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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 47 Effective Month: September 2023 Provision Required Discussion Points

Spousal resource & income rules If applicable, discuss spousal impoverishment rules and provide a copy of the Spousal Resource and Income Rules handout. Discuss the 90- day period for transferring assets to the CS subject to the CS limit. Assets over the spousal limit are considered available to the IS. Discuss the spousal income allocation. PAS and 317 forms from NF For LTC applicants, explain the requirement for medical necessity of the NF placement and that forms submitted by the NF will document the level of care requirement. Post-eligibility For LTC applicants, discuss Medicaid Income requirements including income used in the Medicaid Income calculation (counting lump sum payments and averaging income that varies or is infrequent). Explain deductions such as the Personal Needs Allowance, CS and/or other family member deduction, and the allowance of non-covered medical expenses and the need to timely submit any out-of-pocket expenses. Determine if allowable pre-eligibility expenses need to be submitted. Miscellaneous Discuss any other provisions applicable to the case, such as: Medicare covered days, Substantial Home Equity disqualification period, the 30-consecutive day requirement and any other provisions as applicable.

The following explanations are specific to ABD at-home cases: Provision Required Discussion Points Deeming of income & resources from a spouse If applicable, deeming of income and resources from an ineligible (non-applying) spouse to an eligible spouse is required, if living together. Higher couple need standards are then used to determine eligibility (couple FPL or FBR and couple resource limit). Deeming of income & resources from parent to child If applicable, deeming of income and resources from ineligible (non- applying) parent(s) to an eligible child or eligible children is required, if living together. The exception is deeming from a stepparent to a stepchild. The parent(s) income is subject to certain deductions (allocating to ineligible children, a living allowance, etc.) prior to deeming to the child or children. Resources of the parent(s) are also subject to a reduction before deeming. Asset Verification System (AVS) Explain the authorization for financial institutions to disclose financial account information is a condition of eligibility (AVS matching). If accounts cannot be verified electronically, the applicant must provide the needed verification.