621.07 Payment for Cost of Care: HCBC-CFI Medical Assistance (MAM)

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DFA notifies individuals of their responsibility to pay the correct amount toward the cost of care. New HEIGHTS automatically generates AE0105, HCBC/CFI Patient Liability Letter, when the individual is liable for cost of care. If New HEIGHTS is unavailable, use paper DFA Form 517C, the paper backup to the New HEIGHTS-generated AE0105.

The Office of Finance tracks cost of care payments. If the individual fails to pay the correct cost of care payment for 2 consecutive months, terminate HCBC-CFI services.