Ala. Admin. Code r. 560-X-25-.11

Current through Register Vol. 43, No. 02, November 27, 2024

Section 560-X-25-.11 - Additional Criteria For Institutional Care

(1) In addition to the rules covered in Rules 560-X-25-.05 through .11 the following criteria must also be met for an individual to qualify for Medicaid in a Title XIX institution:

(a) The individual must be certified as needing the level of care received in an institution and as having a continuing need for institutionalized care.

(b) The individual must be in a facility certified to participate in the Medicaid program and which has a current provider agreement with the Medicaid Agency.

(2) In order for an individual institutionalized in a hospital or nursing home to qualify for the maximum income limit allowed for institutionalized Medicaid recipients, as described in Rule No. 560-X-25-.10, the individual must have been a resident of a Title XIX medical institution for 30 consecutive days or longer. Being a resident of an institution for 30 consecutive days means being a resident for the period beginning with day one until the last instant of the 30th consecutive day.

Authors: Arthur Miller, John H. Ziegler

Ala. Admin. Code r. 560-X-25-.11

Rule effective October 1, 1982. Amended: effective March 15, 1983. Emergency rule effective July 1, 1987. Amended: effective August 10, 1987.

Statutory Authority: Social Security Act, Title XIX; 42 C.F.R. §§401, et seq.; State Plan; Chapter 10 this Code; Social Security Act §1902(a)(10)(A)(ii)(V) as amended by §9510 of COBRA 1985.