0840.010.30 Decrease in Spend Down Amount – DSS Manuals

IM-55 June 2, 2023 ; IM-126 October 3, 2002 ; IM-106 September 10, 2002

If a change results in the participant’s spend down amount decreasing, MO HealthNet Division (MHD) will adjust the amount of the spend down in their system for the month following the month of the change. The amount in HealthTrack will be reduced for that month, but a new invoice will not be mailed. If the participant pays the new lower amount, MHD will activate coverage for the month. If the participant pays the amount on the original invoice, MHD will activate coverage and refund the difference.

If the change should have taken effect earlier than the month following the month it was entered and the participant has paid in, Family Support Division (FSD) staff will complete a budget in the Worker Initiated Budget Calculation Area (WIBCA) and send to the supervisor for review and approval. Once the WIBCA is completed, a system generated refund will be sent to the Stakeholder Services Unit (formerly the Premium Collections Unit) and approved by the vendor, who processes all invoices.

On cases meeting spend down with bills, take the following action after entering the change:

Re-examine the bills submitted for the months the spend down should have been lower

If the change results in the claimant meeting spend down earlier in the month or with a lower liability on the same day, enter the corrected information