S.D. Admin. R. 67:46:05:09.02

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:46:05:09.02 - Ineligibility if assets transferred

If an asset is disposed of for the purpose of establishing Medicaid eligibility and the asset was disposed of for less than fair market value within the look-back periods established in § 67:46:05:06.01, the period of ineligibility is determined under the provisions of § 67:46:05:09.

The department shall apportion the number of months of ineligibility equally between the individual receiving home and community based or nursing facility services and the individual's spouse who is applying for home and community based or nursing facility services if the following conditions exist:

(1) Both the individual and the individual's spouse are residing in a nursing facility or receiving home and community based waiver services or if one spouse is in a nursing facility and the other is receiving home and community based waiver services;

(2) The department had previously determined that the individual residing in a nursing facility or receiving home and community based waiver services was ineligible because of a transfer and the individual is currently serving out a period of ineligibility; and

(3) The spouse would otherwise be eligible for nursing facility or home and community based waiver services except for the period of ineligibility.

If more than one transfer occurs, the periods of ineligibility are consecutive. If a period of ineligibility is in effect and a transfer occurs, the period of ineligibility for the additional transfer is added to the period of ineligibility already in effect.

If the individual is an applicant, the period of ineligibility begins the date the applicant is eligible for nursing facility or home and community based waiver services but for the period of ineligibility or the date after a prior period of ineligibility has ended, whichever is later. If the individual is a recipient, the period of ineligibility begins with the date the applicant became eligible for nursing facility or home and community based waiver services, the first day of the month after the transfer occurred or the date after a prior period of ineligibility has ended, whichever is later.

S.D. Admin. R. 67:46:05:09.02

21 SDR 162, effective 3/23/1995; 30 SDR 193, effective 6/13/2004; 31 SDR 107, effective 2/1/2005; 33 SDR 44, effective 8/31/2006; 41 SDR 93, effective 12/3/2014; 43 SDR 31, effective 9/12/2016

General Authority: SDCL 28-6-1, 28-6-3.1.

Law Implemented: SDCL 28-6-3.1.

Disposal of resources for purposes of establishing eligibility, § 67:46:05:06. Lengthening look-back period for all disposals to five years, 42 U.S.C. § 1396p(c)(1)(B)(i). Authority for states to accumulate multiple transfers into one penalty period, 42 U.S.C. § 1396p(c)(1)(H).