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Effective: October 1, 2007 |
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19.40.50arc2 - Archived Transfer Information (Archive) |
Archived: July 1, 2010 |
This section contains archived transfer information for the MA program.
Ineligibility for MA for Transfers Prior to July 1, 1988.
Transfers Before August 11, 1993.
Transfers On or After August 11, 1993 Through August 31, 1994.
Transfers On or After September 1, 1994 Through April 13, 1996.
One-Time Spouse to Spouse Transfer for People in LTCF Prior to October 1, 1989.
The lookback periods for MA changed for transfers made on or before August 11, 1993. Both lookback periods were phased in to meet the current policy.
The lookback period increased from 30 to 36 months for transfers made on or after August 11, 1993 and was phased in as follows:
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If Date of LTC, Waiver Services When Applying For/Receiving MA is: |
Lookback Period is: |
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January 1991 - February 1996 |
30 months |
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March 1996 |
31 months |
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April 1996 |
32 months |
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May 1996 |
33 months |
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June 1996 |
34 months |
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July 1996 |
35 months |
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August 1996 or later |
36 months |
The lookback period increased from 30 months to 60 months for transfers made on or after August 11, 1993 and was phased in as follows:
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If Date of LTC, Waiver Services When Applying For/Receiving MA is: |
Lookback Period is: 1996 |
Lookback Period is: 1997 |
Lookback Period is: 1998 |
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January |
January 1991 - Feb 1996 - 30 months |
41 |
53 |
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February |
42 |
54 |
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March |
31 |
43 |
55 |
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April |
32 |
44 |
56 |
|
May |
33 |
45 |
57 |
|
June |
34 |
46 |
58 |
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July |
35 |
47 |
59 |
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August |
36 |
48 |
Aug 1998 and later - 60 months |
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September |
37 |
49 |
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October |
38 |
50 |
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November |
39 |
51 |
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December |
40 |
52 |
Ineligibility for MA for Transfers Prior to July 1, 1988
If the transfer occurred before July 1, 1988, a client is ineligible for all MA services during the penalty period.
Transfers Before August 11, 1993
l MinnesotaCare and GHO: No provisions.
l MA:
For uncompensated transfers occurring before August 11, 1993, the period of ineligibility is the lesser of 30 months or the number of months resulting from the steps in the following calculation:
1. Total the uncompensated value of transfers made in the same month.
2. Determine the uncompensated value of improperly transferred assets.
3. Divide the uncompensated value of the asset by the statewide average monthly payment rate for skilled nursing facility care (SAPSNF).
m Use the MA SAPSNF in effect on the date of the client's application that covers the current application processing period or period of MA eligibility.
Example:
If someone has been on MA since before July 1, 1990, the SAPSNF to use is $2,177.
m Truncate partial months.
m If the amount improperly transferred is less than the SAPSNF, it does not affect eligibility.
There is a 30-month maximum on penalty periods for transfers made before August 11, 1993.
Note: Because the maximum lookback period for this time frame is 60 months, no transfers made on or after August 11, 1998 will be subject to penalty.
l MA Multiple Transfers:
The following list considerations to keep in mind when processing a case with multiple transfers:
n When a person improperly transfers assets in different months, calculate the transfer period individually for each transfer.
n The transfer period begins the month of the transfer.
n The length of the transfer period for each transfer is the lesser of 30 months or the number of months calculated in the transfer period.
n If separate transfer periods overlap, continue to impose each penalty individually as calculated.
l GAMC:
For GAMC SAPSNF in effect for a particular date see GAMC SAPSNF.
Transfers On or After August 11, 1993 Through August 31, 1994
l MinnesotaCare and GHO: No provisions.
l MA:
Use the following steps to determine the ineligibility period for transfers occurring on August 11, 1993 through August 31, 1994:
1. Total the uncompensated value of transfers made in the same month.
2. Determine a penalty period for the total value of all uncompensated transfers made in each month in the lookback period separately by dividing the uncompensated amount by the monthly MA SAPSNF in effect on the date of the client's current application.
3. Chart out the months that each penalty period runs, beginning in the month each transfer occurred. Look for any months that occur in more than one penalty period. These are considered OVERLAPPING penalty periods.
4. If none of the charted ineligibility periods overlap, begin each ineligibility period in the month each transfer (or transfers, if more than one transfer was made in a given month) transfer was made, and stop here. If any ineligibility periods overlap, go on to Step 5.
5. If any of the penalty periods determined in Step 4 overlap, including any calculated penalty period for uncompensated transfers in amounts less than the monthly statewide average nursing facility payment, add the values of all the uncompensated transfers made in the lookback period together, and re-calculate a single ineligibility period. Truncate a partial month when determining the actual ineligibility period.
