Beneficiary liability definition

Beneficiary liability means the LTSS beneficiary’s financial obligation toward the Medicaid LTSS cost of care, as determined monthly.
Sample 1Sample 2Sample 3
Beneficiary liability means the amount per month a CSLP participant is required to pay toward the cost of Medicaid-funded services based on the determination of financial eligibility and the post-eligibility treatment of income (PETI) by EOHHS LTSS staff in accordance with MCAR, section 0398.30.05. A certified residence is responsible for collecting the beneficiary liability.
Sample 1Sample 2

Examples of Beneficiary liability in a sentence

  • If a Medicare bene- ficiary enrolls with an HMO or CMP, CMS pays the HMO or CMP on his or her behalf for the services to which he or she is entitled.(c) Beneficiary liability.

  • Beneficiary liability may not be imposed without first providing prior notice to the beneficiary indicating the amount of the monthly payment and appeal rights.

  • Beneficiary liability is also adjusted prospectively, even in situations in which a beneficiary did not make a timely report of such a change.

  • Beneficiary liability also includes any expenses for medical or related services and supplies not covered by CHAMPUS.

  • Beneficiary liability also includes any expenses for services and supplies not covered by the TDP, less any available discount provided as a part of the in- surer’s agreement with an approved al- ternative delivery system.

  • A dependent of an active duty, Selected Reserve or Individual Ready Reserve member, or a member of the Selected Reserve or Individual Ready Reserve, who has been enrolled in the TDP, and has been determined to be eligible for benefits, as set forth in paragraph (c) of this section.‌ (4) Beneficiary liability.

  • Beneficiary liability will occur only if an MCE appeal, fair hearing decision, Secretary’s reversal and/or judicial opinion upholds the adverse determination, and the MCE also determines that the beneficiary should be held liable for service costs.

  • A dependent of anactive duty, Selected Reserve or Individual Ready Reserve member, or a member of the Selected Reserve or Individual Ready Reserve, who has been enrolled in the TDP, and has been determined to be eligible for benefits, as set forth in paragraph (c) of this section.(4) Beneficiary liability.

  • Beneficiary liability operates the same as under the current Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) payment system.

  • Beneficiary liability will occur only if an MCO appeal, fair hearing decision, Secretary's reversal and/or judicial opinion upholds the adverse determination, and the MCO also determines that the beneficiary should be held liable for service costs.

Related to Beneficiary liability

  • Beneficiary means each designated person, or the estate of the deceased Executive, entitled to benefits, if any, upon the death of the Executive, determined according to Article 4.

  • Income beneficiary means a person to whom net income of a trust is or may be payable.

  • Qualified beneficiary means a beneficiary who, on the date the beneficiary's qualification is determined:

  • Death Benefit means the insurance amount payable under the Certificate at death of the Insured, subject to all Certificate provisions dealing with changes in the amount of insurance and reductions or termination for age or retirement. It does not include any amount that is only payable in the event of Accidental Death.

  • Beneficiary Designation Form means the form established from time to time by the Plan Administrator that the Executive completes, signs and returns to the Plan Administrator to designate one or more Beneficiaries.