Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 40 - Medicaid for Elders and Adults with Disabilities › Subchapter 00 - Integrated Coverage Groups › Part 3 - Medicaid Integrated Health Care Coverage, SSI Financial Eligibility Determinations › Section 210-RICR-40-00-3.6 - SSI Methodology: Treatment of Resources

Current through June 14, 2024
3.6.1
Scope and Purpose
A. For the
				  purposes of Medicaid eligibility, the assessment of resources is not tied, at
				  least directly, to their availability to pay for health care. Instead, a
				  resource is defined broadly as cash or other property that a person owns or has
				  access to that is or could be used for personal support and maintenance. This
				  Section describes the general treatment of resources when using the SSI
				  methodology to determine eligibility for the IHCC groups to which it applies.
				  There are differences in the types of resources that count and how they are
				  reviewed for Community and LTSS Medicaid. Key differences in the review process
				  are as follows:
1. Simplified Resource Review
				  for Community Medicaid - States that have expanded eligibility for low-income
				  elders and adults with disabilities up to one hundred percent (100%) of the FPL
				  have the authority under Federal Regulations to utilize a simplified standard
				  when evaluating resources for initial eligibility and at renewal. Although the
				  same resources are considered when using this simplified standard, they are
				  evaluated in less depth than required for Medicaid LTSS eligibility because the
				  provisions on resource transfers and spousal allocations do not apply. In
				  addition, attestations with respect to certain resources are accepted at the
				  time of initial application and the point of renewal. Depending on the
				  availability of electronic data sources, verification through materials may be
				  required subsequent to the determination of eligibility in the post-eligibility
				  verification process. Note income and resource deeming is included in the
				  simplified standard in Rhode Island.
2. Comprehensive Resource Review for LTSS -
				  There are both MAGI and SSI-related eligibility pathways for LTSS that differ
				  in terms of the treatment of income and resource limits, at least at the point
				  in which an institutional level of care becomes required. Applicants evaluated
				  using the SSI method (IHCC groups) are subject to a resource review and, in
				  some instances, using specialized criteria as indicated in Part 50-00-6 of this
				  Title; the resources of applicants seeking coverage through a MAGI pathway
				  (MACC groups) are not an eligibility factor and therefore are not considered on
				  that basis. However, all LTSS applicants, irrespective of eligibility pathway,
				  are subject to an in-depth review of the transfer of assets - including income
				  and resources - to ensure that the rules are applied equitably and in
				  accordance with the standards set in Federal and State laws and Regulations
				  governing estate recovery. The specific provisions applicable to the evaluation
				  of resources and transfers if assets for Medicaid LTSS are set forth in Part
				  50-00-6 of this Title.