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information. Once the liability deviation has been processed and the change authorized, the worker must send manual notice indicating approval of the liability deviation request.

Examples of allowable medical expenses that can be deviated include (but are not limited to): • Room and Board for nursing home level care • Unpaid medical bills incurred prior to Medicaid eligibility Examples of nonallowable medical expenses include (but are not limited to): • Ancillary services or products, such as gloves and tissues • Long term care services during a transfer of property penalty period • For HCBS waiver members, non-medical care such as companions, attendants and homemakers that are not deemed medically necessary under the waiver care plan • Copayments for dual eligible members • Over the counter medication • Medical bills already paid by the applicant, member or a third party • Assisted Living expenses Any questions about validity of a liability deviation should be sent to PAL for review.

3455.15.15 LIABILITY EXCEEDS FACILITY PRIVATE RATE (MED 1) The policies in this section apply to the MA A, MA B, MA D, MADW, and MADI categories of assistance. If the liability amount calculated in the post-eligibility determination exceeds the facility's private rate, the AG is subject to the entire payment of the facility’s private rate.

3455.15.15.05 LIABILITY EXCEEDS MEDICAID RATE (MED 1) The policies in this section apply to the MA A, MA B, MA D, MADW, and MADI categories of assistance. An applicant/recipient residing in a long-term care facility, who has a liability greater than the facility's Medicaid rate but less than the private rate, is not eligible for Medicaid reimbursement of the facility's per diem. The applicant/recipient is eligible for payment of all other Medicaid services, including the facility's ancillary charges. The facility will collect the individual's liability and apply it toward the private pay rate. The facility can bill the Medicaid program for all covered services except the per diem. 3455.15.20 MEDICARE INVOLVED IN NURSING FACILITY PAYMENT (MED 1)