55 Pa. Code § 178.123. Determining the spousal share of resources at the same time the institutionalized spouse applies for MA.

§ 178.123. Determining the spousal share of resources at the same time the institutionalized spouse applies for MA.

(a)  The CAO is responsible for determining the spousal share of resources if one of the following exists:
   (1)  The spousal share of resources was not determined by the central assessment unit before the MA application.
   (2)  The total countable verified resources owned by the couple at the time of the MA application is more than the standard community spouse resource standard plus the resource limit in Appendix A for the appropriate MA Program.
(b)  The spousal share determination is based on the total countable verified resources owned by the couple when the spouse was institutionalized for NFC or services in an ICF/MR facility.
(c)  The spousal share and each spouse’s individual legal share shall be determined before the authorization of an MA NFC or services in an ICF/MR facility payment.
(d)  Resources that are excluded in determining the total countable resources of the couple are specified in § §  178.61—178.81 (relating to resource exclusions for the aged, blind and disabled categories of MA).
(e)  Each spouse and, when applicable, the person acting on behalf of either spouse, is notified in writing on the Department’s approved notification form of the spousal share amount and the right to a fair hearing if either spouse disagrees with the Department’s spousal share decision.

Source

   The provisions of this §  178.123 adopted August 28, 1992, effective upon publication and apply retroactively to October 1, 1989, 22 Pa.B. 4432.

Cross References

   This section cited in 55 Pa. Code §  178.121 (relating to general); and 55 Pa. Code §  178.124 (relating to resource eligibility for the institutionalized spouse).

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