Redetermination Qualifications in Missouri

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Medicaid Enrollee Redetermination - Missouri

In the state of Missouri, third-parties can directly connect with Medicaid enrollees regarding their redetermination if the enrollee gives their express permission for information sharing. Otherwise, enrollees' information is protected by privacy and information-sharing laws that prevent the state from disclosing any personal information about its enrollees.

Third-party authorization for Missouri medicaid enrollees

The Medicaid system in Missouri is called MO HealthNet. Within their guidance documents is detailed information about how third-parties can be authorized to assist with applicant redetermination. The enrollee must complete an authorization form (IM-6AR), electing to appoint an authorized representative to access their personal and financial information and discuss their case with the state on the applicant's behalf. The representative can be any one of the applicant's choosing; this includes other family members, attorneys, organizations, other state agency workers, healthcare providers or any competent person. The state cannot release any information about Medicaid enrollees until the form has been processed and the third-party designated as valid.

Medicaid enrollees cannot authorize a third-party under certain circumstances, including if they have been deemed incompetent by a court, under duress or fraudulently. Organizations wanting to act as a third-party representative (for redetermination or otherwise) must provide the name, phone number and address of an individual at that organization who will serve as a point of contact.

The third-party authorization will be valid until thirty days after the appointment if an application is not been received by the state. Additionally, the authorization ends if revoked by the applicant or upon the death of the applicant. Otherwise, the third-party can continue to act during subsequent redeterminations, as long as when the applicant continues to confirm they are happy with authorization when, or if, asked.

Other information about Missouri medicaid redetermination

Missouri has been in the news recently for its sharp decline in Medicaid enrollment. The recently-updated redetermination system is widely blamed for a 7.2% drop in Medicaid participants, though the state officially cites the reason behind this drop is due to an improving economic situation. Experts believe the computer system used for Medicaid redetermination is "notoriously bad", and the call center for helping people re-enroll is chronically understaffed. Under the new system in 2018, those needing to submit additional supporting information to prove their continued eligibility had to do so via phone or mail, which combined with non-prepopulated long application forms, likely contributed to many people being unable to renew, since they were only given ten days to respond to requests for additional information before they were cut off from Medicaid benefits.

Additionally, MO HealthNet, unlike other state's Medicaid programs, does not use data from other public assistance programs like SNAP or TNAF, which meant many families likely missed out on automatic re-enrollment.
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