Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 50 - Medicaid Long-Term Services and Supports › Subchapter 00 - Long-Term Services › Part 6 - Medicaid Long-Term Services and Supports: Financial Eligibility › Section 210-RICR-50-00-6.3 - Definitions

Current through June 14, 2024
A. For the purposes of this Part, the terms
				  below are defined as follows:
1. "ACA
				  expansion adult" means an adult between the ages of nineteen (19) and
				  sixty-four (64) who is not eligible for or enrolled in Medicare or receiving
				  SSI and qualifies for Medicaid coverage under the State Plan option established
				  by the Federal Patient Protection and Affordable Care Act (ACA) of 2010
				  (42 U.S.C. §
												18001).
2. "Annuity" means a purchased contract in
				  which one (1) party (annuity issuer) agrees to pay the purchaser, or the person
				  the purchaser designates (the payee or payees), a return on money deposited
				  with the annuity issuer (either in the form of a single lump sum or several
				  payments deposited over several months or years) according to the terms of the
				  annuity contract.
3. "Authorized
				  representative" means a person or entity whom an applicant or beneficiary
				  designates to act responsibly on his or her behalf when applying for initial or
				  continuing Medicaid eligibility and engaging with the agency on other ongoing
				  communications. Such a designation requires the signed consent of the applicant
				  or beneficiary, provided on paper or through any electronic signatures accepted
				  by the State, unless conferred by court order or State law.
4. "Available resource" means that a person
				  has the legal ability to access and use the resource(s) for support and
				  maintenance. A resource is considered unavailable when there is a legal
				  impediment that prevents the person from utilizing it for such
				  purposes.
5. "Disqualifying
				  transfer" means the divestment of an asset (liquid resource, prospective
				  income, or real property) for less than fair market value or a fair market
				  value than cannot be readily ascertained.
6. "Equity value" means the price an item can
				  be reasonably expected to sell for on the local open market minus any
				  encumbrances.
7. "Fair market
				  value" or "FMV" means a certified appraisal or an amount equal to the price of
				  the property or selling price of the asset on the open market in the locality
				  that is readily ascertainable at the time of the transfer or contract for sale,
				  or the application date if earlier.
8. "Financial responsibility unit" or "FRU"
				  means the persons living with the applicant whose income and resources are
				  considered available when determining financial eligibility.
9. "Guardian" means a person or institution
				  appointed by a court in any state to act as a legal representative for another
				  person, such as a minor or a person with disabilities.
10. "Medicaid eligibility group" means the
				  total number of persons counted in a household - that is, the family size
				  involved - when identifying the Federal Poverty Level (FPL) income level that
				  applies when determining a person's Medicaid eligibility.
11. "Ownership interest" means the Medicaid
				  applicant holds sole or joint legal title to the residential property or is a
				  party to a legal covenant establishing property ownership, such as identified
				  in §
											6.9   of this Part.
12. "Principal place of residence" means the
				  residential property where the beneficiary, and/or in the instances specified,
				  the spouse or a dependent child of such a person, lives the majority of the
				  year (i.e., one hundred eighty-three (183) days in the previous twelve (12)
				  months).
13. "Real property" means
				  land and generally whatever is erected, growing on, or affixed to
				  land.
14. "Representative payee"
				  means an individual, agency, or institution selected by a court or the Social
				  Security Administration (SSA) to receive and manage benefits on behalf of
				  another person.
15. "Trust" means
				  property that is legally held or managed by a person or organization other than
				  by its owners.
16. "Uncompensated
				  value" or "UV" means the equity value (fair market value less any outstanding
				  loans, mortgages or other encumbrances) minus the value of any compensation
				  /consideration received by the applicant/beneficiary in exchange for the
				  asset.