STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
Date: July 27, 2007
Subject: Aged, Disabled and Long Term Care Medicaid Manual Change #6
This manual change implements new transfer of asset policies. It also adds a new resource policy for an individual whose equity interest in a home exceeds $500,000. This is a result from the Deficit Reduction Act ( DRADRA) of 2005, which was signed into law February 8, 2006. These policies are effective for all Medicaid applications and reviews received on or after August 1, 2007, and for any new discovery of transfer of assets for less than fair market value. These policy changes affect individuals applying for or receiving Medicaid long term care or home and community based waiver services.
This manual change also implements new policy resulting from a change in state law that increases the resource limit for the Working Disabled Buy-In program to $10,000 for an individual and $15,000 for a couple.
A description of these changes is included in the overview below. If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or email dpapolicy@health.state.ak.us
OVERVIEW OF CHANGES
MS 524-G - Institutionalized Individuals with Substantial Home Equity
New subsection. Adds Medicaid exception to APA policy regarding the exemption of an individual’s home for long-term care services.
MS 524-H - Promissory Notes, Loans, and Property Agreements for Institutionalized Individuals
New subsection. For transfer of asset purposes only, adds Medicaid exception to APA policy regarding the treatment of promissory notes, loans, and property agreements for long-term care services.
MS 524-I - Purchase of Life Estates for Institutionalized Individuals
New subsection. For transfer of asset purposes only, adds Medicaid exception to APA policy regarding the treatment of life estates for long-term care services.
MS 524-J - Resource Limit for the Working Disabled Buy-In Category
New subsection. For the Working Disabled Buy-In category only, adds resource exception to the APA policy regarding the resource limit.
MS 534 - Working Disabled Buy-In
Adds new policy that increases the resource limit for the Working Disabled Buy-In program to $10,000 for an individual, or $15,000 for a couple.
MS 553-C Substantial Home Equity
New subsection. Adds new policy that an individual is not eligible for long-term care services if the individual’s equity interest in the individual’s home exceeds $500,000. This policy does not apply if a spouse, child under 21, or disabled child of any age is living in the home.
MS 554 - Transfer of Assets
Updated section with new transfer of asset
policies:
Lengthens look-back
period from 3 years (36 months) to 5 years (60 months) for individuals
applying for long term care services, including home and community-based
waivers. The look-back period is lengthened from the 36-months
prior to the month of application to 60-months prior to the month
of application. This will be phased-in over a 5-year period
from the date of enactment, which is February 8, 2006.
Changes the beginning
date for a transfer of asset penalty for transfers for less than fair
market value after February 8, 2006. The penalty period begins
on the date of application or the time of transfer, whichever is later.
Clarifies when the transfer
of the home to an adult child will not result in a transfer of asset
penalty.
Adds a new subsection on non-allowable transfers.
Adds new policy on when
the purchase of promissory notes and loans are not considered a transfer.
Adds new policy on when
the purchase of life estates is considered a transfer.
Adds new policy on when
the purchase of an annuity is an allowable transfer.
Requires an individual
(including the individual’s spouse) to disclose any interest in an
annuity.
Adds new policy on partial
month penalties and examples showing the calculation for the remainder
amount of penalty period.
Adds e-mail contacts for
the Division of Senior and Disabilities Services and the Division
of Health Care Services and describes information that must be provided
to those agencies when a transfer of asset penalty is imposed.
Clarifies policy on undue
hardship determinations.
Allows a long term care facility to file an undue hardship request on behalf of the individual with consent of the individual or personal representative.
Addendum 6 - Medicare Part D Low Income Subsidy Guide
Removes SeniorCare Prescription Drug Coverage
UPDATED FORMS
The following forms have been revised to comply with the new transfer
of asset requirements:
Med
3 - Declaration Denial of Asset Transfer Form; and
Med
4 - Application for Adults and Children with Long Term Care Needs.
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