Or. Admin. Code § 461-180-0020

Current through Register Vol. 63, No. 10, October 1, 2024

Section 461-180-0020 - Effective Dates; Changes in Income or Income Deductions That Cause Increases

This rule is used to determine the effective date when a change in income or income deductions causes an increase in benefits. The effective date is one of the following:

(1) In the GA, REF, SFPSS, and TANF programs, the effective date for an anticipated change reported before the payment month is the first of the payment month in which it will occur. If the change is not reported until the month it occurs or later, the effective date is the first of the month following the month in which the change was reported.

(2) In the SNAP program:

(a) The effective date when verification is not requested is the first of the month following the date the change was reported.

(b) The effective date if verification is requested is:

(A) The first of the month following the date the change was reported if verification is received no later than the due date for the verification.

(B) The first of the month following the date the verification is received by the Department, if received after the verification due date.

(3) In the OSIPM and QMB programs, the effective date for increases resulting from reported changes is determined as follows:

(a) If, based on the reported change, the individual is determined eligible for a new program with a higher benefit level, the effective date for the new program is determined in accordance with OAR 461-180-0090.

(b) For changes in income or increased deductions due to changes to an individual's marital status or number of eligible dependents that reduce patient liability under OAR 461-160-0610 or the OSIPM-EPD participant fee (see OAR 461-001-0035), the effective date is the first of the month in which the change is reported or discovered.

(c) For medical costs allowed in accordance with OAR 461-160-0030 that reduce the patient liability or participant fee:

(A) One-time and ongoing costs that have already been paid when the change is reported are allowed in the month they are reported.

(B) For one-time and ongoing costs that have been incurred but not paid, the change is effective the month the individual reports they paid the cost or began making payments.

(d) When the decrease in patient liability is caused by a higher maintenance standard due to a change in service setting, the effective date is the date the individual moves into the new service setting.

(e) When a decrease in patient liability is caused by a change in income and a change in service setting that occurs in the same month, the effective date is the day the individual moves into the new service setting.

(f) When the decrease in participant fee is caused by a higher maintenance standard due to a change in service setting or a combination of a higher maintenance standard and another change that is reported or discovered in the same month, the effective date is the first of the month the individual moves into the new service setting.

Or. Admin. Code § 461-180-0020

AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92; AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92; AFS 12-1993, f. & cert. ef. 7-1-93; AFS 2-1994, f. & cert. ef. 2-1-94; AFS 13-1994, f. & cert. ef. 7-1-94; AFS 13-2002, f. & cert. ef. 10-1-02; SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 10-2007, f. & cert. ef. 10-1-07; SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08; SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08; SSP 28-2009, f. & cert. ef. 10-1-09; SSP 32-2010, f. & cert. ef. 10-1-10; SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14; SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14; SSP 11-2018, amend filed 03/09/2018, effective 04/01/2018; SSP 15-2018, temporary amend filed 03/28/2018, effective 04/01/2018 through 09/20/2018; SSP 15-2018, temporary amend filed 03/28/2018, effective 4/1/2018; SSP 15-2018, temporary amend filed 03/28/2018, effective 04/01/2018 through 09/20/2018; SSP 22-2018, amend filed 06/05/2018, effective 7/1/2018; SSP 28-2018, amend filed 09/06/2018, effective 10/1/2018; SSP 15-2019, amend filed 06/11/2019, effective 7/1/2019; SSP 21-2020, amend filed 07/08/2020, effective 7/8/2020; SSP 70-2021, minor correction filed 12/14/2021, effective 12/14/2021; SSP 20-2023, amend filed 06/22/2023, effective 7/1/2023

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 411.706, 411.816, 412.014, 412.049, 413.085 & 414.685

Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.404, 411.706, 411.816, 412.014 & 412.049