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Document Index: 462726191

Matched Legal Cases: ['§ 1396', '§ 1396', '§1917', '§132', '§309', '§4211', '§303', '§411', '§608', '§6411', '§13611', '§6011', '§405', '§115', '§5006', '§202', '§5007', '§53102', '§53102', '§202', '§202', '§53102', '§6021', '§6021', '§6021', '§6011', '§6011', '§6016', '§6012', '§6012', '§6016', '§6016', '§6016', '§6011', '§6012', '§6014', '§6012', '§6015', '§6014', '§6015', '§13612', '§13612', '§13612', '§13611', '§13611', '§13611', '§13611', '§13611', '§13611', '§13611', '§13611', '§13611', '§6411', '§6411', '§6411', '§303', '§608', '§608', '§608', '§608', '§608', '§411', '§4211', '§608', '§608', '§4211', '§4211', '§411', '§309', '§309', '§53102', '§5007', '§115', '§405', '§6011', '§6012', '§6014', '§6016', '§13611', '§13612', '§132', '§6011', '§60216021', '§8002', '§10801', '§642']

Section 1396p - Liens, adjustments and recoveries, and transfers of assets, 42 U.S.C. § 1396p | Casetext Search + Citator
Title 42 - THE PUBLIC HEALTH AND WELFAREChapter 7 - SOCIAL SECURITY
Section 1396p - Liens, adjustments and recoveries, and transfers of assets
42 U.S.C. § 1396p
(i) In the case of an individual who has received (or is entitled to receive) benefits under a long-term care insurance policy in connection with which assets or resources are disregarded in the manner described in clause (ii), except as provided in such clause, the State shall seek adjustment or recovery from the individual's estate on account of medical assistance paid on behalf of the individual for nursing facility and other long-term care services.
(A) The State agency shall establish procedures (in accordance with standards specified by the Secretary) under which the agency shall waive the application of this subsection (other than paragraph (1)(C)) if such application would work an undue hardship as determined on the basis of criteria established by the Secretary.
(A) For purposes of clause (iii)(III), the model regulations and the requirements of the model Act specified in this paragraph are:
(A) In order to meet the requirements of this subsection for purposes of section 1396a(a)(18) of this title, the State plan must provide that if an institutionalized individual or the spouse of such an individual (or, at the option of a State, a noninstitutionalized individual or the spouse of such an individual) disposes of assets for less than fair market value on or after the look-back date specified in subparagraph (B)(i), the individual is ineligible for medical assistance for services described in subparagraph (C)(i) (or, in the case of a noninstitutionalized individual, for the services described in subparagraph (C)(ii)) during the period beginning on the date specified in subparagraph (D) and equal to the number of months specified in subparagraph (E).
(i) The look-back date specified in this subparagraph is a date that is 36 months (or, in the case of payments from a trust or portions of a trust that are treated as assets disposed of by the individual pursuant to paragraph (3)(A)(iii) or (3)(B)(ii) of subsection (d) or in the case of any other disposal of assets made on or after February 8, 2006, 60 months) before the date specified in clause (ii).
(i) The services described in this subparagraph with respect to an institutionalized individual are the following:
(i) In the case of a transfer of asset made before February 8, 2006, the date specified in this subparagraph is the first day of the first month during or after which assets have been transferred for less than fair market value and which does not occur in any other periods of ineligibility under this subsection.
(i) With respect to an institutionalized individual, the number of months of ineligibility under this subparagraph for an individual shall be equal to-
(A) In the case of a revocable trust-
(A) In the case of disclosure concerning an annuity under subsection (c)(1)(F), the State shall notify the issuer of the annuity of the right of the State under such subsection as a preferred remainder beneficiary in the annuity for medical assistance furnished to the individual. Nothing in this paragraph shall be construed as preventing such an issuer from notifying persons with any other remainder interest of the State's remainder interest under such subsection.
