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CODE LIVING ARRANGEMENT 14 PACE Private Living Arrangement 15 PACE Private Living with SSI Recipient(s) 54 PACE Living in a Nursing Facility

D. Retroactive Eligibility/Eligibility Prior to PACE Enrollment

1. There is retroactive coverage for regular Medicaid services if Medicaid eligibility requirements are met in the retroactive period or before PACE enrollment is effective.

2. There is no retroactive coverage for PACE services. For all months prior to the month a PACE enrollment agreement is signed the a/b is budgeted using Private Living Arrangement (PLA) rules and should be budgeted with all financially responsible members of the household. Beginning the month the PACE agreement is signed, the budget unit is one. See IV.B, above.

E. Continuous Period of Institutionalization (CPI)

The CPI begins the first day of the month the a/b signs the PACE Enrollment Agreement with the PACE organization.

F. Community Spouse Income Allowance (Spouse in PLA)

Community Spouse Income Allowance (CSIA) applies to PACE a/b’s. Follow policy in MA-2270, Long-Term Care Need and Budgeting.

1. Only one spouse is PACE participant: CSIA policy applies for the community spouse.

2. Both spouses are PACE participants in a private living arrangement: There is no community spouse in this scenario.

3. Both spouses are PACE participants and one is permanently placed in SNF and the other remains at home: CSIA policy applies for the community spouse

G. Dependent Family Member Allowance

Dependent family member allowance applies to PACE a/b’s. Follow policy in MA- 2270, Long-Term Care Need and Budgeting.

H. Reserve

1. The reserve limit is for a budget unit of one in all PACE cases beginning with the month PACE enrollment agreement is signed. Refer to MA-2230, Financial Resources, for instructions regarding reserve requirements and procedures.