PURPOSE: This ruledefines terms to be used in the interpretation of the rules of this chapter.

1. (1) Ability to pay for Missouri residents means that within the standard established in 6 CSR 250-7.030 the patient has sufficient income or sources of income to pay for services. Ability to pay may be for diagnosis only without acceptance for treatment or it may be divided between diagnosis and treatment.
2. (2) Ability to pay for persons who are not residents of Missouri means that one-fifth (1/5)ofthenetannualdisposableincomeofthe patient and the patient’s family and other responsible parties is greater than the net annual charges.
3. (3) Agreement means either the written agreement by residents of Missouri to pay in accordance with their ability to pay for services within the standard established in 6 CSR 250-7.030 or the written agreement by nonresidents of Missouri to pay for all services provided by the State Cancer Center as mandated by section 200.101, RSMo (1986).
4. (4) Gross income means the income of the patient and the responsible party(ies). It includes, but is not limited to? the following: cash or credits of any kind recewed for services performedin a” employment, self-employment ortrainingprogram;publicassistance benefits such as food stamps; maintenance or alimony; child support; unemployment insurance or compensation; disability insurance; pensions; annuities; Workers’ Compensation; Social Security; military benefits; Supplemental Security Income (SSI); retirement benefits; rental income; regular contributions from relatives and others; and dividends or interest received or accumulative on investment interests.
5. (5) Net annual charges means the total projected annual charges minus verified annual insurance resources.

6. (6) Net annual disposable income means the adjusted annual gross income of the patient and the patient’s family and other responsible parties minus federal and state income taxes

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and minus other identified debt payments paid ~““UdlY.

1. (7) Number of persons in the hauseholdmeans the patient or the responsible part&s) and dependents allowable by the Internal Revenue Service as federal income tax exemptions.
2. (8) Patient means any person actually receiving care or other services from the Ellis Fischel State Cancer Center.
3. (9) Residency means that a person is residing at a dwelling place within the borders of Missouri and intends to make that dwelling place his/her permanent (at least one (1) year) home as indicated by the following factors by way of example! but not exclusively: a home(s) outside Missouri has (have) been sold or is (are) listed for sale; place of employment is in Missouri;patient orresponsiblepatiy has paid local property taxes within the last year; or patient or responsible party has filed Missouri income tax returns within the last year.
4. (10) Responsiblepartymeans anypersonwho, as aresult of familial orlegalrelationship with a patient, personally is liable for the cost of health or medical care for the patient; or a person who voluntarily has accepted personal financial responsibility for the payment of medical or health care or services for the patient.
5. (11) State Cancer Center means the State Cancer Center in Columbia, Missouri, more commonly known as the Ellis Fischel State cancer center.
6. (12) Third-party source means, but is not limited to, p&&insurance of any type which is required to be paid as a result of admission either as a” inpatient or as a” outpatient to any hospital or on a” expense-incurred basis for health expenses-Blue Cross or other commercial insurance; Medicare or Medicaid or both, other federal and stats public assistance programs for health care; Workers’ Compensation; trusts; estates: or any other form of indemnity for illness or injury.

7. (13) Timeliness of payment means that charges of two thousand dollars ($2000) or less are paid within six (6) months after the original first billing date, and that charges of more than two thousand dollars ($ZOOO), but less than ten thousand dollars ($lO,OOO), are paid within twelve (12) months after the original first billing date, and that charges over ten thousand dollars ($10,000) are paid within twenty-four (24) months after the original billing date. If a financial analysis indicates that the timeliness of payment requirements cannot be met, then the

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requirements to show the ability to pay have not been met.

Auth: sections 192.005.2. and 200.030, RSMo (1986). This rule was previously filed as 19 CSR 80-1.010. Original rule filed May 15, 1990, effectectiue Sept. 28, 1990.