MO HB961

Establishes specific eligibility criteria for MO HealthNet coverage including Missouri residency, valid Social Security number, U.S. citizenship or qualified alien status, and pregnancy verification for pregnant women applicants.

Requires annual eligibility reviews of all MO HealthNet participants effective January 1, 2014, and mandates that applications be submitted in accordance with federal requirements (42 CFR Section 435.907) with all necessary documentation provided.

Creates two eligibility pathways: mandatory coverage for families, pregnant women, children, and CHIP-eligible children using specified income standards based on AFDC levels or federal poverty percentages; and alternative coverage for adults age 19-64 with income at or below 100% of federal poverty level.

Limits alternative benefit package coverage to non-medically frail adults at poverty level, while medically frail individuals receive full coverage; establishes screening process with departments of mental health and health and senior services to determine medical frailty status.

Authorizes department of social services to provide premium subsidies for employer-provided health plan enrollment and requires submission of state plan amendments and waivers to Centers for Medicare and Medicaid Services to implement the program changes.