MEMORANDUM

DISCUSSION:

Effective June 1, 2011, durable medical equipment expenses will no longer be prorated when determining the date a spenddown is met.  Formerly, the rental of durable medical equipment was calculated by dividing the monthly charge for the equipment by the number of days in the month, allowing the pro-rated charge for each day.  Beginning June 1, 2011, Eligibility Specialists should allow the full amount of the rental on the date the expense is incurred rather than prorating the expense.

EXAMPLE: Mr. X has a spenddown of $100.00. The pharmacy bills him for the use of an oxygen machine on the first of the month for $150.00.  The expense of $150.00 exceeds the spenddown liability of $100.00.  Mr. X meets his spenddown on the 1st day of the month.

Additionally, reasonable cost of transportation and lodging to obtain medical treatment or services is added to the manual.  Transportation cost budgeted is the actual cost charged to the participant for transportation or if the individual uses their personal vehicle, mileage at the current rate of mileage reimbursement for FSD employees. Allow transportation costs for trips to and from a pharmacy or other location to fill prescriptions and doctor office visits.  Verify the mileage claimed is for a medical related trip using the date on the bill or receipt for the medical expense.

The Income Maintenance policy manual section:  0810.010.15.05 has been updated to reflect this change.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Effective June 1, 2011, discontinue prorating billed expenses of durable medical equipment to meet participants’ spenddowns.

KS