6. Begin the ineligibility period in the month of the first uncompensated transfer during the lookback period. The ineligibility period runs for the period of time calculated in Step 5.
l Multiple Transfers - MA:
When transfers have been made by a client in more than one month:
1. Determine if there are overlapping penalty periods for any of the transfers, by comparing the months of penalty to one another. For information on when to begin the MA Transfer Penalty see Applying the Transfer Penalty.
2. If penalty periods overlap, add the uncompensated value of each of the overlapping transfers together and determine a new transfer penalty.
3. Repeat Step 1. Use the new transfer penalty created in Step 2 and compare it to other transfer penalty periods checking for overlap.
4. Repeat Steps 1 and 2 until no transfer penalty periods are overlapping.
l GAMC:
For GAMC SAPSNF in effect for a particular date see GAMC SAPSNF.
Transfers On or After September 1, 1994 Through April 13, 1996
l MinnesotaCare/GHO: No provisions.
l MA:
Use the following steps for transfers made on or after September 1, 1994 through April 13, 1996:
1. Total the uncompensated value of transfers made in the same month.
2. If the total amount transferred for less than fair market value in any month by the client and spouse combined does not exceed $1000 in total value for the month, disregard that amount and do not calculate a penalty period. Disregard transfers of $1000 or less made in any month after September 1, 1994 even if the transfer occurred during a pre-existing penalty period.
3. If the amount transferred for less than fair market value is greater than $1000, determine a penalty period based on the total value of all uncompensated transfers made during that month. Do not disregard the first $1000 transferred.
4. If the total uncompensated value of assets transferred in a month by the client and spouse combined is greater than $1000, divide the uncompensated value by the MA SAPSNF in effect on the date of the client's application.
Note: Do not truncate partial months. Apply a partial month of ineligibility for MA payment of long-term care services to both applicants and recipients.
5. If the transferred amount is less than the applicable SAPSNF, deny eligibility for long-term care services equal to the amount transferred. The result is the dollar amount of long-term care services the client is responsible for before MA eligibility for long-term care services can begin.
6. If the transferred amount is more than the applicable SAPSNF and a fractional part of a month remains after calculating a period of ineligibility, multiply the remainder (rounded to hundredths) by the applicable SAPSNF. Truncate that result. The result is the dollar amount of long-term care services the client is responsible for in the last partial month of ineligibility.
7. Add the amount determined in Step 6 to the client's long-term care spenddown or medical spenddown, whichever applies, for the partial month of ineligibility. This is the client's total liability for the partial month.
Eligibility for payment of long-term care services begins after that amount has been incurred by the client. If a client does not incur long-term care services equal to or greater than his/her total liability, do NOT carry the penalty over to the next month.
l Multiple Transfers - MA:
When transfers have been made by a client in more than one month:
1. Determine if there are overlapping penalty periods for any of the transfers, by comparing the months of penalty to one another. For information on when to begin the MA Transfer Penalty see Applying the Transfer Penalty.
2. If penalty periods overlap, add the uncompensated value of each of the overlapping transfers together and determine a new transfer penalty period.
3. Repeat Step 1. Use the new transfer penalty created in Step 2 and compare it to other transfer penalty periods checking for overlap.
4. Repeat Steps 1 and 2 until no transfer penalty periods are overlapping.
l GAMC:
For GAMC SAPSNF in effect for a particular date see GAMC SAPSNF.
One-Time Spouse to Spouse Transfer for People in LTCF Prior to October 1, 1989
Applicants residing in an LTCF before October 1, 1989, may make a one-time only transfer of assets to their spouses if all the following conditions apply:
l The spouse is not an MA enrollee.
l The amount transferred, when added to the community spouse's verified non-excluded assets, totals $10,000 or less at the time of transfer.
l The transfer must be made between the first of the month before the month of application and 15 days after the date the local agency notifies the applicant of the need to reduce assets or the date of the local agency's action on the application, whichever is later.
Example:
Bertha has resided in an LTCF as a private pay client since 1987. Her husband Frank remains in the community and has private health insurance. Frank applies for MA for Bertha on June 1, because they have exhausted most of their resources. Bertha transferred $1000 of her own assets to Frank on May 15th. Together they have $9000 in joint accounts.
Action:
On June 15, the worker determines that Bertha has excess assets for MA. The worker issues a notice stating Bertha is over assets but that she can reduce her assets by transferring them to Frank.
Bertha’s transfer meets a transfer exception and is not improper. Bertha may also transfer her share of the jointly held funds to Frank because the total of all the funds to be transferred is $10,000. The transfer must be completed by June 30.