(A) Notwithstanding any other provision of this subchapter, subject to subparagraphs (B) and (C) of this paragraph and paragraph (2), in determining eligibility of an individual for medical assistance with respect to nursing facility services or other long-term care services, the individual shall not be eligible for such assistance if the individual's equity interest in the individual's home exceeds $500,000.
Aug. 14, 1935, ch. 531, title XIX, §1917, as added Pub. L. 97-248, title I, §132(b), Sept. 3, 1982, 96 Stat. 370; amended Pub. L. 97-448, title III, §309(b)(21), (22), Jan. 12, 1983, 96 Stat. 2410; Pub. L. 100-203, title IV, §4211(h)(12), Dec. 22, 1987, 101 Stat. 1330-207; Pub. L. 100-360, title III, §303(b), title IV, §411(l)(3)(I), July 1, 1988, 102 Stat. 760, 803; Pub. L. 100-485, title VI, §608(d)(16)(B), Oct. 13, 1988, 102 Stat. 2417; Pub. L. 101-239, title VI, §6411(e)(1), Dec. 19, 1989, 103 Stat. 2271; Pub. L. 103-66, title XIII, §§13611(a)-(c), Aug. 10, 1993, 13612, Aug. 10, 1993, 107 Stat. 622-628; Pub. L. 109-171, title VI, §§6011(a), (b), (e), Feb. 8, 2006, 6012, Feb. 8, 2006, 120 Stat. 61-68; Pub. L. 109-432, div. B, title IV, §405(b)(1), Dec. 20, 2006, 120 Stat. 2998; Pub. L. 110-275, title I, §115(a), July 15, 2008, 122 Stat. 2507; Pub. L. 111-5, div. B, title V, §5006(c), Feb. 17, 2009, 123 Stat. 507; Pub. L. 113-67, div. A, title II, §202(b)(3), Dec. 26, 2013, 127 Stat. 1177; Pub. L. 114-255, div. A, title V, §5007(a), Dec. 13, 2016, 130 Stat. 1197; Pub. L. 115-123, div. E, title XII, §53102(b)(1), Feb. 9, 2018, 132 Stat. 298.
REFERENCES IN TEXTThe Internal Revenue Code of 1986, referred to in subsecs. (b)(1)(C)(iii)(II) and (c)(1)(G)(i), is classified generally to Title 26, Internal Revenue Code.
AMENDMENTS 2018-Subsec. (a)(1)(A). Pub. L. 115-123, §53102(b)(1), repealed Pub. L. 113-67, §202(b)(3), and provided that the provisions amended by section 202(b) shall be applied and administered as if such amendment had never been enacted. See 2013 Amendment note below.2016-Subsec. (d)(4)(A). Pub. L. 114-255 inserted "the individual," after "for the benefit of such individual by". 2013-Subsec. (a)(1)(A). Pub. L. 113-67, §202(b)(3), which directed amendment of subpar. (A) to read as follows: "pursuant to-"(i) the judgment of a court on account of benefits incorrectly paid on behalf of such individual, or"(ii) rights acquired by or assigned to the State in accordance with section 1396a(a)(25)(H) of this title or section 1396k(a)(1)(A) of this title, or",was repealed by Pub. L. 115-123, §53102(b)(1). 2009-Subsec. (b)(3). Pub. L. 111-5 designated existing provisions as subpar. (A) and added subpar. (B) 2008-Subsec. (b)(1)(B)(ii). Pub. L. 110-275 inserted "(but not including medical assistance for medicare cost-sharing or for benefits described in section 1396a(a)(10)(E) of this title)" before period at end. 2006-Subsec. (b)(1)(C)(ii). Pub. L. 109-171, §6021(a)(1)(A)(i), inserted "and which satisfies clause (iv), or which has a State plan amendment that provides for a qualified State long-term care insurance partnership (as defined in clause (iii))" after "1993," in introductory provisions.Subsec. (b)(1)(C)(iii) to (vi). Pub. L. 109-171, §6021(a)(1)(A)(ii), added cls. (iii) to (vi). Subsec. (b)(5). Pub. L. 109-171, §6021(a)(1)(B), added par. (5).Subsec. (c)(1)(B)(i). Pub. L. 109-171, §6011(a), inserted "or in the case of any other disposal of assets made on or after February 8, 2006" before ", 60 months".Subsec. (c)(1)(D). Pub. L. 109-171, §6011(b), designated existing provisions as cl. (i), substituted "In the case of a