Knowledge Management Associates (KMA)

Since 1993 the Department of Insurance, Financial Institutions and Professional Registration (DIFP) has contracted with KMA doing business as Missouri Connections for Health to administer the State Health Insurance Assistance Program (SHIP), known as CLAIM. MCH, is proud to serve Missouri’s Medicare beneficiaries, their families, and caregivers through the CLAIM program. The services, including health-related outreach, education, and free, unbiased counseling, are vital to the state, and with MCH's years of experience with this program, we are uniquely positioned to provide these services to ensure the needs of Missouri’s Medicare beneficiaries are met. MCH is dedicated to upholding CLAIM’s mission and supporting the excellent work of our staff, as well as the network of more than 300 volunteer counselors and nearly 200 community partner organizations. CLAIM operates a call center to field requests for assistance from Missouri Medicare beneficiaries and their families and caregivers. Throughout the history of the CLAIM Program, staff and volunteers have assisted with the implementation of new health care legislation and initiatives from the the Balanced Budget Act of 1997 to 2010's Affordable Care Act. The need for health insurance information, counseling and assistance is immense and increasing due to the continuing changes and complexities of Medicare and Medicaid benefit programs. The Balanced Budget Act of 1997 required CLAIM and other SHIP Program staff, community partners, and volunteers to become proficient to educate beneficiaries on a wide variety of Medicare and Medicare-related programs. Milestones of the program include the following.

• Establishment of the Medicare + Choice Program (now called Medicare Advantage Program);
• Addition of Medigap protections;
• Addition of high-deductible Medigap policies;
• Coverage of additional preventative service initiatives
such as mammograms, pap smears and pelvic exams, prostate cancer screenings, colorectal screenings, diabetes self-management education programs, bone mass measurements and expanded immunization coverage;
• Creation of separate Part A and Part B Home Health Benefits. The CLAIM Program was intricately involved in the implementation of The Medicare Modernization
Act (MMA) of 2004. This act was a historically significant implementation of brand new benefit prescription drug coverage. CLAIM staff and volunteers became proficient in this important new legislation and assisted beneficiaries with accessing the following benefits:
• Prescription Drug Discount Program;
• Prescription Drug Benefit;
• Prescription Drug Coverage for Low-income Individuals;
• Expanded Managed Care Options in 2004; and
• Coordination with State Pharmacy Assistance Programs.
The Medicare Improvements for Patients and Provider Act of 2008 (MIPPA) offered improvements to Medicare Benefits, specifically those with low income and changes to the Medicare Advantage Plans. Once again CLAIM staff, community partners, and volunteers became proficient in explaining these changes and assisted beneficiaries with the following benefits:
• Improvements to the Medicare Savings Program
• Increased assets limits;
• Elimination of estate recovery Medicare Savings Program;
• Changes to how life insurance and in-kind support are counted;
• Elimination of the Part D late enrollment penalty for low income beneficiaries; and
• Funding for SHIPs and other organizations to expand outreach and enrollment efforts;
• Phase-in of Mental Health Coinsurance Parity from 2010 to 2014; and
• Improvments to the Welcome to Medicare Exam by extending eligibility from six months to one year. In 2010 the Affordable Care Act brought additional changes to the Medicare Program and added responsibilities to educate the public. CLAIM staff, community partners, and volunteers became proficient at explaining the following added benefits:
• Annual Wellness Visits,
• Tobacco Use Cessation Counseling,
• Elimination of the Medicare Part B deductible and/or copayment, for services such as the following:
• Bone mass measurement;
• Cervical cancer screenings, including pap smear tests and pelvic exams;
• Cholesterol and cardiovascular screenings;
• Colorectal cancer screenings;
• Diabetes screenings; and
• Mammograms and prostate cancer screening.
• Elimination of the coverage gap starting at 50% reduction in 2011. CLAIM staff, community partners, and volunteers are prepared to build on the success of our current program to enhance our capabilities and capacity to meet the growing and evolving need for Missouri Medicare beneficiaries to be informed about their health care coverage and choices.

Missouri Connections for Health holds a contract with Missouri Foundation for Health to provide the Cover Missouri Call Center, operating a statewide call center for individuals who seek Affordable Care Act assistance. The Customer Service Representatives at the Cover Missouri Call Center assist with general questions, make referrals and/or appointments for consumers to meet with in-person assisters/CACs in their area for enrollment help, and refer consumers to low/no-cost health resources in their area if they are ineligible to get covered.