Reasonable Opportunity to Provide

Reasonable Opportunity is a period of time participants are allowed to provide documentation of citizenship status and Identification, if unable be verified at application or before approval.

 

Allow reasonable opportunity for citizenship status when the participant is requesting MO HealthNet (MHN) benefits and has submitted a signed MHN application or signed an IM-40 Citizen/Eligible Immigrant Attestation form to declare his or her status.

 

Allow reasonable opportunity for proof to identity when identity is needed to verify citizenship.

 

The 95-day reasonable opportunity period begins the day the MO HealthNet application is approved. The participant has 90 days plus 5 days mail time, for a total of 95 days, to verify the information. Reasonable Opportunity evidence in MEDES will track the verification.

 

TO CREATE NEW REASONABLE OPPORTUNITY EVIDENCE

 

NOTE: This is not evidence you add. Reasonable Opportunity Evidence is created when 90 Day Reasonable Opportunity is used as a verification item. See step 2b.

 

    1. If acceptable verification is not provided with the application or found with existing data sources, documentation must be requested. An IM-31A Request for Information form must be sent to the participant requesting the required documents within 10 days. See Generate Request for Information User Guide
    2. When all other eligibility criteria is met except citizenship status and/or Identity:
      1. Allow a 95-day reasonable opportunity period for the participant to provide his or her citizenship documents and/or Identification.
      2. Verify Citizenship Status/Identity evidence with verification item, 90-Day Reasonable Opportunity Period, until proof has been provided. See Verify all Outstanding Evidence
    3. Authorize the MAGI application. Do not deny or delay the approval pending citizenship/identification documents if all other eligibility factors are met.

 

NOTE: Until the changes are complete, send a manual IM-32 Approval Notice with the below specific language to all participants approved while pending verification of citizenship, nationality, or eligible immigrant status. Save a copy to the ECM and include a comment on the HOH person page.

      • Proof of [Choose one of the following] Citizenship/national/qualified immigration status was requested for _____ and was not provided.  _____ was approved for MO HealthNet, but may lose coverage if his/her proof of [choose one of the following] citizenship/national/qualified immigration status is not provided within 95 days of this letter. Contact FSD if you have a delay in obtaining this verification.

 

NOTE: The system will end date the Reasonable Opportunity evidence once the verification is added, evidence applied, and case is finalized.

 

NOTE: At the end of 95 days, a BPT may review and extend the Reasonable Opportunity period an additional 90 days on an as-needed basis. See Edit Reasonable Opportunity Evidence

 

NOTE: If coverage ended after the 95 day reasonable opportunity period because the individual failed to provide citizenship, only authorize another 95 day reasonable opportunity period if re-applying.