New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 71 - MEDICAID ONLY › Subchapter 4 - RESOURCES › Section 10:71-4.1 - Financial eligibility standards; resources

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The resources
				criteria and eligibility standards of this section apply to all applicants and
				beneficiaries.
(b) Resources
				defined: For the purpose of this program a resource shall be defined as any
				real or personal property which is owned by the applicant (or by those persons
				whose resources are deemed available to him or her, as described in
				10:71-4.6 ) and which could be
				converted to cash to be used for his or her support and maintenance. Both
				liquid and nonliquid resources shall be considered in the determination of
				eligibility, unless such resources are specifically excluded under the
				provisions of
				10:71-4.4(b).
(c) Availability of resources: In order to be
				considered in the determination of eligibility, a resource must be "available."
				A resource shall be considered available to an individual when:
1. The person has the right, authority or
				power to liquidate real or personal property or his or her share of
				it;
2. Resources have been deemed
				available to the applicant (see
				10:71-4.6 regarding deeming of
				resources); or
3. Resources arising
				from a third-party claim or action are considered available from the date of
				receipt by the applicant/beneficiaries, his or her legal representative or
				other individual acting on his or her legal behalf in accordance with the
				following definition and provisions.
i.
				Definition of "availability of resources in third-party situations": In
				third-party situations in which applicants/beneficiaries have brought an action
				or made a claim against a third party who is or may be liable for payment of
				medical expenses related to the cause of the action or claim, funds are
				considered available or countable at the moment of receipt by the
				applicant/beneficiary, his or her legal representative, guardian, relative or
				any person acting on the applicant's/beneficiary's behalf. Such funds should be
				considered available or countable at the earliest date of receipt by any of the
				aforementioned entities.
(1) In determining
				resource eligibility in accordance with
				10:71-4.5(a),
				those funds actually available to the applicant/beneficiary or any person
				acting on his or her behalf as of the first day of the month subsequent to the
				month of receipt shall be considered a countable resource, unless otherwise
				excluded (see
				10:71-4.4 ).
(2) If a bona fide lien or judgment exists
				against such funds, making all or some portion of the funds inaccessible to the
				applicant/beneficiary, CWAs shall deduct the encumbrances and consider the
				remaining amount as a countable resource.
(3) If between the date of receipt of such
				moneys and the first day of the subsequent month the applicant/beneficiary pays
				outstanding medical expenses and/or other expenses, the CWA shall consider only
				the funds remaining after such payment as a countable resource.