18 CRR-NY 360-9.3NY-CRR

OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 18. DEPARTMENT OF SOCIAL SERVICES
CHAPTER II. REGULATIONS OF THE DEPARTMENT OF SOCIAL SERVICES
SUBCHAPTER B. PUBLIC ASSISTANCE
ARTICLE 2. DETERMINATION OF ELIGIBILITY—CATEGORICAL
PART 360. MEDICAL ASSISTANCE
SUBPART 360-9. CATASTROPHIC HEALTH CARE EXPENSE PROGRAM
18 CRR-NY 360-9.3
18 CRR-NY 360-9.3
360-9.3 Definitions.
For the purposes of this Subpart:
(a) Adjusted family income means the family income during a calendar year reduced by documented alimony payments, support payments, FICA contributions and Federal, State and local income tax payments.
(b) Eligible catastrophic health care expenses means those health care expenses which can be paid for under the Medical Assistance (MA) program excluding expenses incurred for services provided to in-patients or residents of health care facilities, other than expenses incurred for acute care services that are provided by general hospitals. Eligible catastrophic health care expenses must be incurred in a calendar year after the time when a family's total health care expenses exceed 50 percent of the difference between the annual adjusted family income and the maximum amount of public assistance (PA) the family would receive if it were eligible for PA.
(c) Hardship.
Hardship means an applicant's adjusted annual family income does not exceed 200 percent of the comparable Federal income official poverty line (as defined and annually revised by the Federal Office of Management and Budget) for a family of the same size and the family's total countable resources, computed according to Subpart 360-4 of this Part, do not exceed $10,000.
18 CRR-NY 360-9.3
Current through May 15, 2021
End of Document