FAMIS

Staff in FAMIS offices will not be responsible for processing annual reviews for MAGI cases. At the time the annual review becomes due, the notification for the review will be directed to staff in a MAGI processing center. Any documents related to the MAGI annual review that are received in a FAMIS office will be scanned to the FSD WorkSite SharePoint.

NOTE: There will be no annual review for cases in the MAGI categories due in the months of January, February, or March 2014.

NOTE:  If the case requiring annual review is a combination case of more than one assistance type, staff in the FAMIS office will be required to complete the annual review for the non-MAGI assistance program(s).

In-Person Applications

Staff in FAMIS offices will continue to accept and receive applications for MAGI cases. If the applicant comes into a FAMIS office to apply for one of the MAGI programs, and is not applying for or receiving any other type of assistance, staff in the FAMIS office will:

NOTE: If questions arise during the application process through the citizen portal, staff members can call 855-373-9994 for assistance.

If the applicant comes into a FAMIS office to apply for MAGI assistance and one or more other types of assistance, staff in the FAMIS office will:

Applications by Mail, FAX, and Drop-Off

If a FAMIS office receives an application for MAGI assistance only, staff will:

If a FAMIS office receives an application for MAGI and one or more other assistance programs, staff will:

Application Requests by Telephone

If a FAMIS office receives a call from someone who wants to obtain an application for MAGI assistance only, staff will:

If customers request a paper application, staff will mail the IM-1SSL form including the Rights and Responsibilities, the IM-1ADP with adequate pages for the number of household members, and voter registration information.

DETERMINING IF A CASE OR INDIVIDUAL IS ACTIVE IN MEDES

FAMIS offices will review the EU Action Log (EULOG/FM40) screen to determine the status of a MAGI case. If the EULOG shows closed with the reason "MDS" MO HealthNet Benefits Redetermined, the MAGI case is in MEDES. 

FAMIS offices cannot register or approve applications, complete interim changes, or issue benefits in FAMIS for MAGI cases that are closed with reason MDS.

FAMIS offices will review the MO HealthNet Division Title XIX Cross Reference Eligibility Screen (MXIX) field "SYS" for code "MS" to determine if an individual is active in MEDES.

NECESSARY ACTION:

AC/cw/jl


2013 Memorandums