Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart D - Determination of Need and Amount of Assistance › Chapter 178 - RESOURCE PROVISIONS FOR CATEGORICALLY NMP-MA AND MNO-MA › Subchapter B - AGED, BLIND AND DISABLED CATEGORIES OF MA › DISPOSITION OF PROPERTY AND FAIR CONSIDERATION PROVISIONS FOR THE AGED, BLIND AND DISABLED CATEGORIES OF MA › Section 178.104a - Clarification of fair consideration provisions for disposition of assets made on or after February 8, 2006-statement of policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Consistent with section 1917(c)(1)(B)(i)
						of the Social Security Act (42 U.S.C.A. §
													1396p(c)(1)(B)(i)),
						regarding liens, adjustments and recoveries, and transfers of assets, effective
						for an application made on or after March 3, 2007, the look-back period for
						assets transferred on or after February 8, 2006, shall be 60 months.
(b) Consistent with section 1917(c)(1)(D) of
						the Social Security Act, effective for an application made on or after March 3,
						2007, in the case of a transfer of assets for less than Fair Market Value (FMV)
						made on or after February 8, 2006, by an applicant or spouse of an applicant,
						the penalty period shall commence on the date the applicant would otherwise be
						eligible for Medicaid based on an approved application for these services.
(c) Consistent with section
						1917(c)(1)(D) of the Social Security Act, effective with transfers of assets
						for less than FMV made on or after March 3, 2007, by a recipient, the beginning
						date of a period of ineligibility for payment of long-term care services shall
						commence on the first day of the month following the date specified in the
						Appeal and Fair Hearing section of the Advance Notice provided to the
						recipient.
(d) Consistent with
						section 1917(c)(1)(E)(iv) and (H) of the Social Security Act, effective for an
						application made on or after March 3, 2007, a period of ineligibility for
						payment of long-term care services will result when an applicant or spouse of
						an applicant disposes of assets for less than FMV on or after February 8, 2006.
						The period of ineligibility shall be determined by dividing the total
						cumulative uncompensated value of all assets disposed of by the applicant or
						the applicant's spouse on or after the look-back date, by the average daily
						private pay rate in effect at the time the application is processed.
(e) Consistent with section 1917(c)(1)(E)(iv)
						and (H) of the Social Security Act, effective March 3, 2007, a period of
						ineligibility for payment of long-term care services will result when a
						recipient disposes of assets for less than FMV on or after March 3, 2007. The
						period of ineligibility shall be determined by dividing the total cumulative
						uncompensated value of all assets disposed of by the recipient on or after the
						look back date, by the average daily private pay rate in effect at the time the
						period of ineligibility is determined.
(f) Consistent with section 1917(c)(1)(I) of
						the Social Security Act, effective for an application made on or after March 3,
						2007, the outstanding balance due on a promissory note, loan or mortgage
						purchased on or after February 8, 2006, that does not meet all of the following
						requirements will be treated as a transfer of assets for less than FMV:
(1) The repayment terms must be actuarially
						sound.
(2) The terms must provide
						for payments in equal amounts throughout the term, with no deferral of payments
						and no balloon payments.
(3) The
						terms must prohibit cancellation of the balance upon death of the
						lender.