transfer of asset made before February 8, 2006, the date" for "The date", and added cl. (ii). Subsec. (c)(1)(E)(iv). Pub. L. 109-171, §6016(a), added cl. (iv). Subsec. (c)(1)(F). Pub. L. 109-171, §6012(b), added subpar. (F).Subsec. (c)(1)(F)(i). Pub. L. 109-432 substituted "institutionalized individual" for "annuitant".Subsec. (c)(1)(G). Pub. L. 109-171, §6012(c), added subpar. (G). Subsec. (c)(1)(H). Pub. L. 109-171, §6016(b), added subpar. (H). Subsec. (c)(1)(I). Pub. L. 109-171, §6016(c), added subpar. (I).Subsec. (c)(1)(J). Pub. L. 109-171, §6016(d), added subpar. (J).Subsec. (c)(2). Pub. L. 109-171, §6011(e), substituted period for semicolon at end and inserted concluding provisions.Subsec. (e). Pub. L. 109-171, §6012(a), added subsec. (e). Former subsec. (e) redesignated (f).Subsec. (f). Pub. L. 109-171, §6014(a), added subsec. (f). Former subsec. (f) redesignated (g). Pub. L. 109-171, §6012(a), redesignated subsec. (e) as (f). Subsec. (g). Pub. L. 109-171, §6015(b), added subsec. (g). Former subsec. (g) redesignated (h). Pub. L. 109-171, §6014(a), redesignated subsec. (f) as (g).Subsec. (h). Pub. L. 109-171, §6015(b), redesignated subsec. (g) as (h). 1993-Subsec. (b)(1). Pub. L. 103-66, §13612(a), substituted "except that the State shall seek adjustment or recovery of any medical assistance correctly paid on behalf of an individual under the State plan in the case of the following individuals:" and subpars. (A) to (C) for "except-" and former subpars. (A) and (B) which read as follows: "(A) in the case of an individual described in subsection (a)(1)(B) of this section, from his estate or upon sale of the property subject to a lien imposed on account of medical assistance paid on behalf of such individual, and"(B) in the case of any other individual who was 65 years of age or older when he received such assistance, from his estate." Subsec. (b)(3). Pub. L. 103-66, §13612(b), added par. (3).Subsec. (b)(4). Pub. L. 103-66, §13612(c), added par. (4).Subsec. (c)(1). Pub. L. 103-66, §13611(a)(1), amended par. (1) generally. Prior to amendment, par. (1) read as follows: "In order to meet the requirements of this subsection (for purposes of section 1396a(a)(51)(B) of this title), the State plan must provide for a period of ineligibility for nursing facility services and for a level of care in a medical institution equivalent to that of nursing facility services and for services under section 1396n(c) of this title in the case of an institutionalized individual (as defined in paragraph (3)) who, or whose spouse, at any time during or after the 30-month period immediately before the date the individual becomes an institutionalized individual (if the individual is entitled to medical assistance under the State plan on such date) or, if the individual is not so entitled, the date the individual applies for such assistance while an institutionalized individual, disposed of resources for less than fair market value. The period of ineligibility shall begin with the month in which such resources were transferred and the number of months in such period shall be equal to the lesser of-"(A) 30 months, or "(B)(i) the total uncompensated value of the resources so transferred, divided by (ii) the average cost, to a private patient at the time of the application, of nursing facility services in the State or, at State option, in the community in which the individual is institutionalized."Subsec. (c)(2)(A). Pub. L. 103-66, §13611(a)(2)(A), substituted "assets" for "resources" in introductory provisions.Subsec. (c)(2)(B). Pub. L. 