Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.06-068 - State Plan Amendment #2006-015 - U.S. Deficit Reduction Act of 2005

Current through Register Vol. 49, No. 6, June, 2024
SUPPLEMENT 9(b) to ATTACHMENT 2.6-A
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
State:___
ARKANSAS
___________________________________________
TRANSFER OF ASSETS
1917(c)
FOR TRANSFERS OF ASSETS FOR LESS THAN FAIR MARKET
				VALUE MADE ON OR AFTER FEBRUARY 8, 2006,
the agency provides for the
				denial of certain Medicaid services.
1. Institutionalized individuals are denied
			 coverage of certain Medicaid services upon disposing of assets for less than
			 fair market value on or after the look-back date.
The agency does not provide medical assistance coverage for
				institutionalized individuals for the following services:
Nursing facility services;
Nursing facility level of care provided in a medical
				institution;
Home and community-based services under a 1915(c) or (d)
				waiver.
2.
			 Non-institutionalized individuals:
_
X
_ The agency applies
				these provisions to the following non-institutionalized eligibility groups.
				These groups can be no more restrictive than those set forth in section 1905(a)
				of the Social Security Act:
Individuals eligible under Home and Community Based
				Services waivers under 1915(c).
The agency withholds payment to non-institutionalized
				individuals for the following services:
Home health services (section 1905(a)(7));
Home and community care for functionally disabled elderly
				adults (section 1905(a)(22));
Personal care services furnished to individuals who are not
				inpatients in certain medical institutions, as recognized under agency law and
				specified in section 1905(a)(24).
_
X
_ The following other
				long-term care services for which payment for medical assistance is otherwise
				made under the agency plan:
Any services provided to individuals under a Home and
				Community Based Services waivers under 1915 (c) or (d).
3.
Penalty Date
--The
			 beginning date of each penalty period imposed for an uncompensated transfer of
			 assets is
the later of:
* the first day of a month during or after which assets have
				been transferred for less than fair market value;
_
X
_
The State uses the
				first day of the month in which the assets were transferred
___
The State uses the first day of
				the month after the month in which the assets were transferred or
* the date on which the individual is eligible for medical
				assistance under the State plan and is receiving institutional level care
				services described in paragraphs 1 and 2 that, were it not for the imposition
				of the penalty period, would be covered by Medicaid;
AND
which does not occur during any other period of ineligibility
				for services by reason of a transfer of assets penalty.
4.
Penalty Period -
			 Institutionalized Individuals
--
In determining the penalty for an institutionalized individual,
				the agency uses:
_
X
_ the average monthly
				cost to a private patient of nursing facility services in the State at the time
				of application;
___ the average monthly cost to a private patient of nursing
				facility services in the community in which the individual is institutionalized
				at the time of application.
5.
Penalty Period -
			 Non-institutionalized Individuals
--The agency imposes a penalty
			 period determined by using the same method as is used for an institutionalized
			 individual, including the use of the average monthly cost of nursing facility
			 services;
___ imposes a shorter penalty period than would be imposed for
				institutionalized individuals, as outlined below:
6.
Penalty period for amounts of
			 transfer less than cost of nursing facility care
--
Where the amount of the transfer is less than the monthly cost
				of nursing facility care, the agency imposes a penalty for less than a full
				month, based on the option selected in item 4.
The state adds together all transfers for less than fair market
				value made during the look-back period in more than one month and calculates a
				single period of ineligibility, that begins on the earliest date that would
				otherwise apply if the transfer had been made in a single lump sum.
7.
Penalty periods -
			 transfer by a spouse that results in a penalty period for the
			 individual
--
(a) The agency
			 apportions any existing penalty period between the spouses using the method
			 outlined below, provided the spouse is eligible for Medicaid. A penalty can be
			 assessed against the spouse, and some portion of the penalty against the
			 individual remains.
(b) If one
			 spouse is no longer subject to a penalty, the remaining penalty period must be
			 served by the remaining spouse.