Connecticut Administrative Code › Title 27 - Armed Forces and Veterans › 102ld - Administration, Programs, and Patient Rights and Obligations › Article VI - PAYMENT FOR SERVICES AND CARE › Part B - Payment and Billing Procedures › Section 27-102l(d)-258 - Determination of charges

Current through July 10, 2024
(a) For any
				  program administered by the Department of Veterans' Affairs, the per diem
				  charge or fee shall be inclusive of all services provided to the veteran in
				  that program on that day, unless that service is billed separately as declared
				  by the Commissioner each year when publishing the various rates for each
				  program. The applicable per diem fee depends upon whether the veteran resides
				  in the Health Care Facility or in the Residential Facility.
(b) The daily charge for Health Care Facility
				  residents, who have been determined to be eligible to participate in the
				  Medicaid program, shall be equal to the Title XIX Medicaid rate that is set
				  annually by the Department of Social Services for purposes of administering the
				  Medicaid program. Residents are charged monthly based upon the applicable daily
				  charge and the number of days in the month. The resident is obligated to
				  contribute his monthly applied income toward the applicable charge, with the
				  balance of the monthly charge being accepted by the Facility in the form of
				  payment from the Medicaid program. The resident's applied income for purposes
				  of this subsection shall be equal to his total monthly income from all sources
				  minus any deductions that are allowed by the Department of Social Services for
				  purposes of determining the patient's liability to contribute his income
				  towards the cost of care, including but not limited to, the monthly personal
				  needs allowance that is allowed by said Department, minus an additional ninety
				  dollars per month that is allowed by the Facility as a veteran allowance. In
				  accordance with the provisions of
				  38 U.S.C. §
											1741(e), per diem allowances
				  that are paid by the United States Department of Veterans Affairs are not
				  counted as income to the resident and are not counted as a third party payment
				  that reduces the Medicaid payment amount.
(c) The daily charge for Health Care Facility
				  residents, who have not been determined Medicaid eligible to participate in the
				  Medicaid program, shall be equal to the daily per capita cost of providing care
				  at the Health Care Facility, as determined by the State Comptroller annually.
				  Residents shall be charged monthly based upon the applicable daily charge and
				  the number of days in the month. Per diem allowances that are paid by the
				  United States Department of Veterans Affairs on behalf of the veteran shall be
				  applied towards the charge to the resident.
(d) Residential Facility residents shall pay
				  a monthly charge which is equal to the amount of the per diem allowances that
				  are paid in the month on behalf of the resident by the United States Department
				  of Veterans Affairs pursuant to
				  38 U.S.C. §
											1741, plus an additional amount that the
				  veteran is required to pay from his other own resources, which additional
				  amount shall be set by the Facility, approved by the Board of Trustees of the
				  Veterans' Home, and published by the Department in its Veteran
				  Handbook.