Section 456.423 - Patient-paid Amount(A) If the MassHealth agency determines that a member is financially eligible for nursing facility services, the MassHealth agency will issue a notice that contains the effective date of coverage and the patient-paid amount.(B) The patient-paid amount is applied to the nursing facility's per diem rate for the member. If the member is discharged from the facility or transferred to another nursing facility, the patient-paid amount is applied up to the last full day of the member's stay and the nursing facility must do the following. (1) If the member is transferred from one facility to another, the first facility must notify the second facility of the disposition of the patient-paid amount. If the first facility receives a patient-paid amount in excess of the per diem rate for the number of days the member was in the facility, then the first facility must issue a check to the second facility for the amount of the balance. The first facility must submit a claim for the member's stay up to, but not including, the day of transfer, even if the claim will not result in any payment by MassHealth to the facility. Submission of this claim is necessary to ensure that the second facility is correctly paid.(2) If the member is discharged to the community and the facility received a patient-paid amount in excess of the per diem rate for the number of days the member was in the facility, then the facility must return the balance of the patient-paid amount to the member.(3) If the patient dies and the facility has received a patient-paid amount in excess of the per diem rate for the number of days the member was in the facility, then the facility must deposit the balance into the member's personal needs account or return the balance to the party who paid the patient-paid amount. See130 CMR 456.614 for the disposition of the personal needs allowance account when a member dies.Amended by Mass Register Issue 1505, eff. 10/1/2023.