5101:1-39-15 Medicaid: treatment of earned income.

“Earned income” is payment received by an individual for services performed as an employee or as a result of being engaged in self-employment or as a result of providing room and board, or board.

(A) Earned income includes wages and net earnings from self-employment.

(B) When the assistance group is both employed and self-employed, earned income will consist of wages plus net earnings from self-employment.

(C) The county department of job and family services (CDJFS) shall determine the gross monthly amount of earnings, i.e., the amount of earnings before taxes and other deductions as set forth in rules 5101:1-39-201 and 5101:1-39-202 of the Administrative Code. The monthly amount of gross earnings is rounded down to the nearest whole dollar to arrive at the gross earned income. The appropriate income disregards are combined by category and deducted from the gross earned income. The subtotal is rounded down to the nearest whole dollar to determine the monthly countable earned income.

(1) Verification of wages is required at initial application, reapplication, when discrepancies in earnings information is discovered, and whenever wage amounts change.

(2) Verification of wages is not necessary when the assistance group alleges he or she has not worked in the current period and there is no reason to question the statement, or reports earnings sufficiently high to make him clearly ineligible for medicaid.

(D) “Net earnings from self-employment” is that income derived from a trade/business after the costs associated with the operation of such trade/business have been deducted.

(E) The amount of earnings from self-employment reflected in the employee’s tax return shall be used to determine projected monthly countable income. Business records may also be used when the tax return filed for the previous year does not cover the twelve months of the calendar year.

(F) When the prior year’s tax return cannot be used to determine net earnings from self-employment, the CDJFS shall obtain an estimate of net earnings for the entire taxable year and allocate the net earnings equally into all months of the taxable year even if the business is seasonal.

(G) After net income from self-employment has been determined, the CDJFS shall combine the appropriate income disregards and subtract from the net income. The subtotal is rounded down to the nearest whole dollar to determine the monthly countable income. Income disregards must be applied in the order in which they are listed.

HISTORY: Eff 9-3-77; 12-31-77; 3-1-79; 10-1-79; 12-7-79; 1-3-80; 10-1-88 (Emer.); 12-20-88; 10-1-89 (Emer.); 12-16-89; 5-1-91 (Emer.); 9-1-94; 10-1-02

Rule promulgated under: RC 111.15

Rule authorized by: RC 5111.011, 5111.01

Rule amplifies: RC 5111.01, 5111.011

R.C. 119.032 review dates: 6/11/2002 and 10/01/2007