reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50555 - Deductions from Any Income - All MN or MI Programs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The deductions specified in Sections
						50555.1 through
						50555.2 shall be subtracted from
						any nonexempt income that remains after the application of all preceding
						exemptions and deductions.
1.
						Amendment filed 8-18-82 as an emergency; effective upon filing (Register 82,
						No. 34). A Certificate of Compliance must be transmitted to OAL within 120 days
						or emergency language will be repealed on 12-16-82.
2. Editorial
						correction of NOTE filed 4-12-83 (Register 83, No. 16).
3. Editorial
						correction of NOTE filed 6-10-83 (Register 83, No.
						24).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4
						  and
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50555.1 - Income of an MN or MI Person Used to Determine Public Assistance Eligibility of Another Family Member

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) That portion of the income of an MN or MI
					 person or a person responsible for the MFBU which is counted in determining the
					 eligibility of a spouse, parent or child as a PA or Other PA recipient shall be
					 deducted.
(b) Income of a
					 stepparent and the value of income in kind provided by a stepparent which is
					 counted in determining the eligibility of a spouse or stepchildren as PA or
					 Other PA recipients shall be deducted.
1.
						Amendment filed 12-15-77; effective thirtieth day thereafter (Register 77, No.
						51).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50555.2 - Health Insurance Premiums

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Health insurance premiums shall be
					 deducted if paid by and purchased for any person in the family.
(b) Health insurance payments paid less often
					 then monthly shall be averaged on a monthly basis.
(c) The premium for Part B Medicare shall be
					 deducted for those months in which the beneficiary actually makes the payment,
					 notwithstanding Section
					 50773(b).
1.
						Editorial correction adding NOTE filed 6-10-83 (Register 83, No.
						24).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4
						  and
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50555.3 - Court Ordered Child Support. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 1-8-81; effective thirtieth day thereafter (Register 81, No.
						2).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4
						  and
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50555.4 - Special Deduction for Aged, Blind or Disabled MN. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Amendment of subsection (a)(2) filed 12-15-77; effective thirtieth day
						thereafter (Register 77, No. 51).
2. Repealer filed 8-18-82 as an
						emergency; effective upon filing (Register 82, No. 34). A Certificate of
						Compliance must be transmitted to OAL within 120 days or emergency language
						will be repealed on 12-16-82.
3. Certificate of Compliance
						transmitted to OAL 12-16-82 and filed 1-21-83 (Register 83, No.
						4).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  57(c), Chapter
						  328, Statutes of 1982. Reference: Section
						  8, Chapter 328, Statutes of
						  1982.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50557 - Treatment of Income

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
					 following income shall be considered in determining the share of cost of a
					 person or family:
(1) Net nonexempt income of
					 all persons included in the MFBU in accordance with Section
					 50371 through
					 50381.
(2) Income specified in Sections
					 50558 through
					 50564.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50558 - Income of Persons Excluded from the MFBU

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The income of children excluded from the
					 MFBU shall not be counted in determining the share of cost for the
					 MFBU.
(b) In addition to their own
					 income, children excluded from the MFBU shall be allocated an amount to meet
					 their combined need, which shall be determined as follows, unless the condition
					 of (c) is met:
(1) Determine the maintenance
					 need for the MFBU with the children included.
(2) Determine the maintenance need for the
					 MFBU with the children excluded.
(3) Subtract the amount determined in (2)
					 from the amount determined in (1).
(4) Subtract the net nonexempt income of all
					 excluded children from the amount determined in (3). This is the amount that
					 shall be allocated to the children excluded from the MFBU.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50559 - Income Deemed Available from the Stepparent

