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 178.104 - Disposition of assets and fair consideration provisions for transfers on or after July 30, 1994

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If assets
						are disposed of on or after July 30, 1994, §§
												178.105 and
						178.106 (relating to presumption
						of disposition of assets to qualify for MA for transfers on or after July 30,
						1994; and reestablishment of MA eligibility after transfers made on or after
						July 30, 1994) and this section apply to an institutionalized individual who is
						applying for or receiving MA for NFC as defined in §
												178.2 (relating to definitions),
						including services in an ICF/MR, or a level of care in an institution
						equivalent to NFC, or home or community-based services furnished under a Title
						XIX waiver and the individual or the individual's spouse transfers assets for
						less than FMV.
(b) An
						institutionalized individual who disposes of assets for less than FMV on or
						after the look back date in subsection (c) is ineligible for MA for NFC which
						includes the services set forth in subsection (a). A transfer of assets by the
						community spouse to a person other than the institutionalized spouse is treated
						and affects the eligibility of the institutionalized spouse the same as a
						transfer by the institutionalized spouse.
(c) The look-back date shall be 36 months
						from the date on which the individual is both institutionalized and has applied
						for MA, except in the case of payments from a trust, or portions of a trust, as
						described in §
												178.7(e)(1)(iii) and
						(2)(ii) (relating to treatment of trust
						amounts for all categories of MA for trusts established on or after July 30,
						1994) which are considered assets disposed of for less than FMV by the
						individual. In this instance, the look-back date shall be 60 months.
(d) The number of months of ineligibility for
						the institutionalized individual who disposes of assets for less than FMV shall
						be equal to the total cumulative UV of all assets transferred by the individual
						or the individual's spouse on or after the look-back date divided by the
						average monthly cost to a private patient of NFC in effect in the Commonwealth
						at the time of application.
(e) An
						individual will not be ineligible for payment for NFC if:
(1) The assets were the resident property and
						title to the home was transferred to:
(i) The
						spouse of the individual.
(ii) The
						individual's child who is under 21 years of age, or blind or permanently and
						totally disabled as determined under §
														140.81 (relating to deductions
						from earned income), or is blind or disabled based on SSI criteria as specified
						in 42 U.S.C.A. §
															1382c(a)(3).
(iii) A sibling of the individual who has an
						equity interest in the home and who resided in the individual's home for at
						least 1 year immediately before the date the individual became an
						institutionalized individual.
(iv)
						A son or daughter of the individual, other than a child described in
						subparagraph (ii), who resided in the individual's home for at least 2 years
						immediately before the date the individual became an institutionalized
						individual and who provided care to the individual which permitted the
						individual to reside at home rather than in an institution or
						facility.