1320.000.00  REVIEWS AND INTERIM ACTIVITIES

IM-111, November 26, 2007

BCCT reinvestigations are done every 12 months. A reinvestigation can be completed without a reinvestigation form if the need for continued treatment is verified and other pertinent eligibility criteria are not in question.

BCCT participants are required to report changes in circumstances affecting eligibility factors within ten calendar days of the change. If a change occurs that results in potential eligibility elsewhere (excluding MHABD spend down), explore eligibility for the new category as BCCT should be a last option.

If a participant is determined ineligible on any factor (either at the annual reinvestigation or an interim contact), follow pre-closing/exparte review procedures outlined in Section 1320.005.00.

1320.005.00  PRE-CLOSING / EXPARTE REVIEW

IM-111, November 26, 2007

If a change in circumstances results in a determination of ineligibility for BCCT, eligibility for all MO HealthNet programs must be explored prior to taking action to close the case. All available information should be carefully reviewed. If potential eligibility exists under another program, continue MO HealthNet healthcare coverage under BCCT while exploring the other eligibility.

Do not ask the participant to provide information that is available to the agency or to reverify current case information. In some situations it may be necessary to obtain additional information from the participant to determine eligibility in another MO HealthNet program. Do not discontinue BCCT eligibility until the new eligibility determination is complete.

1320.010.00  CHANGES IN CATEGORIES

When changing eligibility from BCCT to regular MHABD it is necessary to change the entry in Field 23 and Field 13g2 and make other appropriate entries. If an active MA spend down claimant becomes eligible for BCCT, it is not necessary to register a BCCT application. Complete system entries in Section 1315.015.00 to transfer the case to BCCT.

1320.015.00  NEWBORNS

Babies born to BCCT participant qualify for Newborn status.