103-66, §13611(a)(2)(B), amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: "the resources were transferred (i) to or from (or to another for the sole benefit of) the individual's spouse, or (ii) to the individual's child described in subparagraph (A)(ii)(II);". Subsec. (c)(2)(C). Pub. L. 103-66, §13611(a)(2)(C), in introductory provisions, substituted "with regulations" for "with any regulations", in cl. (i), substituted "assets" for "resources" and struck out "or" at end, in cl. (ii), substituted "assets" for "resources" and ", or" for "; or", and added cl. (iii).Subsec. (c)(2)(D). Pub. L. 103-66, §13611(a)(2)(D), amended subpar. (D) generally. Prior to amendment, subpar. (D) read as follows: "the State determines that denial of eligibility would work an undue hardship." Subsec. (c)(3). Pub. L. 103-66, §13611(a)(2)(E), added par. (3) and struck out former par. (3) which read as follows: "In this subsection, the term 'institutionalized individual' means an individual who is an inpatient in a nursing facility, who is an inpatient in a medical institution and with respect to whom payment is made based on a level of care provided in a nursing facility, or who is described in section 1396a(a)(10)(A)(ii)(VI) of this title." Subsec. (c)(4). Pub. L. 103-66, §13611(a)(2)(F), inserted at end "In the case of a transfer by the spouse of an individual which results in a period of ineligibility for medical assistance under a State plan for such individual, a State shall, using a reasonable methodology (as specified by the Secretary), apportion such period of ineligibility (or any portion of such period) among the individual and the individual's spouse if the spouse otherwise becomes eligible for medical assistance under the State plan."Subsec. (d). Pub. L. 103-66, §13611(b), added subsec. (d).Subsec. (e). Pub. L. 103-66, §13611(c), added subsec. (e). 1989-Subsec. (c)(1). Pub. L. 101-239, §6411(e)(1)(A), inserted "or whose spouse," after "an institutionalized individual (as defined in paragraph (3)) who,". Subsec. (c)(2)(B)(i). Pub. L. 101-239, §6411(e)(1)(B)(i), amended cl. (i) generally. Prior to amendment, cl. (i) read as follows: "to (or to another for the sole benefit of) the community spouse, as defined in section 1396r-5(h)(2) of this title,,".Subsec. (c)(2)(B)(ii), (iii). Pub. L. 101-239, §6411(e)(1)(B)(ii), struck out ", or" after "subparagraph (A)(ii)(II)" in cl. (ii) and struck out cl. (iii) which read as follows: "to (or to another for the sole benefit of) the individual's spouse if such spouse does not transfer such resources to another person other than the spouse for less than fair market value".1988-Subsec. (c). Pub. L. 100-360, §303(b), amended subsec. (c) generally, substituting pars. (1) to (4) relating to taking into account certain transfers of assets, for former pars. (1) to (3) relating to denial of medical assistance, period of eligibility, and exceptions. Subsec. (c)(1). Pub. L. 100-485, §608(d)(16)(B)(i), substituted "period of ineligibility for nursing facility services and for a level of care in a medical institution equivalent to that of nursing facility services and for services under section 1396n(c) of this title in the case of an institutionalized individual (as defined in paragraph (3)) who, at any time during or after the 30-month period immediately before the date the individual becomes an institutionalized individual (if the individual is entitled to medical assistance under the State plan on such date) or, if the individual is not so entitled, the date the individual applies for such assistance while an institutionalized