1800.005.00 Legal Basis – DSS Manuals

IM-90 November 1, 2023 ; IM-04 January 20, 2016

42 CFR 435.907 under authority of the Social Security Act provides requirements for application, determination of eligibility and furnishing of assistance for Medicaid programs.

13 CSR 40-2.010 states that any person shall have the right to file an application for any type of assistance or service administered by the Family Support Division. The Family Support Division shall inform the applicant of the types of assistance and services which are available, the requirements of eligibility, and additional information necessary, if any, to determine eligibility. It is the right of any individual to apply for benefits, including individuals who are clearly ineligible.

13 CSR 40-7.015 states that an application for any Family MO HealthNet program or the Children’s Health Insurance Program (CHIP) shall be accepted by mail, telephone, or in person at any Family Support office, or via the department’s Internet website found at dss.mo.gov. The division shall also accept applications through providers who the division contracts with in order to facilitate eligibility decisions.

42 CFR 435.945(j) and 457.380(j) require state Medicaid and CHIP agencies to develop and maintain a MAGI State Eligibility Verification plan outlining policies, processes and data sources used to determine MAGI Eligibility. The Missouri MAGI Verification Plan was updated in 2023 and is posted on Medicaid.gov .