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West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 72 Chapter 4 Income

Changes reported or information received from a source other than the AG, such as information received from a medical provider for a Medicaid client, must be acted on only when the information is verified by the outside source and contact with the AG is not necessary for additional information or verification. Otherwise, such information is acted on at the next redetermination or when the client reports and verifies it. ▪ Actual Expenses The client may claim a medical deduction by using actual expenses. Once he reports his actual expenses at application or redetermination, he is not required to report further, even if his expenses increase or decrease during the certification period. However, reported changes must be acted on. Monthly payments toward medical expenses are allowable as a deduction only when a monthly payment schedule is negotiated prior to the due date of the bill. If the client must renegotiate the payment schedule for any reason, only the amount that is not past due, and for which the client has not already received a deduction, is an allowable expense. Renegotiated Payment Example: The AG agrees in January to make monthly payments of $100 for 10 months on a $1,000 bill. They make timely payments in January and February. In March and April, they make no payment due to a change in circumstances, but they do receive the deduction. In May, they renegotiate the payments to pay the balance of $800 at $80 a month for 10 months. Because the AG has already received a total deduction of $400, and the amount of $200 for March and April is overdue, the client may only receive a deduction for $600. He may receive the $80 a month deduction only until the $600 is paid. When a bill becomes overdue during the certification period, the deduction continues until the end of the certification period, unless the client reports the overdue bill. Ongoing medical expenses that are regularly incurred on a weekly, biweekly or semi-monthly basis must be converted to a monthly amount using the following conversion figures: • Weekly - Multiply by 4.3 • Biweekly - Multiply by 2.15 • Semi-monthly - Multiply by 2 ➢ Medical Deduction for Residents of Group Living Facilities (GLF) Allowable medical expenses that can be identified apart from food and shelter payments are deducted. See Section 16.2.