- TO:
- ALL FAMILY SUPPORT DIVISION OFFICES
- FROM:
- JULIE GIBSON, DIRECTOR
- SUBJECT:
- INTRODUCTION OF MAGI NOTICE OF CASE ACTION (IM-33 MAGI) FORM
- FORMS MANUAL REVISION #14
DISCUSSION:
The purpose of this memorandum is to introduce a new form, MAGI Notice of Case Action (IM-33 MAGI). This form may be used immediately.
The Family Support Division began determining eligibility for Family MO HealthNet programs using Modified Adjusted Gross Income (MAGI) January 2014. Since then, staff reported a number of circumstances not addressed with other available forms. Additions specific to the IM-33 MAGI are:
- Notification that review was completed and there are no changes;
- MO HealthNet coverage has changed for specific individuals in the household;
- Notification that participant is not required to pay a premium;
- Multiple reasons for a change in coverage;
- Transitional MO HealthNet eligibility concerns; and
- Notification an Ex Parte Review was completed and the outcome.
This form must be used when manual adjustments to a case are completed and notification is necessary.
A sentence at the bottom was added to comply with a federal regulation to advise participants to report any change in circumstance within ten (10) days.
NECESSARY ACTIONS:
- Review memorandum with staff
- Begin using this form immediately, when applicable.
ATTACHMENTS:
JG/df/mks