Or. Admin. Code § 411-014-0025
Current through Register Vol. 63, No. 11, November 1, 2024
Section 411-014-0025 - [Effective until 11/26/2024] Financial Eligibility for OPI-M(1) The income and resource methodology for OSIPM outlined in OAR chapter 461 is used to determine financial eligibility for the OPI-M except as follows: (a) In OPI-M an individual must have adjusted income (see OAR 461-001-0000) that is equal to or less than 400 percent of the federal poverty level for a family of one and may not be exceeded through qualifying trusts as specified in OAR 461-145-0540(9)(c).(b) For an individual, the resource limit is calculated using the basic statutory daily nursing facility rate as described in OAR 411-070-0075(1) multiplied by 30.4 (average days per month) multiplied by six (6) months.(c) At initial eligibility, the resources of the spouse (see OAR 461-001-0000) are considered and the provisions of OAR 461-160-0580(2)(f)(A) apply, except that the individual's resource limit is calculated in accordance with subsection (b) of this section.(d) Individuals are subject to the rules regarding both of the following: (A) The transfer of assets as set forth in OAR 461-140-0210 to 461-140-0300.(B) The home equity value limits as set forth in OAR 461-145-0220.(2) No payments or benefits paid under OPI-M shall be subject to the estate recovery program, including, without limitation, under OARs 461-135-0835, 461-135-0837, and 461-135-0845. Trustees of Medicaid-qualifying trusts (OARs 461-145-0540(10)(a), 461-145-0540(10)(c), or 461-145-0540(11)) need not repay these benefits under those trusts' required payback clauses. Notwithstanding the exclusion of OPI-M services from estate recovery, an individual must still comply with OAR 461-145-0022 Annuities: OSIPM.(3) OPI-M recipients are not subject to a liability as described in OAR 461-160-0620.Or. Admin. Code § 411-014-0025
APD 23-2024, temporary adopt filed 05/20/2024, effective 5/31/2024 through 11/26/2024Statutory/Other Authority: ORS 409.050, 410.060, 410.070, 411.070, 411.404, 411.816, 412.049, 413.085 & 414.685
Statutes/Other Implemented: ORS 409.010, 410.060, 410.070, 411.070, 411.404, 411.816, 412.049, 413.085 & 414.685