0105.045.00 DELAYS IN PROCESSING IM APPLICATIONS

IM applications must be processed without delay unless there are unusual or extreme circumstances. Approve or deny applications within the following timeframes:

1. Temporary Assistance (TA):  The first check or notice of denial must be mailed within 45 days of the date of application.
2. MO HealthNet for Families (MHF:  Mail the notice of approval or denial within 30 days from the date of the application.
3. MO HealthNet for Kids (MHK):  Mail the notice of approval or denial within 30 days from the date of application.
4. MO HealthNet for Pregnant Women (MPW):  Mail the notice of approval or denial within 15 days from the date of application.
5. Supplemental Aid To the Blind (SAB):  Mail the notice of approval or denial within 90 days from the date of application.
6. Blind Pension (BP):  Mail the notice of approval or denial within 90 days from date of application.
7. General Relief (GR):  Mail the notice of approval or denial within 45 days from the date of application.

NOTE: This program is no longer funded.

8. Supplemental Nursing Care (SNC):  Mail the notice of approval or denial within 45 days (if OAA eligibility is used), and 90 days (if using PTD or AB criteria) from the date of application.
9. MO HealthNet for the Aged, Blind or Disabled (MHABD): Mail the notice of approval or denial within 45 days (if based on OAA), or 90 days (if using PTD or AB criteria) from the date of application.

NOTE: For spend down applications, the participant must provide verification of incurred medical expenses for which the individual is responsible to pay before MO HealthNet coverage is activated.

10. Qualified Medicare Beneficiary (QMB):  Mail the notice of approval or denial within 45 days from the date of application. Do not hold a QMB application pending the approval of any other type of assistance.
11. Specified Low Income Medicare Beneficiary (SLMB):  Mail the notice of approval or denial within 45 days from the date of application.
12. Qualified Working Disabled Individual (QWDI):  Mail the notice of approval or denial within 45 days from the date of application.

NOTE: The following applications can be rejected for failure to cooperate or failure to provide verification prior to the application due date if the participant has been provided with at least 2 FA325 Requests for Information and has failed to provide. If the information is provided by or on the final day of the application timeframe as outlined above, the application should be cancel rejected and processed using the original application date:

• Supplemental Aid to the Blind
• Blind Pension
• General Relief (Not currently funded)
• Supplemental Nursing Care
• MO HealthNet for the Aged, Blind or Disabled
• 45 days if using OAA eligibility
• 90 days if using PTD or AB criteria
• Qualified Medicare Beneficiary
• Specified Low Income Medicare Beneficiary
• Qualified Working Disabled Individual

0105.045.05 Reasons for Delay of Application Processing

Record the appropriate reason for delay when IM applications become delinquent. Choose from the following reasons:

1. Agency Delay:  due to an agency delay.
2. Medical Delay:  due to delays in receiving medical information from doctors, hospitals, etc.  or a delay beyond the agency's control in scheduling a doctor's appointment for the claimant.  Also when MRT requests additional medical information.
3. Client Delay:  due to a delay that is STRICTLY the fault of the claimant.  The application cannot be considered client delay on the basis of the applicant's failure to supply requested information unless prior notification was given to the applicant in writing.
4. Level of Care Delay:  when the level of care decision, Initial Assessment - Social History or Medical Summary, NF cash, or NF vendor cases is not received from Central Office Medical Review Unit (COMRU) in a timely manner.  Exception: This does not apply to Temporary Assistance.
5. Hearing or Court Decision Delay:  when an administrative hearing or court decision orders that an application be registered back to the original date of application.