Page 267
Medical Services Policy Manual, Section H
H 100 Long Term Services and Supports
H-114 Changes to an Income Trust Refer to Health Care Procedures Manual for more information. MS Manual 08/29/22 1. Medicare and Other Third Party Payments If in any month or part of a month a patient is in a Medicare bedor hasother third party coverage which lessens or eliminates the obligation of the trustee to pay the facility for the patient’s share of cost as computed in the electronic record, the funds that would have been paid to the facility in that month shall remain in the trust and may not be disbursed for reasons other than for the recipient’s medical care for which there is no other third party liability. 2. Individual Leaves Facility If an individual leaves a facility for a therapeutic homevisit up to fourteen (14) days or for a hospital visit up to five (5) days, Health Care benefits and vendor payment will continue, and the trustee will make disbursements in that month as specified on the Notice of Action and in the electronic record. If an individual improves to the extent that they are able to return home and are deemed unlikely to need continuing care in a facility according to written medical statement, the Health Care case must be closed. However, the trust must be maintained according to the terms of the trust, i.e., the individual’s income must continue to go into the trust; no other individual’s income may be put into the trust, etc. Disbursements may be made only for medical care, food, clothing, transportation, and shelter for the individual. 3. Changes in Community Spouse or Dependent Status If a community spouse or dependent who has been receiving a monthly income allowance from the facility resident enters a facility, has an income change, divorces the recipient, or dies, the eligibility worker in charge of the case must be notified within ten (10) days by the recipient, representative, trustee, or other responsible party. No additional disbursements for the spouse or dependent can be made until the eligibility worker has revised the post-eligibility budget and provided the trustee with a copy of the Notice of Action.