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PA Bulletin, Doc. No. 15-879

NOTICES

Chronic Renal Disease Program Income Criteria

[45 Pa.B. 2321]
[Saturday, May 9, 2015]

 The Department of Health (Department) provides notice of intent to implement the following income criteria for the Chronic Renal Disease Program (Program), effective immediately.

Income

 New Program applicants must have an annual household income of 0% to 300% of the Federal Poverty Income Guidelines (FPIG) as published by the United States Department of Health and Human Services (HHS) in the Federal Register and any revisions thereto (to the extent services are not covered by Medical Assistance). Current enrollees must meet the same eligibility criteria at the time of renewal as new applicants. A Patient Share of Cost will be applied on a sliding scale to applicants with an annual household income of 185% to 300% of the FPIG as published by the HHS in the Federal Register and any revisions thereto. Applicants must submit their Federal 1040 tax return from the prior calendar year to verify annual household income. If no Federal 1040 tax return was filed, other supporting documentation of annual household income is required.

 For additional information or for persons with a disability who require an alternative format of this notice (for example, large print, audio tape or Braille), contact Carolyn S. Cass, Director, Bureau of Family Health, Division of Child and Adult Health Services, 7th Floor East, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120, (717) 772-2762, or for a speech and/or hearing impaired persons, call V/TT (717) 783-6514 or the Pennsylvania AT&T Relay Service at (800) 654-5984.

KAREN M. MURPHY, PhD, RN, 
Acting Secretary

[Pa.B. Doc. No. 15-879. Filed for public inspection May 8, 2015, 9:00 a.m.]


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