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) If there is a stepparent living in the
					 home and only the parent and the parent's separate children are included in the
					 MFBU, the income deemed available from the stepparent shall be determined as
					 follows:
(1) Combine the stepparent's
					 nonexempt unearned income with the stepparent's gross earned income minus the
					 deduction for work expenses specified in Section
					 50553.1.
(2) Deduct, from the amount determined in
					 (1), the following amounts:
(A) Amounts
					 actually paid by the stepparent to persons not living in the home but who are
					 claimed as dependents for purposes of determining the stepparent's Federal
					 personal income tax liability.
(B)
					 Voluntary or court-ordered child support and alimony payments made by the
					 stepparent to persons not living in the home.
(C) The maintenance need for the stepparent
					 unit which includes the:
1.
					 Stepparent.
2. Mutual
					 children.
3. Stepparent's
					 children.
(3)
					 The remainder, if any, is income available to the MFBU.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50561 - Treatment - Stepparent Cases

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) If there is a stepparent living in the
					 home, and only the parent and the parent's separate children are included in
					 the MFBU, the income considered in determining the share of cost of those
					 children shall be:
(1) The income of the
					 children.
(2) The income of the
					 parent.
(3) The income available
					 from the stepparent as determined in accordance with Section
					 50559.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50563 - Treatment of Income - Aged, Blind or Disabled MN Person or Person's Spouse in LTC or Board and Care

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 When an aged, blind or disabled MN person or the spouse of that person is in
					 LTC or board and care and that person has a spouse and/or children who are not
					 Public Assistance recipients, the income of that person shall be treated in the
					 following manner, beginning the first of the month the spouses, or the parent
					 and children, are in separate MFBUs:
(1) The
					 net nonexempt income of the person in LTC or board and care which is in excess
					 of the appropriate maintenance need for that person in accordance with the
					 provisions of Article 11 of this chapter shall be allocated to the spouse
					 and/or children as follows:
(A) When the
					 family is applying for Medi-Cal, determine the maintenance need for the spouse
					 and/or children other than any children excluded from the MFBU.
(B) When only the person in LTC or board and
					 care is applying for Medi-Cal, determine the maintenance need for the spouse
					 and/or all the children.
(C)
					 Subtract the net nonexempt income of the spouse and/or children, other than the
					 excluded children, from the amount determined in (A) or (B). This is the amount
					 that shall be allocated to the spouse and/or children from the net nonexempt
					 income of the MN person in LTC or board and care which is in excess of the
					 maintenance need as determined in (1).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50564 - Treatment of Income - Persons No Longer Receiving Title XVI Due to a Cost of Living Increase in OASDI Benefits Under Title II

