Mass changes happen in January, July, and October of each year. These changes can change an individual's payment toward cost of care.
PMN17784472 Long Term Care (LTC) Related Cost of Living Adjustment (COLA) Posted: November 21, 2015
The Client Information System (CIS) identifies LTC persons who are affected by the COLA and changes their payments. CIS lets the CAO know of any cases it can’t handle.
For cases it can’t handle, the CAO must determine the amount of the new benefit and figure out the individual’s new payment toward cost of care. On or before January 16, the CAO must send the individual a notice about the change in his or her payment toward cost of care as of January 1st. This allows for 15 days advance notice, as the LTC facilities cannot bill for the month of January until February. The CAO must process an overpayment on any COLAs processed after this date.
Note: The special income limit for nonmoney payment (NMP) MA LTC will increase at the same time that RSDI benefits increase. The CAO must use the new limit to determine whether the individual can keep getting benefits.
The CAO must not count the Social Security COLA in January if it would keep the individual from being able to have Buy-In. Instead the CAO must wait until the federal poverty guidelines are updated.
In July of each year, the federal government increases the minimum monthly maintenance needs allowance (MMMNA), the excess shelter standard, and the dependent living with community spouse allowance.
The change gives the community spouse (CS) a new community spouse monthly maintenance needs allowance (CSMMNA).
CIS finds the names of individuals who are affected and makes the changes.
CIS lets the CAO know of any cases it can’t process automatically.
By July 31, the CAO must decide whether the CS can get an increase in the CSMMNA effective July 1.
The CAO must send a notice about the decision to the individual, the individual’s representative (if any), and the LTC facility.
In October of each year, the federal government increases the SNAP standard utility allowances. This change affects the amount a person’s CS can get for a Community Spouse Monthly Maintenance Needs Allowance (CSMMNA).
CIS finds the names of individuals who are affected and makes the changes.
CIS lets the CAO know of any cases it can’t process automatically.
By October 31, the CAO must decide whether the CS can get an increase in the CSMMNA effective October 1.
The CAO must send a notice about the decision to the individual, the individual’s representative (if any), and the LTC facility.
Updated December 21,2015 Replacing March 12, 2012