55 Pa. Code § 181.451. General policy on posteligibility determination of eligibility for MA payment toward cost of care in institutions.

POSTELIGIBILITY DETERMINATION PROVISIONS

§ 181.451. General policy on posteligibility determination of eligibility for MA payment toward cost of care in institutions.

(a)  A person who is eligible for MA and who requests an MA payment toward his cost of skilled care, heavy care/intermediate services or intermediate care, including services in an ICF/MR facility shall have his total gross income considered to determine the amount he is expected to pay toward his cost of care. This process is separate from the eligibility determination for MA eligibility. The total gross income considered to determine the amount the MA eligible person shall pay toward his cost of care includes income amounts previously deducted in determining MA eligibility.
(b)  The Department will reduce its payment for skilled care, heavy care/intermediate services, intermediate care or services in an ICF/MR facility by the amount of income available from an MA eligible person toward his cost of care.

Authority

   The provisions of this §  181.451 issued under section 403(b) of the Public Welfare Code (62 P. S. §  403(b)).

Source

   The provisions of this §  181.451 adopted August 26, 1988, effective November 1, 1988, 18 Pa.B. 3949; amended August 28, 1992, effective upon publication and apply retroactively to October 1, 1989, 22 Pa.B. 4432. Immediately preceding text appears at serial page (165982).

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