Section 400.3163. Special living arrangements.

(1) A client who resides in an adult foster care  facility, county infirmary, or home for the aged may  be  eligible  for  a   client incidental allowance and for provider payment.

(2)        A client who resides in a substance abuse treatment center, long-term care facility, or hospital may be eligible for a client incidental allowance, but is not eligible for provider payment.

(3)        A special living arrangement facility must be licensed in order to receive payment.

(4)       The department must determine a client's level of care  to  be  either domiciliary care or personal care before provider payment may be authorized.

(5)     Provider payment for a special living arrangement may begin up to 10 calendar days before the application filing date for an eligible client who was residing in a facility 10 days before the date of application.

(6)      Subject to subrule (5) of this rule, per diem provider payment eligibility begins the day an eligible  client  enters  a  special  living arrangement facility and ends the day the client becomes ineligible for assistance or the day before the date of discharge, whichever is earlier.

(7)      If a client's failure to report timely, complete, and accurate information results in an overpayment for special living arrangement care, then the department shall recover the amount overpaid from the client.

(8)     If a provider of special living arrangement care is overpaid as a result of incorrect provider billing or level of care authorization, then the department shall recover the amount overpaid from the provider.

History: 1998-2000 AACS; 2015 AACS.