Incurred Medical Expenses must be allowed as a deduction at an amount equal to the Medicaid reimbursement rate.
Docket Number: ***** , Decision Date: August 1, 2014
Attachment: Click here to download the decision.
After Petitioner, a nursing home resident, was approved to receive Medicaid, the Department of Community Health (DCH) was required to deduct the expenses that he incurred at the nursing home three months prior to his Medicaid application, or incurred medical expenses (IMEs), from his share of the prospective cost of his care. Respondent was not permitted to reduce the amount of Petitioner’s IMEs by his pre-eligibility income because the State Medicaid Plan requires that IMEs be “allowed as a deduction at an amount equal to the Medicaid reimbursement rate.”