individual" for "period of ineligibility in the case of an institutionalized individual (as defined in paragraph (3)) who, at any time during the 30-month period immediately before the individual's application for medical assistance under the State plan".Subsec. (c)(2)(A)(ii). Pub. L. 100-485, §608(d)(16)(B)(ii), inserted subcl. (I) and (II) designations. Subsec. (c)(2)(A)(iii). Pub. L. 100-485, §608(d)(16)(B)(iii), substituted "the individual becomes an institutionalized individual" for "of the individual's admission to the medical institution or nursing facility". Subsec. (c)(2)(A)(iv). Pub. L. 100-485, §608(d)(16)(B)(iv), substituted "the individual becomes an institutionalized individual" for "of such individual's admission to the medical institution or nursing facility".Subsec. (c)(2)(B). Pub. L. 100-485, §608(d)(16)(B)(v), inserted cl. (i) designation, substituted "section 1396r-5(h)(2) of this title,," for "section 1396r-5(h)(2) of this title, or the individual's child who is blind or permanently and totally disabled", and added cl. (ii).Subsec. (c)(2)(B)(ii). Pub. L. 100-360, §411(l)(3)(I), amended Pub. L. 100-203, §4211(h)(12)(B), see 1987 Amendment note below. Subsec. (c)(3). Pub. L. 100-485, §608(d)(16)(B)(vi), substituted "in a nursing facility, who is an inpatient in a medical institution and with respect to whom payment is made based on a level of care provided in a nursing facility, or who is described in section 1396a(a)(10)(A)(ii)(VI) of this title" for "in a medical institution or nursing facility".Subsec. (c)(5). Pub. L. 100-485, §608(d)(16)(B)(vii), added par. (5). 1987-Subsecs. (a)(1)(B)(i), (c)(2)(B)(i). Pub. L. 100-203, §4211(h)(12)(A), substituted "nursing facility, intermediate care facility for the mentally retarded" for "skilled nursing facility, intermediate care facility". Subsec. (c)(2)(B)(ii). Pub. L. 100-203, §4211(h)(12)(B), as amended by Pub. L. 100-360, §411(l)(3)(I), substituted "a nursing facility" for "a skilled nursing facility" in two places each in subcls. (I) and (II).1983-Subsec. (b)(2)(B). Pub. L. 97-448, §309(b)(21), substituted "who" for "and" before "has lawfully resided".Subsec. (c)(2)(B)(iii). Pub. L. 97-448, §309(b)(22), substituted in subcl. (I) "can" for "cannot" and struck out from subcl. (IV) the introductory word "if".
EFFECTIVE DATE OF 2018 AMENDMENT Pub. L. 115-123, div. E, title XII, §53102(b)(1), Feb. 9, 2018, 132 Stat. 298, provided that the repeal of section 202(b) of Pub. L. 113-67 is effective Sept. 30, 2017, and the provisions amended by section 202(b) shall be applied and administered as if such amendments had never been enacted. In addition, such repeal by section 53102(b)(1) of Pub. L. 115-123 applicable with respect to any open claims, including claims pending, generated, or filed, after Sept. 30, 2017, see section 53102(b)(3) of Pub. L. 115-123 set out as a note under section 1396a of this title.
EFFECTIVE DATE OF 2016 AMENDMENT Pub. L. 114-255, div. A, title V, §5007(b), Dec. 13, 2016, 130 Stat. 1197, provided that: "The amendment made by subsection (a) [amending this section] shall apply to trusts established on or after the date of the enactment of this Act [Dec. 13, 2016]."
EFFECTIVE DATE OF 2009 AMENDMENT Amendment by Pub. L. 111-5 effective July 1, 2009, see section 5006(f) of Pub. L. 111-5 set out as a note under section 1396a of this title.
EFFECTIVE DATE OF 2008 AMENDMENT Pub. L. 110-275, title I, §115(b), July 15, 2008, 122 Stat. 2507, provided that: "The amendment made by subsection (a) [amending this section] shall take effect as of January 1, 2010."
