Disqualifying Transfer Provisions 510-05-80-10
(Revised 1/1/13 ML #3358)
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(N.D.A.C. Section 75-02-02.1-33.1 and 75-02-02.1-33.2)
- An
individual is ineligible for nursing care services
if the individual or the spouse of the individual disposes of assets or
income for less than fair market value on or after the look-back date.
(Transfers by a parent of the parent's assets do not affect a child’s
coverage of nursing facility services and transfers by a child of the
child's assets do not affect the parent's coverage.)
- The look-back date for income or
asset transfers made before February 8, 2006 (other than for transfers
to or from a trust) is a date that
is thirty-six months before the date on which the individual is both receiving
nursing care services and has applied for benefits under this chapter,
without regard to the action taken on the application.
- The look-back date
for income or assets transferred on or after February 8, 2006, or transferred
to
an irrevocable trust, or from
a revocable or irrevocable trust, established by an applicant, a recipient,
their spouse, or any one acting on their behalf, other than by will, is
a date that is 60 months before the date on which the individual is both
receiving nursing care services and has applied for benefits under this
chapter, without regard to the action taken on the application.
- Once a look-back
date is established for an individual, it will always be the look-back
date for that individual.
Example:
Mr. Green entered LTC and applied for Medicaid in January 2000. Since
he is both receiving nursing care and has applied for Medicaid, his look-back
date is established as January 1997. Mr. Green left LTC in March 2001,
closed his Medicaid case, and made a large transfer. In May 2004, he enters
LTC again and reapplies for Medicaid. The March 2001 transfer (38 months
ago) was made on or after the look-back date (January 1997), so is considered.
- Each individual
establishes their own look-back date.
Example:
Mr. and Mrs. Brown make a large disqualifying transfer that causes 70
months of ineligibility. At the same time, Mr. Brown enters LTC and applies
for Medicaid. He is ineligible because the disqualifying transfer was
made on or after his look-back date. Mrs. Brown enters LTC 75 months later.
The disqualifying transfer was made prior to her look-back date (60 months).
Mrs. Brown can be eligible for Medicaid coverage of her LTC costs while
Mr. Brown is still ineligible.
- A transfer is complete when the individual
(or the individual's spouse) making the transfer has no lawful means of
undoing the transfer or requiring a restoration of ownership. A
transfer takes effect upon delivery, and unless proven otherwise, delivery
is presumed to occur at the date the deed was signed. The deed does not
have to be physically delivered or registered at the county office to
be delivered.
- The provisions of this section do not
apply in determining eligibility for Medicare Savings Programs.