How are “reasonable” business expenses defined for a self-employed applicant?
OAC 5101:3-2-07.17 (B)(2) does not specify which business expenses can be deducted from a self-employed patient’s income. Hospitals are advised to use common sense and the applicant’s most recent federal income tax return as guidance regarding which business expenses are deductible. This FAQ was moved from Section 3 on Documentation (07/01/10) COVERED MEDICAL SERVICES Note this section is renumbered as 7 (070110) 7.1 OAC 5101:3-2-07.17(A)(1) allows a hospital to include only medically necessary, “hospital-level” services in HCAP write-offs. How does a hospital determine which services are considered “hospital level?” The most important indicator is whether Medicaid would have covered the service had it been billed on a UB-04 using the hospital’s provider number. ODJFS maintains a list of Medicaid-covered UB-92 Revenue Codes in Attachment A to OAC 5101:3-2-02. Hospitals should use the list of covered Medicaid codes as a general indicator of what is considered covered “hospital-level” se