EFFECTIVE DATE OF 2006 AMENDMENT Pub. L. 109-432, div. B, title IV, §405(b)(2), Dec. 20, 2006, 120 Stat. 2998, provided that: "The amendment made by paragraph (1) [amending this section] shall be effective as if included in the enactment of section 6012 of the Deficit Reduction Act of 2005 [ Pub. L. 109-171]." Pub. L. 109-171, title VI, §6011(c), Feb. 8, 2006, 120 Stat. 62, provided that: "The amendments made by this section [amending this section] shall apply to transfers made on or after the date of the enactment of this Act [Feb. 8, 2006]." Pub. L. 109-171, title VI, §6012(d), Feb. 8, 2006, 120 Stat. 64, provided that: "The amendments made by this section [amending this section] shall apply to transactions (including the purchase of an annuity) occurring on or after the date of the enactment of this Act [Feb. 8, 2006]." Pub. L. 109-171, title VI, §6014(b), Feb. 8, 2006, 120 Stat. 65, provided that: "The amendment made by subsection (a) [amending this section] shall apply to individuals who are determined eligible for medical assistance with respect to nursing facility services or other long-term care services based on an application filed on or after January 1, 2006." Pub. L. 109-171, title VI, §6016(e), Feb. 8, 2006, 120 Stat. 67, provided that: "(1) IN GENERAL.-Except as provided in paragraphs (2) and (3), the amendments made by this section [amending this section] shall apply to payments under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) for calendar quarters beginning on or after the date of enactment of this Act [Feb. 8, 2006], without regard to whether or not final regulations to carry out such amendments have been promulgated by such date."(2) EXCEPTIONS.-The amendments made by this section shall not apply- "(A) to medical assistance provided for services furnished before the date of enactment;"(B) with respect to assets disposed of on or before the date of enactment of this Act; or"(C) with respect to trusts established on or before the date of enactment of this Act."(3) EXTENSION OF EFFECTIVE DATE FOR STATE LAW AMENDMENT.-In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by a provision of this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature."
EFFECTIVE DATE OF 1993 AMENDMENT Pub. L. 103-66, title XIII, §13611(e), Aug. 10, 1993, 107 Stat. 627, provided that:"(1) The amendments made by this section [amending this section and sections 1396a and 1396r-5 of this title] shall apply, except as provided in this subsection, to payments under title XIX of the Social Security Act [ 42 U.S.C. 1396 et seq.] for calendar quarters beginning on or after October 1, 1993, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date."(2) The amendments made by this section shall not apply- "(A) to medical assistance provided for services furnished before October 1, 1993,"(B) with respect to assets disposed of on or before the date of the enactment of this Act [Aug. 10, 1993], or "(C) with respect to trusts established on or before the date of the enactment of this Act."(3) In the case of a State plan for medical assistance under title XIX of the Social Security Act [ 42 U.S.C. 1396 et seq.] which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendment made by subsection (b) [amending this section], the State plan shall not be regarded as failing to comply with the requirements imposed by such amendment solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act [Aug. 10, 1993]. For purposes of the preceding sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature." Pub. L. 103-66, title XIII, §13612(d), Aug. 10, 1993, 107 Stat. 628, provided that:"(1)(A) Except as provided in subparagraph (B), the amendments made by this section [amending this section] shall apply to payments under title XIX of the Social Security Act [ 42 U.S.C. 1396 et seq.] for calendar quarters beginning on or after October 1, 1993, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date."(B) In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements imposed by such amendments solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act [Aug. 10, 1993]. For purposes of the preceding sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature. "(2) The amendments made by this section shall not apply to individuals who died before October 1, 1993."
EFFECTIVE DATE OF 1989 AMENDMENT Amendment by Pub. L. 101-239 applicable to transfers occurring after Dec. 19, 1989, see section 6411(e)(4) of Pub. L. 101-239 set out as a note under section 1396a of this title.
