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Health Care Finance and Administration Policy Manual Number: 110.020 Section: Financial Eligibility Requirements Chapter: ABD Financially Responsible Relatives July 1, 2016 HCFA 5 Version History Revision Date Section Section Title Page Number(s) Reason for Revision Reviser 03.23.15

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4.5.16 1 Policy Statement 1 Non-Substantive Change AK 4.5.16 2 Defined Terms 1 Non-Substantive Change AK 4.5.16 4-d-ii Parental Financial Responsibility -Equally- Shared Joint Custody/Parenting Time 4 Non-Substantive Change AK 7.1.16 4-b Parental Financial Responsibility -When Parental Financial Responsibility Does Not Apply 3 Policy Clarification LW