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The provisions of this section shall be
					 applied to any MFBU which includes an aged, blind or disabled person who meets
					 all of the following conditions:
(1) Was
					 eligible for and receiving Title XVI benefits in any month since April
					 1977.
(2) Was in receipt of OASDI
					 Title II benefits and received a cost of living increase since April
					 1977.
(3) Has not been entitled to
					 Title XVI benefits in any month since receipt of a Title II cost of living
					 increase, including the month of receipt of the Title II increase.
(4) Would be entitled to Title XVI benefits,
					 as determined in accordance with Department procedures, if the Title II cost of
					 living increases received after Title XVI ineligibility occurred are
					 disregarded. Increases to be disregarded include the increase which rendered
					 Title XVI ineligibility.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50565 - Projection of Anticipated Income. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Amendment filed 12-15-77; effective thirtieth day thereafter (Register 77, No.
						51).
2. Repealer and new section filed 11-30-81 as an emergency;
						effective upon filing (Register 81, No. 49). A Certificate of Compliance must
						be transmitted to OAL within 120 days or emergency language will be repealed on
						3-30-82.
3. Certificate of Compliance filed 3-30-82 (Register 82,
						No. 14).
4. Repealer filed 10-1-82 as an emergency; effective upon
						filing (Register 82, No. 40). A Certificate of Compliance must be transmitted
						to OAL within 120 days or emergency language will be repealed on
						1-29-83.
5. Certificate of Compliance transmitted to OAL 12-30-82
						and filed 2-2-83 (Register 83, No. 6).
Note: Authority cited: Sections
						  10725,
						  14005.9(c)
						  and
						  14124.5,
						  Welfare and Institutions Code, Section
						  133.5, AB 251, Chapter 102,
						  Statutes of 1981. Reference: Section
						  14005.9,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50567 - Adjustment for Decreases in Income. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 11-30-81 as an emergency; effective upon filing (Register 81,
						No. 49). A Certificate of Compliance must be transmitted to OAL within 120 days
						or emergency language will be repealed on 3-30-82.
2. Certificate of
						Compliance filed 3-30-82 (Register 82, No. 14).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; Section
						  133.5, AB 251, Chapter 102,
						  Statutes of 1981. Reference: Section
						  14005.9,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50569 - County Failure to Change Income. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 11-30-81 as an emergency; effective upon filing (Register 81,
						No. 49). A Certificate of Compliance must be transmitted to OAL within 120 days
						or emergency language will be repealed on 3-30-82.
2. Certificate of
						Compliance filed 3-30-82 (Register 82, No. 14).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; Section
						  133.5, AB 251, Chapter 102,
						  Statutes of 1981. Reference: Section
						  14005.9,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50570 - Income Determination and Limit for the Qualified Medicare Beneficiary (QMB) or the Specified Low-Income Medicare Beneficiary (SLMB)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) To determine
					 the eligibility of an adult, couple, or child for the QMB program, net
					 nonexempt income shall not exceed 90% of the official poverty level in 1990,
					 100% of the official poverty level in 1991 and thereafter, as defined by the
					 federal Office of Management and Budget, and revised annually in accordance
					 with section
					 673(2) of the
					 Omnibus Budget Reconciliation Act of 1981. Income attributable to a Title II
					 cost of living adjustment is excluded according to federal law.
(b) To determine the eligibility of an adult,
					 couple, or child for the SLMB program, net nonexempt income shall not exceed
					 110% in 1993 and 1994, rising to 120% in 1995 and ongoing of the official
					 poverty level in each year as defined by the federal Office of Management and
					 Budget in accordance with Section
					 4501 of the Omnibus Budget
					 Reconciliation Act of 1990. Income attributable to a Title II cost of living
					 adjustment is excluded according to federal law.
(c) Net nonexempt income shall first be
					 determined in accordance with all the applicable provisions of Article 8 and
					 Article 10, except that the health insurance premiums as specified under
					 Section 50555.2 are not allowed and the
					 deduction for IRWE as defined in Section
					 50045.1 is allowed.
(d) If ineligibility results from the
					 computation under (c) above, the net nonexempt income then will be determined
					 following SSI methodology specified in Section
					 1612, Title XVI of the federal
					 Social Security Act.
1. New
						section filed 8-13-90 as an emergency; operative 8-13-90 (Register 90, No. 40).
						A Certificate of Compliance must be transmitted to OAL by 12-11-90 or emergency
						language will be repealed by operation of law on the following
						day.
2. Certificate of Compliance including amendment transmitted to
						OAL 12-11-90 and filed 1-9-91 (Register 91, No. 8).
3. Amendment of
						section heading, new subsection (b) and subsection redesignation, and amendment
						of newly designated subsections (c)-(d) and NOTE filed 12-21-93; operative
						1-20-94 (Register 93, No. 52).
Note: Authority cited: Sections
						  10725,
						  14005.11
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  12, Chapter 1430, Statutes of
						  1989. Reference: Sections
						  1396 a(a)(10)(E)(iii) and
						  1396d(p), Title 42, United States Code; Section
						  4501, Omnibus Budget
						  Reconciliation Act of 1990,
						  Public Law
						  101-508; and Section
						  14005.11,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 10 - INCOME › Section 50571 - Income Determination and Limit for the Qualified Disabled and Working Individual (QDWI)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) To
					 qualify for the QDWI Program, the net nonexempt income of a QDWI
					 applicant/beneficiary cannot exceed 200 percent of the federal poverty
					 level.
(b) Net nonexempt income
					 shall be determined following SSI methodology specified in Section
					 1612, Title XVI of the federal
					 Social Security Act.
1. New
						section filed 10-3-94 as an emergency; operative 10-3-94 (Register 94, No. 40).
						A Certificate of Compliance must be transmitted to OAL by 1-31-95 or emergency
						language will be repealed by operation of law on the following
						day.
2. Editorial correction of HISTORY NOTE 1 (Register 95, No.
						9).
3. Repealed by operation of Government Code section
						11346.1(g)
						(Register 95, No. 9).
4. New section refiled 3-3-95 as an emergency;
						operative 3-3-95 (Register 95, No. 9). A Certificate of Compliance must be
						transmitted to OAL by 7-1-95 or emergency language will be repealed by
						operation of law on the following day.
5. Certificate of Compliance
						as to 3-3-95 order including amendment of NOTE transmitted to OAL 2-22-95 and
						filed 4-5-95 (Register 95, No. 14).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  12, Chapter 1430, Statutes of
						  1989. Reference: Section
						  14005.3,
						  Welfare and Institutions Code; and Sections
						  1396 a(a)(10)(E) and 1396d(s),
						  Title 42, United States Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 11 - MAINTENANCE NEED › Section 50601 - Maintenance Need - General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The amount of income a person or family is allowed to retain for living
					 expenses shall be determined by adding the following:
(1) The maintenance need for the members of
					 the MFBU living in the home as determined in accordance with Section
					 50603.
(2) The maintenance need for the members of
					 the MFBU in long-term care as determined in accordance with Section
					 50605.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 11 - MAINTENANCE NEED › Section 50603 - Maintenance Need - Persons Living in the Home

