(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.
(b) In situations where a change in income or other circumstances, which results in a decrease in the share of cost, is not 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) Not make an adjustment for the excess income the beneficiary may have paid or obligated prior to county action specified in (b)(1) unless the county department determines that there was good cause for failure to report in a timely manner. Good cause shall be determined in accordance with Section 50175.
(c) When it is determined in accordance with (a) or (b) that there has been a decrease in the share of cost which is to be adjusted, the adjustment shall be made in accordance with the following:
(1) The period of adjustment shall begin with the month the county department takes action in accordance with (a) or (b), and shall terminate when the total adjustment has been made.
(2) The amount of the adjustment is the difference between the original share of cost and the corrected share of cost.
(3) The amount of the adjustment or a portion of the adjustment equal to the share of cost shall be subtracted from the share of cost each month until the adjustment is completed.
Credits
Note: Authority cited: Sections 10725, 14005.9 and 14124.5, Welfare and Institutions Code; Section 133.5, AB 251, Chapter 102, Statutes of 1981. Reference: Sections 14005.4, 14005.7 and 14005.9, Welfare and Institutions Code.
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. Amendment of subsections (a) and (b) filed 10-1-82 as an emergency; effective upon filing (Register 82, No. 40).
4. Certificate of Compliance transmitted to OAL 12-30-82 and filed 2-2-83 (Register 83, No. 6).
5. Editorial correction of Note filed 4-12-83 (Register 83, No. 16).
This database is current through 6/21/24 Register 2024, No. 25.
Cal. Admin. Code tit. 22, § 50653.3, 22 CA ADC § 50653.3
