N.H. Code Admin. R. He-E 801.11 - Post-Eligibility Computation of Cost of Care for CFI Services

Current through Register Vol. 41, No. 39, September 30, 2021

(a) Except for individuals who reside in residential care facilities, the amount of income that an individual is liable to contribute toward the cost of his or her CFI services shall be computed as follows:
(1) The amount of the applicant or recipient's gross earned income as defined in He-W 601.81 shall be determined;
(2) The employment expense disregard, as specified in He-W 654.18 for OAA or ANB recipients or the earned income disregard, as specified in He-W 654.15 for APTD recipients, shall be subtracted from the individual's gross earned income to obtain the individual's net earned income;
(3) The total amount of the individual's unearned income, as defined in He-W 601.176, shall be added to the net earned income to determine the individual's net income;
(4) The allowable deductions, as defined in He-W 654.20 and He-W 654.21, shall be subtracted from the individual's net income;
(5) For the maintenance needs of the individual, 300% of the maximum SSI benefit for an eligible individual as determined in accordance with 20 CFR 416.410, adjusted by cost of living increases pursuant to 20 CFR 416.405 shall be subtracted from the amount in (4) above;
(6) The cost of the following medical expenses incurred by the recipient that are not subject to third-party payment shall be subtracted from the amount in (5) above:
a. Health insurance premiums, including Medicare Part A, Part B, Part C, and Part D, coinsurance payments, and deductibles;
b. Necessary and remedial care that would be covered by medical assistance except that allowable payment limits have been exceeded;
c. Necessary and remedial care that is recognized by state law, but not covered by medical assistance; and
d. Currently obligated, unpaid prior medical debt;
(7) The amount of any continuing SSI benefits, under section 1611 (e) (1) (E) and (G) of the Social Security Act, shall be subtracted from the amount in (6) above;
(8) The veterans affairs aid and attendance allowance shall be added to the amount in (6) or (7) above as required by 42 CFR 435.733(c) ; and
(9) The result in (8) above shall be the amount of income for which the individual is liable to remit as payment toward the cost of his or her CFI services.
(b) For individuals who reside in residential care facilities, the amount of income that the individual is liable to contribute toward the cost of his or her CFI services shall be computed as follows:
(1) The amount of the applicant or recipient's gross earned income as defined in He-W 601.81 shall be determined;
(2) The employment expense disregard, as specified in He-W 654.18 for OAA or ANB recipients or the earned income disregard, as specified in He-W 654.15 for APTD recipients, shall be subtracted from the individual's gross earned income to obtain the individual's net earned income;
(3) The total amount of the individual's unearned income, as defined in He-W 601.176, shall be added to the net earned income to determine the individual's net income;
(4) The allowable deductions, as defined in He-W 654.20 and He-W 654.21, shall be subtracted from the individual's net income;
(5) The personal needs allowance as defined in He-W 654.17(b) shall be subtracted from the amount in (4) above;
(6) The cost of the following medical expenses incurred by the recipient that are not subject to third-party payment shall be subtracted from the amount in (5) above:
a. Health insurance premiums, including Medicare Part A, Part B, Part C, and Part D, coinsurance payments, and deductibles;
b. Necessary and remedial care that would be covered by medical assistance except that allowable payment limits have been exceeded;
c. Necessary and remedial care that is recognized by state law, but not covered by medical assistance; and
d. Currently obligated, unpaid prior medical debt;
(7) The amount of any continuing SSI benefits, under section 1611 (e) (1) (E) and (G) of the Social Security Act, shall be subtracted from the amount in (6) above;
(8) The veterans affairs aid and attendance allowance shall be added to the amount in (6) or (7) above as required by 42 CFR 435.733(c) ; and
(9) The result in (8) above shall be the amount of income for which the individual is liable to remit as payment toward the cost of his or her CFI services.

Notes

N.H. Code Admin. R. He-E 801.11

(See Revision Note at part heading for He-E 801) #9969, eff 8-8-11

Amended by Volume XXXIX Number 32, Filed August 8, 2019, Proposed by #12830, Effective 8/7/2019, Expires 2/3/2020.

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