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The maintenance need for members of the
					 MFBU living in the home shall be determined in the following manner with
					 amounts of 1 cent or more rounded to the next highest dollar.
(1) The maintenance need for an MFBU
					 consisting of one individual shall equal 80 percent of the AFDC payment level
					 for a family of two persons multiplied by 133 1/3 percent.
(2) The maintenance need for an MFBU
					 consisting of two adults shall equal the AFDC payment level for a family of
					 three persons multiplied by 133 1/3 percent.
(3) The maintenance need for an MFBU
					 consisting of two persons when one or both persons are not adults and for an
					 MFBU consisting of three through ten persons shall equal 133 1/3 percent of the
					 AFDC payment level for a family group of corresponding size.
(4) The monthly maintenance need determined
					 in accordance with (1) through (3) shall be calculated on an annual basis,
					 rounded to the next higher multiple of $100, and then prorated.
(5) The maintenance need for an MFBU
					 consisting of 11 or more persons shall equal the maintenance need level for a
					 family group of 10 established in accordance with (3) and (4) plus an amount
					 equal to the AFDC MBSAC increase level for additional persons in excess of 10
					 for each MFBU member in excess of 10.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 11 - MAINTENANCE NEED › Section 50604 - Maintenance Need - Family Members Maintaining Separate Residences with Eligibility Determined As a Single MFBU

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An MFBU which includes a child who
					 maintains a separate residence from his/her parent(s) in accordance with
					 Section 50351(c) shall be
					 assigned a combined maintenance need to be calculated according to (1) through
					 (3).
(1) In accordance with Section
					 50603, determine the maintenance
					 need for the separate household of the child as follows:
(A) For one child living alone or one child
					 sharing a residence with other persons not financially responsible for the
					 child, use the maintenance need level for one person established in accordance
					 with Section
					 50603(a).
(B) For two or more children who are living
					 together and who are claimed as dependents by the parent(s) for tax purposes,
					 use the maintenance need level for the corresponding number of persons
					 established in accordance with Section
					 50603(a).
(C) For two or more children who live alone
					 in separate residences, use the maintenance need level for one for each child
					 established in accordance with Section
					 50603(a).
(D) For a married child living with his/her
					 spouse, use the maintenance need level for two established in accordance with
					 Section 50603(a).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 11 - MAINTENANCE NEED › Section 50605 - Maintenance Need - Persons in Long-Term Care

