MEMORANDUM

DISCUSSION:

The purpose of this memorandum is to introduce the new MO HealthNet Spend Down Transportation Log (IM-29TE). Use of the log may allow more timely determination of the participant's MO HealthNet coverage start date.

A printable version of the MO HealthNet Spend Down Transportation Log (IM-29TE) can be found in the forms manual and also on the Department of Social Services website at MO HealthNet for the Elderly, Blind and Disabled.

Participants who wish to claim transportation costs toward their spend down may complete and return this log to any Family Support Division (FSD) office. The participant will need to attach a receipt or bill for the medical service received, such as receipt for prescription(s) picked up at pharmacy or doctor appointment.

After receiving the information in the local FSD office, staff should send the information, via SharePoint, to the appropriate Spend Down Unit (SDU). The SDU will evaluate the information and notify the participant.

• When the log is received with all of the required information, and the participant meets spend down with the expenses listed on the form, or with a combination of the expenses listed on the form and other submitted expenses, authorize the spend down coverage and notifiy the participant using the Spend Down Notification IM-29 (SPND) form.
• When the log is received with none or only part of the required information, send the IM-29 (SPDN) form to the participant listing the date on Transportation Expense Log, the provider information, and explaining the reason it was not applied to the spend down liability.
• When the log is received with medical expenses that are not allowable expenses to meet spend down, send the IM-29 (SPND) form to the participant listing the expenses that were not used to meet spend down with the reason it was not applied to the spend down liability.

  NOTE: If participant is receiving Consumer Directed Services (CDS) they are not eligible to use transportation charges to meet their spend down, as transportation is a covered service of CDS.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Provide the form to participants who request a copy of the form.
• Effective immediately, accept a completed MO HealthNet Spend Down Transportation Expense Log as documentation of incurred medical transportation expenses to meet spend down when a receipt or bill for the service has been attached.

ATTACHMENTS:

• MO HEALTHNET SPEND DOWN TRANSPORTATION EXPENSE LOG

AC/df