Section 17-1725.1-57 - Determining a penalty period(a) A penalty period shall be calculated by dividing the total uncompensated value of the asset transferred, by the statewide average monthly cost of nursing facility services assessed to a private patient at the time the individual requests and is determined eligible for the coverage of long-term care services.(b) A penalty period that results in a partial month penalty shall not be rounded down or disregarded.(c) A penalty period established for an asset that was transferred, shall be applied as follows: (1) The value of all non-exempt transfers during the applicable look-back period specified in subsection 17-1725.1-51(a) shall be combined and a single penalty period shall be determined.(2) A separate penalty period shall be determined for non-exempt transfers which occurred while a penalty is being applied for a previous transfer by an individual determined eligible for coverage of long-term care services.(3) The penalty period shall commence the later of:(A) The date of request for long-term care services;(B) The date the individual would be eligible for coverage of long-term care services but a penalty is being imposed under this subchapter; or(C) The date a negative action can be taken in situations when timely notice of adverse action is required for the individual currently receiving coverage of long-term care services.(4) A penalty period that would commence within the term of another penalty period shall commence at the end of the prior penalty period.(d) An established penalty period shall continue to run, regardless of whether the penalized individual no longer is eligible for medical assistance, or is not receiving long-term care services.(e) The department shall send a denial notice to an individual requesting coverage of long-term care services, or an adverse action notice to an individual who is receiving coverage for long-term care services when imposing a penalty period. The notices shall meet the requirements of chapter 17-1713.1, and must inform the individual of: (1) The type and amount of the transferred asset used to determine the penalty period;(2) The length of the penalty period;(3) The start and end date of the penalty period;(4) The authority under the Hawaii administrative rules to impose the negative action; and(5) The individual's right to request a hardship waiver of the penalty period.(f) If the spouse of a penalized individual becomes eligible for coverage of long-term care services, the remaining penalty period may be allocated between both spouses.(g) If one of the spouses should die before completing the allocated penalty period, the remaining spouse shall be allocated the balance remaining for the deceased spouse.Haw. Code R. § 17-1725.1-57
[Eff 09/30/13] (Auth: HRS § 346-14; 42 C.F.R. §431.10; 42 U.S.C. §1396 p(c)) (Imp: 42 C.F.R. §431.10; 42 U.S.C. §1396 p(c))