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The maintenance need for a member of the
					 MFBU in long-term care shall be either of the following:
(1) Thirty-five dollars for personal and
					 incidental needs, when the beneficiary will remain in long-term care for the
					 entire calendar month.
(2) For
					 individuals with therapeutic wages, thirty-five dollars plus an additional
					 amount equal to either a) 70 percent of the gross therapeutic earnings; or, b)
					 70 percent of the maintenance need level allowed for a noninstitutionalized
					 person or family of corresponding size, as described in Section
					 50603, whichever is less.
(A) The provisions of subsection (a)(2) of
					 this regulation also apply to eligibility determinations or redeterminations
					 made retroactively to October 1, 1984.
(3) The appropriate maintenance need
					 determined in accordance with Section
					 50603, if the person will be in
					 long-term care for only a portion of the month.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50651 - Share of Cost - General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Share of cost shall be determined and processed in
						accordance with the requirements of this article.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50652 - Share of Cost Period. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 11-30-81 as an emergency; effective upon filing (Register 81, No.
						49). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 3-30-82.
2. Certificate of
						Compliance filed 3-30-82 (Register 82, No. 14).
3. Repealer filed
						10-1-82 as an emergency; effective upon filing (Register 82, No. 40). A
						Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 1-29-83.
4. Certificate of
						Compliance transmitted to OAL 12-30-82 and filed 2-2-83 (Register 83, No.
						6).
Note: Authority cited: Sections
						  10724,
						  10725,
						  14005.9(c)
						  and
						  14124.5,
						  Welfare and Institutions Code; Section
						  133.5, AB 251, Chapter 102,
						  Statutes of 1981. Reference: Section
						  14005.9,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50653 - Determination of Share of Cost

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The share of cost shall cover a one month
					 period and be determined as follows:
(1) For
					 MFBUs which do not include a person in LTC:
(A) Determine the net nonexempt income
					 available to the members of the MFBU.
(B) Round the total net nonexempt income
					 determined in (A) to the nearest dollar, with amounts ending in 50 cents or
					 more rounded to the next higher dollar.
(C) Determine the appropriate maintenance
					 need for the MFBU in accordance with Section
					 50603.
(D) Subtract the combined maintenance need
					 from the total rounded net nonexempt income. The remainder, if any, is the
					 share of cost.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50653.3 - Changes Which Decrease the Share of Cost

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) In situations where a change in income or
					 other circumstances, which results in a decrease in the share of cost is
					 reported by the beneficiary in a timely manner, as specified in Section
					 50185, the county department
					 shall:
(1) Make the necessary changes in the
					 ongoing share of cost by the first of the month following the month in which
					 the change was reported.
(2)
					 Determine what the share of cost should have been for the month in which the
					 change occurred.
(3) Implement the
					 beneficiary's choice of either of the following:
(A) Having an adjustment made in future
					 months in accordance with (c) for the months in which income in excess of the
					 correct share of cost was paid or obligated toward medical bills.
(B) Having the correct Form MC 177S or
					 Medi-Cal card with a share of cost issued and processed for the months in which
					 the share of cost should have been lower.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50653.5 - Changes Which Increase the Share of Cost

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Except as described in Section
					 50262.3, in situations where a
					 change in income or other circumstances, which result in an increase in the
					 share of cost, is reported by the beneficiary in a timely manner, as specified
					 in Section
					 50185, the county department shall
					 make necessary changes effective:
(1)
					 Immediately, if the increase is due to the voluntary inclusion of a family
					 member who has income. The share of cost to be met shall be either of the
					 following:
(A) The total increased share of
					 cost shall be met by all members of the MFBU providing Medi-Cal cards have not
					 been issued to the MFBU for the share-of-cost month and form MC 177S has not
					 been submitted to the Department in accordance with Section
					 50658(c).
(B) The difference between the increased
					 share of cost and the former share of cost shall be met by the newly included
					 family member(s) when Medi-Cal cards have been issued to the MFBU for the
					 share-of-cost month or form MC 177S has been submitted to the Department in
					 accordance with Section
					 50658(c).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50653.7 - Changes in Share of Cost Determination Due to Administrative Error

