H-3600, When Not to Reconcile

H-3610 Variable Income

Revision 09-4; Effective December 1, 2009

  1. The average monthly variable income adjustment for the reconciliation period is less than $5. 
  2. Variable income is stable with minor fluctuations.

    Example: The review is completed in February, with the preceding six months being August through January. Actual variable income for the period totaled $100; projected variable income for the period totaled $75. Calculation: $100 Total Actual − $75 Total Projected = +$25 Income Adjustment. Divide the income adjustment by the number of months (+$25 ÷ 6 = +$4.17). The +$4.17 monthly average is less than +$5, so reconciliation is not required. Do not reconcile if the monthly average is less than +$5.

H-3620 Incurred Medical Expenses (IMEs)

Revision 09-4; Effective December 1, 2009

  1. If the person's only IME is a fixed amount, there is no variable income, and the IME has been projected for a 12-month period. The case is monitored at regular intervals (such as every six months for monthly, quarterly and semi-annual payments) to ensure that payments continue, but reconciliation is not required unless the payments are no longer made or the amount paid is different from the amount projected.
  2. If a missed monthly IME payment was made up by a double payment in a subsequent month, do not reconcile for the missed payment.

H-3630 Both Variable Income and Incurred Medical Expenses (IME)

Revision 09-4; Effective December 1, 2009

If co-payment is $0 and reconciliation would not change the co-payment amount, do not reconcile.