EFFECTIVE DATE OF 1988 AMENDMENTS Amendment by Pub. L. 100-485 effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, Pub. L. 100-360, see section 608(g)(1) of Pub. L. 100-485 set out as a note under section 704 of this title.Amendment by section 303(b) of Pub. L. 100-360 applicable to payments under this subchapter for calendar quarters beginning on or after July 1, 1988 (except in certain situations requiring State legislative action), without regard to whether or not final regulations to carry out such amendment have been promulgated by such date, and subsection (c) of this section, as amended by section 303(b) of Pub. L. 100-360 applicable to resources disposed of on or after July 1, 1988, but not applicable with respect to inter-spousal transfers occurring before Oct. 1, 1989, see section 303(g)(2), (5) of Pub. L. 100-360 set out as an Effective Date note under section 1396r-5 of this title.Except as specifically provided in section 411 of Pub. L. 100-360 amendment by section 411(l)(3)(I) of Pub. L. 100-360 as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, Pub. L. 100-203 effective as if included in the enactment of that provision in Pub. L. 100-203, see section 411(a) of Pub. L. 100-360 set out as a Reference to OBRA; Effective Date note under section 106 of Title 1, General Provisions.
EFFECTIVE DATE OF 1987 AMENDMENT Amendment by Pub. L. 100-203 applicable to nursing facility services furnished on or after Oct. 1, 1990, without regard to whether regulations implementing such amendment are promulgated by such date, except as otherwise specifically provided in section 1396r of this title, with transitional rule, see section 4214(a), (b)(2) of Pub. L. 100-203 as amended, set out as an Effective Date note under section 1396r of this title.
EFFECTIVE DATE OF 1983 AMENDMENT Amendment by Pub. L. 97-448 effective as if originally included as a part of this section as this section was added by the Tax Equity and Fiscal Responsibility Act of 1982, Pub. L. 97-248, see section 309(c)(2) of Pub. L. 97-448 set out as a note under section 426-1 of this title.
EFFECTIVE DATEPub. L. 97-248, title I, §132(d), Sept. 3, 1982, 96 Stat. 373, provided that: "The amendments made by this section [enacting this section and amending section 1396a of this title] shall become effective on the date of the enactment of this Act [Sept. 3, 1982], but the provisions of section 1917(c)(2)(B) of the Social Security Act [ 42 U.S.C. 1396p(c)(2)(B) ] shall not apply with respect to a transfer of assets which took place prior to such date of enactment."
AVAILABILITY OF HARDSHIP WAIVERS Pub. L. 109-171, title VI, §6011(d), Feb. 8, 2006, 120 Stat. 62, provided that: "Each State shall provide for a hardship waiver process in accordance with section 1917(c)(2)(D) of the Social Security Act ( 42 U.S.C. 1396p(c)(2)(D) )-"(1) under which an undue hardship exists when application of the transfer of assets provision would deprive the individual-"(A) of medical care such that the individual's health or life would be endangered; or"(B) of food, clothing, shelter, or other necessities of life; and"(2) which provides for-"(A) notice to recipients that an undue hardship exception exists;"(B) a timely process for determining whether an undue hardship waiver will be granted; and "(C) a process under which an adverse determination can be appealed."
