Medicaid Resident Liabilities Update

In a January 26, 2021 Bulletin, FSSA announced it would resume standard rules for calculating patient and waiver liability on March 1, 2021.  Prior to the Bulletin, IHCA had received concerns from several members while this standard process was paused regarding “overpayments” and potential future audits or takebacks  from the state.  The Bulletin clarified that the change would be prospective only and no additional amounts would be added to past months.

The Bulletin added that if a resident is over the asset limit when the  Public Health Emergency ends, their coverage can be suspended for up to 60 days to allow them to pay down their assets by spending it on their own medical care.  When the member is under the limit again, their Medicaid coverage can be reinstated without the need for a new application.  You can read the full Bulletin at this link.