Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 101 - Coverage Groups and Processing Applications and Reviews Redetermination Processes
Chapter 15 - Other Changes - Aged, Blind and Disabled (ABD) Programs
Rule 23-101-15.1 - Changes in Medicaid Income
Universal Citation: MS Code of Rules 23-101-15.1
Current through September 24, 2024
A. Medicaid income is defined as the amount of income an institutional beneficiary must pay to the nursing facility toward the cost of his or her care.
B. Changes in income, marital status or non-covered medical expenses will increase or decrease Medicaid income with the effective dates of such changes determined as follows:
1. A decrease in Medicaid income is effective
the month in which the change is reported or becomes known to the Division of
Medicaid.
2. An increase in
Medicaid income requires advance notice to the beneficiary advising of the
increase.
a) Advance notice for Medicaid
income increases is based on issuing notice ten (10) days before the date the
Division of Medicaid makes its payment to the nursing facility.
b) If a state or local hearing is requested
within the advance notice period, the increase is not effective until the final
hearing decision is rendered.
3. A temporary decrease in Medicaid income
occurs due to the allowance of a deduction including, but not limited to, a
health insurance premium or other non-covered medical expense.
a) Medicaid income is subsequently returned
to the amount previously in effect.
b) This action is not considered an increase
in Medicaid income subject to advance notice.
4. An increase in Medicaid income combined
with a closure occurs when income is counted in the month received and receipt
of the income also renders the beneficiary ineligible. The excess income is
included in the Medicaid income computation provided there are ten (10)
calendar days left in the month of receipt to allow for advance notice.
5. A temporary increase in
Medicaid income occurs when excess resources are not an issue, but receipt of
additional income results in the monthly income total being over the income
limit for long-term care eligibility.
a) The
case will remain open if there is not time to allow for advance notice of
closure.
b) If there are ten (10)
calendar days left in the month, Medicaid income is increased to the amount of
that month's income or the Medicaid reimbursement per-diem rate for the
facility, whichever is less.
42 C.F.R. § 435.725.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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