S.C. Code Regs. § § 126-535

Current through Register Vol. 48, No. 11, November 22, 2024

Section 126-535 - Sponsorship From the Medically Indigent Assistance Program

A. Payments shall be made only to general hospitals.

B. Individuals shall not be sponsored by the MIAP until all other means of reimbursement or service provision have been exhausted. This includes payments from third party sources defined in R126-500 K. This does not include payments by county indigent programs.

C. Rates for hospital reimbursement shall be prospectively determined. Payment from all sources shall not exceed the prospectively determined rate.

D. Full sponsorship for inpatient hospital services is available for eligible individuals whose gross family income is equal to or less than one hundred (100) percent of the poverty guidelines.

E. Partial sponsorship for inpatient hospital services is available for eligible individuals whose gross family income is between one hundred (100) and two hundred (200) percent of the poverty guidelines. Partial sponsorship is based on a sliding scale which is calculated by determining the percentage by which the individual's gross family income exceeds the poverty guidelines for the appropriate size family, multiplied by an amount which is equal to 1% of the mean MIAP payment amount. The MIAP sponsorship shall be determined based on the following formula: the prospectively determined rate minus all third party payments, excess liquid assets paid to the hospital, and the sliding scale amount for which the individual is responsible.

S.C. Code Regs. § 126-535