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Division of Welfare and Supportive Services F-325.2 Medical Assistance Manual LONG TERM CARE SERVICES 24 Sept MTL 05/24 PARTIAL MONTH PRORATION – PATIENT LIABILITY BUDGETING PROCEDURES

MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID Determine what the patient liability would be for a full month. Divide that full month amount by the number of days in the month of partial institutionalization to determine the daily amount of patient liability. Multiply this daily amount by the number of days the client was institutionalized in that month (include the day of admission but not the day of discharge/ death). The result is the amount of patient liability due for the partially institutionalized month. F-325.3 Effective Date of Patient Liability a. State Institutional Patient liability is effective the first month of eligibility (this includes requested months prior to the application month). b. State Institutional/QMB (SLMB) Hospital Stay Only: For inpatient hospital stays under 90 consecutive days, do not calculate or send notice of patient liability. This is because Medicare will cover up to 90 days in a hospital and Medicaid must pay the hospital deductible and co–pay charges. If hospitalized beyond the 90 day time period, begin patient liability the first of the month following the 90 days. c. Deceased Clients The facility is notified of the patient liability amount due for the month of death. The facility will collect only for charges actually incurred. Any unused patient liability will be deposited in the patient trust fund account. F-325.4 Notification of Patient Liability/Case Status When a case is approved or patient liability changes, the client, facility and authorized representative (if applicable) are notified on a Notice of Decision of the amount and effective date. When the client moves from one facility to another, notify the facilities of the current case status and MONTHLY patient liability when this information has not already been provided them in or for that month. F-325.5 Patient Liability Budgeting Procedures – Form 2220–EM a. Determine the client's total gross countable monthly income 1. Subtract income excluded in patient liability b. Subtract the following items from total monthly income in the following order: