A.__To the extent reasonably practicable, the department shall determine, on a prospective basis, the MaineCare cost of care of an individual MaineCare recipient residing in a nursing facility or other health care institution, referred to in this subsection as "a health care institution."__The department shall simultaneously determine:

(1)__The amount of the MaineCare payments to be paid to the health care institution; and

(2)__The amount of the income and other resources that the individual MaineCare recipient and the recipient's spouse may retain for their personal use.

B.__When it is not reasonably practicable for the department to make its initial cost-of-care determinations effective prior to the beginning of a particular month, the department shall make its initial determination as soon as practicable and that determination may be effective retroactively for up to 3 months prior to the date of the determination.

C.__The department shall make monthly prospective MaineCare payments to a health care institution for care rendered to each MaineCare recipient in accordance with the cost-of-care determination it has made in accordance with paragraph A or B.

D.__When the department has already made an initial determination pursuant to paragraph A or B and the department subsequently determines to adjust that determination in a manner that reduces the cost-of-care amount that is paid to a health care institution by the MaineCare program, the department may not retroactively reduce the amount of the MaineCare payment to the health care institution unless the individual MaineCare recipient, or the recipient's responsible party, has paid to the health care institution the additional amount for which the individual is determined responsible following the department's redetermination.

E.__The department, and not a health care institution, has the obligation to recover from an individual MaineCare recipient the amount by which the previously determined MaineCare cost-of-care payment has been determined to exceed the amount of MaineCare benefit that individual is entitled to receive.