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An
					 administrative error which causes the share of cost amount to be in excess of
					 the correct share of cost amount shall be adjusted in accordance with Section
					 50653.3(a).
(b) If the county fails to take action on an
					 increase in income within the time frames specified in Section
					 50653.5, excess income received
					 after the time the county department should have taken action shall not be
					 reported as a potential overpayment.
1. New
						section filed 11-30-81 as an emergency; effective upon filing (Register 81, No.
						49). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 3-30-82.
2. Certificate of
						Compliance filed 3-30-82 (Register 82, No. 14).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; Section
						  133.5, AB 251, Chapter 102,
						  Statutes of 1981. Reference: Section
						  14005.9,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50655 - Record of Health Care Costs - Share of Cost

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Record of Health Care Costs--Share of
					 Cost, form MC 177S, shall be used to verify that health care costs have been
					 obligated or paid by the beneficiary in an amount equal to the share of cost.
					 The form shall be used for all beneficiaries who have a share of cost, except
					 as specified in (b).
(b) Form MC
					 177S shall not be used for beneficiaries who meet both of the following
					 conditions:
(1) Are in long-term
					 care.
(2) Have a share of cost
					 which is less than or equal to the monthly cost of care at the Medi-Cal
					 reimbursement rate for the long-term care facility.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50657 - Completion of Form MC 177S

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Form MC 177S shall be completed as follows:
(1) The identifying information shall be
					 completed by the county department. The only persons who shall be listed on
					 form MC 177S as eligible to have the cost of their health services used to meet
					 the share of cost are those:
(A) Eligible
					 members of the MFBU in accordance with Sections
					 50373,
					 50375 and
					 50377.
(B) Ineligible members of the MFBU in
					 accordance with Section
					 50379.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50658 - Form MC 177S Processing

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 When the share of cost has been met, the beneficiary shall return the signed
					 form MC 177S to the county department. The county department shall review form
					 MC 177S to ensure that:
(1) The case
					 description portion of the form is complete.
(2) The services listed were provided to
					 persons listed on form MC 177S.
(3)
					 The providers have completed the form in accordance with Section
					 50657(a)(4) through
					 (6).
(4) The beneficiary or the beneficiary's
					 representative has signed the form.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50659 - Long - Term Care Patients with a Share of Cost

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Form MC 177S shall not be required for a
					 person or family with a share of cost when all the following conditions are
					 met:
(1) One or more members of the MFBU are
					 LTC patients.
(2) The share of cost
					 is less than or equal to the monthly cost of care at the Medi-Cal reimbursement
					 rate for the long-term care facility.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 12 - SHARE OF COST › Section 50660 - MFBUs Which Include a Title II Disregard Person

