65A-1.708: Family-Related Medicaid Budgeting Criteria
65A-1.713: SSI-Related Medicaid Income Eligibility Criteria
PURPOSE AND EFFECT: This rule amendment will revise the number of weeks used to average income budgeting in determining eligibility for Medicaid.
SUMMARY: The proposed rule amendments provide for changing income averaging from the past eight weeks to the past four weeks to determine Medicaid eligibility. A longer period of past time may be used if necessary to provide a more accurate indication of anticipated fluctuations in future income.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.903, 409.904, 409.906, 409.919 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: July 25, 2007, 1:30 p.m.
PLACE: 1317 Winewood Boulevard, Building 3, Room 455, Tallahassee, FL 32399
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Pat Whitford, Economic Self-Sufficiency, Telephone (850)410-3479
THE FULL TEXT OF THE PROPOSED RULE IS:
65A-1.708 Family-Related Medicaid Budgeting Criteria
(1) The department uses a prospective budgeting system. In a prospective budgeting system, eligibility is based on the department’s best estimate of the coverage group’s income and circumstances. This estimate shall be based on the department’s reasonable expectation and knowledge of current or future circumstances. When eligibility is being determined for a month which has passed, the actual income and circumstances for that month shall be used. In converting weekly income to monthly income, the conversion factor of 4.3 shall be used; in converting biweekly income to monthly income, the conversion factor of 2.15 shall be used. Converting semi-monthly income to monthly income will be made using a conversion factor of 2. When averaging income, all income from the most recent consecutive four eight weeks shall be used if it is representative of the individual’s future earnings. A longer period of past time may be used if necessary to provide a more accurate indication of anticipated fluctuations in future income in accordance with 42 CFR 435.601. In budgeting income received by an individual on a contractual basis, at the option of the individual, the income is prorated over the period of the contract or counted when received, in the amount received.
(2) through (4) No change.
Specific Authority 409.919, 414.45 FS. Law Implemented 409.903, 409.904, 409.919 FS. History–New 10-8-97, Amended 2-15-01, ________.
65A-1.713 SSI-Related Medicaid Income Eligibility Criteria
(1) through (3) No change.
(4) Income Budgeting Methodologies. To determine eligibility SSI budgeting methodologies are applied except where expressly prohibited by 42 U.S.C. § 1396, or another less restrictive option is elected by the state under 42 U.S.C. § 1396a(r)(2). When averaging income, all income from the most recent consecutive four weeks shall be used if it is representative of future earnings. A longer period of past time may be used if necessary to provide a more accurate indication of anticipated fluctuations in future income.
(a) through (c) No change.
Specific Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS. History–New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06 (1), (4), 8-10-06 (1),_________.