<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.11.03.07" title_num="10" subtitle_num="11" chapter_num="03" heading="Financial Eligibility.">
  <paragraph num="A.">
    <text>An applicant's financial eligibility is based upon the composition and income of the family unit.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Family Unit. A family unit consists of one or more of the following members residing in the same household:</text>
    <paragraph num="(1)">
      <text>The applicant;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The natural or adoptive parents, stepparents, or legal guardian if the applicant is unmarried;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The unmarried natural or adoptive siblings of the applicant who are younger than 22 years old;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The lawful spouse of the applicant; or</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Other individuals who are not included in this regulation and who are dependents for federal income tax purposes.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Income.</text>
    <paragraph num="(1)">
      <text>For the purpose of determining financial eligibility, the CMS Program shall treat the income of members of the family unit listed in §B of this regulation as the sole source for determining an applicant’s eligibility.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The CMS Program shall determine the family’s income from the following sources:</text>
      <paragraph num="(a)">
        <text>Wages, including sick or severance pay;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Commissions and fees;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Salaries and tips;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Profit from self-employment, including income from the operation of a farm;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The earned income tax credit (EITC);</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Social Security benefits;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Veterans' Administration benefits;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Workers' Compensation benefits;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Black Lung or Agent Orange benefits;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Railroad Retirement;</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Government, private, or company pensions and annuities;</text>
      </paragraph>
      <paragraph num="(l)">
        <text>Unemployment insurance benefits;</text>
      </paragraph>
      <paragraph num="(m)">
        <text>Payments from oil or mineral rights (leases);</text>
      </paragraph>
      <paragraph num="(n)">
        <text>Government payments on land;</text>
      </paragraph>
      <paragraph num="(o)">
        <text>Insurance benefits paid directly to an applicant;</text>
      </paragraph>
      <paragraph num="(p)">
        <text>Trust funds;</text>
      </paragraph>
      <paragraph num="(q)">
        <text>Individual retirement accounts (IRAs);</text>
      </paragraph>
      <paragraph num="(r)">
        <text>Keough plans;</text>
      </paragraph>
      <paragraph num="(s)">
        <text>Military allotments;</text>
      </paragraph>
      <paragraph num="(t)">
        <text>Alimony or court-ordered and voluntary child support payments received from an absent spouse, or an absent natural or adoptive parent;</text>
      </paragraph>
      <paragraph num="(u)">
        <text>Loan repayments made to the applicant or family member including, but not limited to, mortgage payments;</text>
      </paragraph>
      <paragraph num="(v)">
        <text>Lump-sum benefits or other amounts of income received on a one-time-only basis;</text>
      </paragraph>
      <paragraph num="(w)">
        <text>Profit from rental income;</text>
      </paragraph>
      <paragraph num="(x)">
        <text>Cash assistance received from non-governmental social service agencies greater than the amount allowed by Medical Assistance;</text>
      </paragraph>
      <paragraph num="(y)">
        <text>Sick pay which does not count as earnings for deduction purposes under Title II of the Social Security Act; and</text>
      </paragraph>
      <paragraph num="(z)">
        <text>Any subsidy covering basic needs for food or shelter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>If an individual in the family unit has recently resumed employment, the Program shall determine income for a 12-month period by averaging actual income for 6 months preceding resumption of employment and projected income for 6 months following resumption of employment.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If additional CMS Program services are requested 6 months after resuming employment, the CMS Program may re-determine financial eligibility based on current income.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Medical Deductions. The applicant may deduct the following from the applicant’s income:</text>
    <paragraph num="(1)">
      <text>Loan payments related to medical or medically related emergency debt;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Payment to a hospital or other health care provider for a member of the family unit not covered by other third-party insurance entitlements, or the Program; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Payments for health insurance for a member of the family unit.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Effective Dates for Financial Eligibility.</text>
    <paragraph num="(1)">
      <text>The CMS Program shall establish financial eligibility for a 12-month period from the date a completed application is received by the CMS Program.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Exceptions to the 12-month financial eligibility period are:</text>
      <paragraph num="(a)">
        <text>If financial eligibility was determined by averaging the previous 6 months, financial eligibility shall be reconsidered after 6 months;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>When an eligible applicant enrolled in the CMS Program informs the CMS Program of changes in family size, income, or expense, the CMS Program may reconsider eligibility as soon as possible if financial assistance is being given, or when the next request for services is made.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Those receiving CMS Program financial assistance shall notify the CMS Program within 10 business days of any changes in circumstance which could affect continuing financial eligibility.</text>
    </paragraph>
  </paragraph>
</regulation>