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Form MC 177S shall not be required for an
					 aged, blind or disabled person who meets the conditions specified in Section
					 50564. Each Title II disregard
					 person shall be issued a Medi-Cal card with no share of cost.
(b) The remaining MFBU members with a share
					 of cost shall have their case processed in accordance with Section
					 50655. Those services received by
					 the aged, blind or disabled MN person meeting the conditions of Section
					 50564 shall not be used to meet
					 the remaining MFBU members' share of cost.
(c) A person meeting the conditions of
					 Section 50564 shall be identified in the
					 case file by the notation "Title II Disregard Person" beside the person's name
					 on the applicable MC 176.
1. New
						section filed 1-5-78 as an emergency; effective upon filing (Register 78, No.
						1).
2. Certificate of Compliance filed 5-5-78 (Register 78, No.
						18).
3. New subsection (d) filed 6-30-78 as an emergency; effective
						upon filing (Register 78, No. 26).
4. Editorial correction deleting
						subsection (d) filed 6-10-83 (Register 83, No.
						24).
Note: Authority cited: Section
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4
						  and
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 13 - PERIOD OF ELIGIBILITY [REPEALED] › Section 50701 - Beginning Date of Eligibility. [Renumbered]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Amendment of subsections (a) and (b)(2) filed 8-7-78; effective thirtieth day
						thereafter (Register 78, No. 32).
2. Amendment of subsections (a)
						and (b) filed 7-31-81 as an emergency; effective upon filing (Register 81, No.
						33). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 11-28-81.
3. Certificate of
						Compliance transmitted to OAL 11-6-81 and filed 1-27-82 (Register 82, No.
						5).
4. Amendment of subsection (d) filed 4-1-83; effective thirtieth
						day thereafter (Register 83, No. 14).
5. Amendment filed 6-3-87;
						operative 7-3-87 (Register 87, No. 24).
6. Change without regulatory
						effect repealing article 13 and renumbering former section
						50701 to new section
						50193 filed 9-19-2000 pursuant to
						section 100, title 1, California Code of
						Regulations (Register 2000, No. 38).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  11014,
						  11016,
						  14005,
						  14018
						  and
						  14053,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 13 - PERIOD OF ELIGIBILITY [REPEALED] › Section 50703 - Period of Eligibility. [Renumbered]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Amendment of subsection (a) filed 8-7-78; effective thirtieth day thereafter
						(Register 78, No. 32).
2. Amendment of subsection (d) filed 10-31-78
						as an emergency; designated effective 11-1-78 (Register 78, No.
						44).
3. Certificate of Compliance filed 2-6-79 (Register 79, No.
						6).
4. Amendment of subsection (f) filed 5-30-80 as an emergency;
						effective upon filing (Register 80, No. 22). A Certificate of Compliance must
						be transmitted to OAH within 120 days or emergency language will be repealed on
						9-27-80.
5. Certificate of Compliance filed 9-26-80 (Register 80,
						No. 39).
6. Amendment of subsection (a) filed 7-31-81 as an
						emergency; effective upon filing (Register 81, No. 31). A Certificate of
						Compliance must be transmitted to OAL within 120 days or emergency language
						will be repealed on 11-28-81.
7. Certificate of Compliance
						transmitted to OAL 11-6-81 and filed 1-27-82 (Register 82, No.
						5).
8. Amendment of subsection (c) filed 12-31-82 as an emergency;
						effective upon filing (Register 83, No. 2). A Certificate of Compliance must be
						transmitted to OAL within 120 days or emergency language will be repealed on
						4-30-83.
9. Amendment of subsection (e) filed 4-1-83; effective
						thirtieth day thereafter (Register 83, No. 14).
10. Certificate of
						Compliance as to 12-31-82 order transmitted to OAL 4-13-83 and filed 5-16-83
						(Register 83, No. 21).
11. Change without regulatory effect
						renumbering section
						50703 to section
						50195 filed 9-19-2000 pursuant to
						section 100, title 1, California Code of
						Regulations (Register 2000, No. 38).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  11014,
						  11016
						  and
						  14053,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 13 - PERIOD OF ELIGIBILITY [REPEALED] › Section 50710 - Retroactive Eligibility. [Renumbered]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Amendment of subsection (a)(1) filed 7-19-82; effective thirtieth day
						thereafter (Register 82, No. 30).
2. Repealer of subsection
						(a)(3)(C) filed 8-18-82 as an emergency; effective upon filing (Register 82,
						No. 34). A Certificate of Compliance must be transmitted to OAL within 120 days
						or emergency language will be repealed on 12-16-82.
3. Amendment of
						subsection (a)(1) and new subsection (c) filed 9-1-82 as an emergency;
						effective upon filing (Register 82, No. 38). A Certificate of Compliance must
						be transmitted to OAL within 120 days or emergency language will be repealed on
						12-30-82.
4. Amendment of subsection (c) filed 10-1-82 as an
						emergency; effective upon filing (Register 82, No. 40). A Certificate of
						Compliance must be transmitted to OAL within 120 days or emergency language
						will be repealed on 1-29-83.
5. Certificate of Compliance as to
						9-1-82 order filed 12-30-82 (Register 83, No. 1).
6. Editorial
						correction of 12-30-82 Certificate of Compliance filed 1-3-83 (Register 83, No.
						1).
7. Certificate of Compliance as to 8-18-82 order transmitted to
						OAL 12-14-82 and filed 1-21-83 (Register 83, No. 5).
8. Certificate
						of Compliance as to 10--82 order transmitted to OAL 1-28-83 and filed 2-25-83
						(Register 83, No. 9).
9. Amendment of subsection (a)(2) filed
						7-9-87; operative 8-8-87 (Register 87, No. 30).
10. Change without
						regulatory effect renumbering section
						50710 to section
						50197 filed 9-19-2000 pursuant to
						section 100, title 1, California Code of
						Regulations (Register 2000, No. 38).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4,
						  14019,
						  14019.6,
						  14142
						  and
						  14145,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 13 - PERIOD OF ELIGIBILITY [REPEALED] › Section 50715 - Certification for Medi-Cal - Completion. [Renumbered]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Change
						without regulatory effect renumbering section
						50715 to section
						50199 filed 9-19-2000 pursuant to
						section 100, title 1, California Code of
						Regulations (Register 2000, No. 38).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 14 - MEDI-CAL CARD USE AND ISSUANCE › Section 50731 - Medi-Cal Card Use

