Or. Admin. Code § 461-160-0030 - Overview of Costs
(1) Costs
incurred by the filing group that the filing group has a legal responsibility
to pay are deductible from income in accordance with the rules in this division
of rules.
(2) The following costs
are not deductible:
(a) A cost paid by
someone outside the filing group through a reimbursement, vendor payment, or
in-kind benefit.
(b) A cost that is
paid by a person or company outside the filing group or that is written off by
a medical facility. These are referred to as third-party payments.
(c) The cost for a service provided by
someone in the filing group, such as child care provided by the father while
the mother works.
(d) A cost used
as an income deduction in one budget month or averaged over several months
cannot be used again.
(e) In the
OSIPM program, a cost that the client incurred while the client was serving a
disqualification from Medicaid under OAR
461-140-0210 to
461-140-0300 for a transfer of
assets for less than fair market value.
(3) In the OSIP and OSIPM programs, the
medical deduction allowed under OAR
461-160-0620 is determined as
follows:
(a) In order to be allowed as a
deduction, a cost or portion of a cost that has already been paid must be
reported in the month it is paid or within 10 days of the date it is
paid.
(b) For one-time costs that
have been incurred but not paid in full:
(A)
Any amount already paid when reported is allowed if it was reported in the
month that it was paid or within 10 days of the date it was paid.
(B) For amounts not already paid, the amount
allowed as a deduction is the amount the individual expects to pay each month,
not to exceed the total amount due at the time the cost is reported.
(c) Deductions for one-time
medical expenses that have been paid with a credit card are allowed as follows:
(A) The amount allowed as a deduction is the
amount the individual expects to pay or is currently paying each month on the
card until the outstanding balance of the medical cost would be paid in
full.
(B) For costs charged prior
to the month reported, the outstanding balance is the amount of the original
cost charged to the card less any subsequent payments to the card.
(C) Count all payments made to the credit
card toward the principal balance of the medical cost.
(D) Additional deductions are not allowed if
the individual incurs interest or fees.
(d) Recurring costs, such as those for
ongoing prescription medications, may be anticipated and allowed until the
total amount of the cost has been allowed or through the next annual
redetermination (see OAR
461-115-0430), whichever occurs
first.
(A) The amount anticipated should
reflect actual and verified costs.
(B) Recurring costs may not be
averaged.
(e) The
effective date for an allowable cost is determined in accordance with OAR
461-180-0020.
(f) Additional deductions are not allowed if
the individual fails to pay the cost.
Notes
Statutory/Other Authority: ORS 409.050, 411.060, 411.400, 411.816, 412.014, 412.049, 411.404, 413.085 & 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.400, 411.816, 412.014, 412.049 & 411.404
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