MEMORANDUM

DISCUSSION:

The purpose of this memorandum is to introduce the code “CTV- Citizenship Verification Not Provided” to remove active MO HealthNet participants who have not cooperated in providing verification of citizenship within 90 days from approval for MO HealthNet benefits. This code is available for use effective November 25, 2013.

This memorandum discusses the following:

• CASES THAT DO NOT PROVIDE CITIZENSHIP AND ID VERIFICATION PRIOR TO APPROVAL
• IDENTIFYING CASES WITH PARTICIPANTS WHO HAVE NOT PROVIDED CITIZENSHIP VERIFICATION WITHIN 90 DAYS
• ENTRY OF CTV-CITIZENSHIP VERIFICATION NOT PROVIDED CODE
• NOTICES
• USER GUIDE

CASES THAT DO NOT PROVIDE CITIZENSHIP AND ID VERIFICATION PRIOR TO APPROVAL

As discussed in IM-#54, dated July 21, 2009 and IM-#49, dated August 25, 2011, if an applicant does not have verification of citizenship when making an original application for MO HealthNet, he/she is allowed a reasonable amount of time to provide verification of citizenship. The Family Support Division defines a “reasonable amount of time” as 90 days. If an applicant meets all other eligibility criteria except citizenship verification, the application for MO HealthNet (MHN) is approved.

NOTE: Documentation of citizenship includes proof of identity. Therefore, the application may be approved pending documentation of citizenship even when proof of identity has not been provided.

When completing the controlled flow for an applicant who meets all eligibility requirements other than documentation of citizenship, the ES will take the following actions:

• Enter “Pend” in the Citizen Document field.
• Leave the Verification field blank.
• Complete the controlled flow. The TECH result for citizenship shows pending and there is an outstanding verification for documentation of citizenship.
• Create a Request for Information (FA-325) to send to the participant. In the Text field of the FA-325, enter the following:
  • Please provide documentation of citizenship and identity. If citizenship and identity documentation is not provided within 90 days, MO HealthNet benefits will be closed for all individuals who have not provided the documentation.
• Fastpath to the Citizenship Verification (FM8X/CITVERF) and enter “CS” in the Verification field.
• Complete an eligibility determination (EDRES). The case passes on citizenship.

NOTE: IM-#49, dated August 25, 2011 includes instructions to send an additional FA-325 90 days after approval. This step is no longer valid as the participant will be informed of the 90 day limit with the FA-325 sent during the application process.

IDENTIFYING CASES WITH PARTICIPANTS WHO HAVE NOT PROVIDED CITIZENSHIP AND ID VERIFICATION WITHIN 90 DAYS

FAMIS does not have an automated process in place to remove active participants who fail to provide verification of citizenship within 90 days of approval.

A monthly report is compiled that identifies cases that have not had hard copy verification entered on the Citizenship Verification (FM8X/CITVERF) screen. The Citizenship and ID Pending More than 90 Days Report is emailed to each individual county email address on the 4th of the month. The subject line of the email includes FAMRC151 MO HealthNet Citizenship Pending Over 90 Days Report.

Each office will develop a procedure to have the report distributed to the appropriate eligibility specialists (ES) to complete the action to remove the participants.

ENTRY OF CTV-CITIZENSHIP VERIFICATION NOT PROVIDED CODE

When the Citizenship and ID Pending More than 90 Days Report is received by the ES, the ES will review the case file to ensure citizenship and id verification has not been received. If verification of citizenship and id has been received, the ES will enter hard copy (HC) in the Verification (VER) field on the Citizenship Verification (FM8X/CITVERF) screen and make a clear comment explaining what verification has been received.

If verification of citizenship and id has not been received, the ES will complete the entry of the code CTV-Citizenship Verification Not Provided on the Eligibility Unit Member Role (FM3Z/CITVERF) screen and an eligibility determination (EDRES) to remove the participant from the active case. A FAMIS User Guide has been added to the intranet with the steps to complete the action.

The ES must make a clear comment explaining why the participant is being removed from the case.

NOTICES

A MO HealthNet Adverse Action Notice (FA-410) will be sent for Family Healthcare cases. A MO HealthNet Action Notice (FA-450) will be sent once the adverse action notice expires. The reason for closing listed on both the FA-410 and FA-450 is Citizenship Verification Not Provided with a legal reference of RSMo 208.040, 42 CFR 435.406 and RSMo 208.009.

An Adult MO HealthNet Adverse Action Notice (FA-420) will be sent for Adult MO HealthNet cases. An Adult MO HealthNet Benefit Notice (FA-460) will be sent once the adverse action notice expires.  The reason for closing listed on both the FA-420 and FA-460 is CTV- You are not eligible for MO HealthNet benefits because you have not provided verification or documentation of your citizenship. The legal reference listed on both notices is 42 CFR 435.406 and RSMo 208.009.

USER GUIDE

A FAMIS User Guide REMOVING AN INDIVIDUAL FOR FAILING TO PROVIDE CITIZENSHIP VERIFICATION has been added to the intranet.

To access the guide:

• From the Family Support Division (FSD) Intranet, under Quick Links on the right side of the screen, click on Manuals & Memos to go to the Policy/Procedure screen;
• From the Policy/Procedure screen under Quick Links on the right side of the screen, click on FAMIS User Guides;
• On the FAMIS Guides screen, click on the User Guides; and
• From the FAMIS User Guides screen, click the name of the guide to view.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

AC/ha