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons
					 certified for Medi-Cal shall receive a Medi-Cal card or either a PHP
					 identification card, or a PCCM plan restricted card and shall show proof of
					 eligibility for Medi-Cal services by one of the following:
(1) Presenting a valid Medi-Cal card to the
					 Medi-Cal provider of their choice.
(2) Presenting their valid PHP identification
					 card to a provider in the PHP in which the beneficiary is enrolled. PHP
					 enrollees may obtain their services under emergency circumstances from non-PHP
					 providers by presenting their valid PHP identification card to the provider for
					 purposes of billing the PHP. PHP enrollees also may be entitled to a restricted
					 Medi-Cal card if they are enrolled in a noncomprehensive PHP.
(3) Presenting a valid PCCM plan restricted
					 card to a provider in the PCCM plan in which the beneficiary is enrolled. PCCM
					 plan enrollees may obtain services under emergency circumstances from nonplan
					 providers by presenting a valid PCCM plan restricted card to the provider for
					 purposes of billing the PCCM plan.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 14 - MEDI-CAL CARD USE AND ISSUANCE › Section 50732 - Medi-Cal - Signature Requirement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each Medi-Cal beneficiary must sign and
					 date his/her Medi-Cal card in the space provided upon receipt and prior to
					 presentation of the card for any services.
(b) The requirement in (a) above shall not
					 apply to the following:
(1) Medi-Cal
					 beneficiaries who are under 18 years of age.
(2) Medi-Cal beneficiaries who are in Long
					 Term Care as defined in Section
					 50056.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 14 - MEDI-CAL CARD USE AND ISSUANCE › Section 50733 - Medi-Cal Card - Authorization for Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Medi-Cal card shall be authorization
					 for the person named on the card to receive those Medi-Cal covered services for
					 which the person is eligible.
(b)
					 The Medi-Cal card shall be authorization for payment of claims only for the
					 cost of Medi-Cal covered services which are all of the following:
(1) Incurred during the month in which the
					 Medi-Cal card is valid.
(2) Not
					 paid or obligated by the beneficiary to meet the share of cost
					 requirement.
(3) Not provided by
					 the PHP or PCCM plan of which the beneficiary is a member.
(4) Not payable by a third party under a
					 contractual or other legal entitlement.
(5) Not prohibited due to the limited service
					 status of the beneficiary.