EXPANSION OF STATE LONG-TERM CARE PARTNERSHIP PROGRAM Pub. L. 109-171, title VI, §60216021,, 120 Stat. 68, as amended by Pub. L. 111-148, title VIII, §8002(d), title X, §10801(c), Mar. 23, 2010, 124 Stat. 847, 1015; Pub. L. 112-240, title VI, §642(b)(3), Jan. 2, 2013, 126 Stat. 2358, provided that: "(a) EXPANSION AUTHORITY.-"(1) IN GENERAL.-[Amended this section.]"(2) STATE REPORTING REQUIREMENTS.-Nothing in clauses (iii)(VI) and (v) of section 1917(b)(1)(C) of the Social Security Act [ 42 U.S.C. 1396p(b)(1)(C)(iii)(VI), (v) ] (as added by paragraph (1)) shall be construed as prohibiting a State from requiring an issuer of a long-term care insurance policy sold in the State (regardless of whether the policy is issued under a qualified State long-term care insurance partnership under section 1917(b)(1)(C)(iii) of such Act) to require the issuer to report information or data to the State that is in addition to the information or data required under such clauses."(3) EFFECTIVE DATE.-A State plan amendment that provides for a qualified State long-term care insurance partnership under the amendments made by paragraph (1) may provide that such amendment is effective for long-term care insurance policies issued on or after a date, specified in the amendment, that is not earlier than the first day of the first calendar quarter in which the plan amendment was submitted to the Secretary of Health and Human Services."(b) STANDARDS FOR RECIPROCAL RECOGNITION AMONG PARTNERSHIP STATES.-In order to permit portability in long-term care insurance policies purchased under State long-term care insurance partnerships, the Secretary of Health and Human Services shall develop, not later than January 1, 2007, and in consultation with the National Association of Insurance Commissioners, issuers of long-term care insurance policies, States with experience with long-term care insurance partnership plans, other States, and representatives of consumers of long-term care insurance policies, standards for uniform reciprocal recognition of such policies among States with qualified State long-term care insurance partnerships under which-"(1) benefits paid under such policies will be treated the same by all such States; and "(2) States with such partnerships shall be subject to such standards unless the State notifies the Secretary in writing of the State's election to be exempt from such standards."(c) ANNUAL REPORTS TO CONGRESS.-"(1) IN GENERAL.-The Secretary of Health and Human Services shall annually report to Congress on the long-term care insurance partnerships established in accordance with section 1917(b)(1)(C)(ii) of the Social Security Act ( 42 U.S.C. 1396p(b)(1)(C)(ii) ) (as amended by subsection (a)(1)). Such reports shall include analyses of the extent to which such partnerships expand or limit access of individuals to long-term care and the impact of such partnerships on Federal and State expenditures under the Medicare and Medicaid programs. Nothing in this section shall be construed as requiring the Secretary to conduct an independent review of each long-term care insurance policy offered under or in connection with such a partnership."(2) APPROPRIATION.-Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary of Health and Human Services, $1,000,000 for the period of fiscal years 2006 through 2010 to carry out paragraph (1)."(d) NATIONAL CLEARINGHOUSE FOR LONG-TERM CARE INFORMATION.- "(1) ESTABLISHMENT.-The Secretary of Health and Human Services shall establish a National Clearinghouse for Long-Term Care Information. The Clearinghouse may be established through a contract or interagency agreement."(2) DUTIES.- "(A) IN GENERAL.-The National Clearinghouse for Long-Term Care Information shall-"(i) educate consumers with respect to the availability and limitations of coverage for long-term care under the Medicaid program and provide contact information for obtaining State-specific information on long-term care coverage, including eligibility and estate recovery requirements under State Medicaid programs; "(ii) provide objective information to assist consumers with the decisionmaking process for determining whether to purchase long-term care insurance or to pursue other private market alternatives for purchasing long-term care and provide contact information for additional objective resources on planning for long-term care needs; and"(iii) maintain a list of States with State long-term care insurance partnerships under the Medicaid program that provide reciprocal recognition of long-term care insurance policies issued under such partnerships."(B) REQUIREMENT.-In providing information to consumers on long-term care in accordance with this subsection, the National Clearinghouse for Long-Term Care Information shall not advocate in favor of a specific long-term care insurance provider or a specific long-term care insurance policy. "(3) APPROPRIATION.-Out of any funds in the Treasury not otherwise appropriated, there is appropriated to carry out this subsection, $3,000,000 for each of fiscal years 2006 through 2010."
Section 1396o-1 - State option for alternative premiums and cost sharing
Section 1396q - Application of provisions of subchapter II relating to subpoenas