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1. Subtract from the spousal income standard the countable income of the family member. (Note: an allocation is not permissible if the family member's countable income equals or exceeds the spousal income standard.) 2. Divide the difference by three. The resulting amount is the family allocation. 3. Repeat the previous two steps for each appropriate family member to arrive at the total family allocation to be deducted from the income of the institutionalized or HCBS Waiver applicant/recipient.

3455.15.10.20 LIABILITY DEVIATIONS (MED 1) The policies in this section apply to the MA A, MA B and MA D and for those residing Medicaid certified long-term care (LTC) facility, MADW and MADI categories of assistance. categories of assistance. A liability deviation allows unpaid medical expenditures, which are not covered by Medicaid or other third-party insurance, to be entered as a countable expense and temporarily lower the liability amount. Upon approval of a liability deviation request, the liability will be reduced giving the member the opportunity to pay the unpaid medical expense. Members potentially eligible for a liability deviation include those who have a liability obligation and: 1. Reside in a facility that provides 24-hour medical care for those with significant complex medical needs (this does not include room and board for Assisted Living or other such facilities) 2. Are on an approved HCBS waiver A member who does not have a liability obligation is not eligible to receive a liability deviation. Documentation of the unpaid medical expenses is required and must include an actual provider generated bill, or a copy of such bill, which details the date(s) of service, type(s) of service, and clearly shows the amount that the member owes after any third-party payment, including Medicare. A medical expense which is already paid in full or was previously approved for a deviation cannot be deviated. The bill must clearly indicate who is responsible for the cost. If the member is not the party responsible, the liability deviation is not allowable. If the dates of services for Medicaid covered expenses were during a month the member received Medicaid, the liability deviation cannot be approved. However, if a member was in a LTC facility and was on HIP, a deviation may be completed for medical expenses incurred in a retro month that the member was eligible for HIP coverage, if the claim was not a HIP covered service. Verification that HIP denied the claim is required. See section 2220.05.00 for additional information.