South Carolina Code of Regulations
Chapter 126 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
Article 3 - MEDICAID
Subarticle 2 - ELIGIBILITY FOR THE MEDICAL ASSISTANCE (MEDICAID) PROGRAM
Section 126-350 - Definitions

A. Medicaid is the common name for Title XIX of the Social Security Act.

B. Medicare is the common name for Title XVIII of the Social Security Act.

C. Supplemental Security Income (SSI) is the common name for Title XVI of the Social Security Act. It is administered by the Social Security Administration (SSA).

D. Medical Assistance Only (MAO) is the common name for those programs that provide medical assistance and services to eligible recipients, but which do not provide any cash assistance.

E. Medicaid Cap is the gross monthly income limitation which is established by the South Carolina General Assembly. An individual whose monthly income, before deductions, exceeds this limitation shall not be eligible for MAO.

F. A medical institution is a licensed institution, organized and authorized under State law to provide medical, nursing and convalescent care.

G. Community Long Term Care (CLTC) performs certification of medical necessity and level of long term care for Medicaid applicants and recipients.

H. Recurring Income, also known as patient liability, is the individual's gross income, less certain exclusions as defined by federal regulation, that the individual must apply to the cost of care.

I. Personal Needs Allowance is the amount that is set aside from the individual's income for his personal needs, such as clothing, toiletries and incidentals. The allowance, set by the Title XIX State agency for persons in certified medical facilities, varies according to the category of assistance for which the person qualifies. The appropriate personal needs allowance for each category of assistance is found in the Title XIX State Plan.

J. Vendor Payment is the net payment made by the agency to a medical facility for an individual's cost of care after deducting the individual's recurring income, if any, from the South Carolina Medicaid rate of payment.

K. Categorically Needy means aged, blind, or disabled individual or families and children who are otherwise eligible for Medicaid and who meet the financial eligibility requirements for Aid to Families with Dependent Children (AFDC), SSI, or an optional State supplement, or are considered under section 1619(b) of the Social Security Act to be SSI recipients; or whose categorical eligibility is protected by statute.

L. Federal poverty level means the non-farm poverty level for the appropriate family size as published by the federal Office of Management and Budget (OMB) and revised yearly.

M. Deleted.