WAG 15-08-03-b: Long Term Care/Supportive Living Facility Cases

  1. (FCRC) Complete Notice of Determination of Spenddown Met/Unmet - MANG Long Term Care Case (Form 458SP-3) in duplicate for each month a determination is made that spenddown is met/not met.
  2. (FCRC) Distribute Form 458SP-3.
    1. Send the original to client.
    2. File the copy in the case record.
  3. (FCRC) Return any medical bills/receipts and supporting documents to the client if spenddown has not been met.

    Make sure the Form 458SP-3 tells the client to ask the FCRC for a new determination when additional expenses are incurred that may cause spenddown to be met. 

  4. (FCRC) If spenddown is met, copy all supporting documents for allowable costs used in computing spenddown.
    1. File the copies and Form 2430ASP in the case record, as proof that spenddown has been met.
    2. Return the original documents to the client.