10A NCAC 21B .0311       TRANSFER OF RESOURCES

In accordance with 42 U.S.C. 1396p(c), an individual who transfers resources and receives compensation that is less than the fair market value shall be ineligible to receive nursing facility services or in-home health services and supplies, as follows:

(1)           As provided for by P.L. 100‑360, Section 303(g) amended by P.L. 100‑485, Section 608(d)(16)(D), the provisions of 42 U.S.C. 1396p(c) shall be effective for all transfers of resources, including transfers of tenancy-in-common interest in real property, when requesting nursing facility services, for a level of care in a medical institution equivalent to that of a nursing facility services, or for home and community-based services, except transfers between spouses, occurring on or after July 1, 1988.  The provisions of 42 U.S.C. 1396p(c) shall be effective for transfers between spouses, occurring on or after October 1, 1989.

(2)           As allowed under 42 U.S.C. 1396p(c)(2)(D), the provisions of 42 U.S.C. 1396p(c) for ineligibility for nursing services due to transfer of resources shall not be applied:

(a)           To individuals who transferred resources after July 1, 1988 and before March 15, 1989 and were found eligible prior to March 15, 1989;

(b)           When it is determined by the agency's judgment that the applicant or recipient is a victim of fraud and did not take the action with the intent of becoming eligible for Medicaid.

(3)           In accordance with 42 USC 1396p(c), an Aged, Blind, or Disabled individual (42 CFR 435.120) or Qualified Medicare Beneficiary as described in (1905(p)(1) in a private living arrangement who transfers resources and receives compensation that is less than fair market value shall be ineligible to receive in-home health services and supplies (1905(a)(7) and 1905(a)(24) of the Social Security Act in accordance with this item.  These provisions do not apply to optional State Supplements (42 CFR 435.130).  The provisions of 42 USC 1396p(c) shall be effective for all transfers occurring on or after February 1, 2003.  As allowed under 42 USC 1396p(c), the provisions for ineligibility for these services due to transfer of resources shall not be applied;

(a)           to the individuals who referenced in this Paragraph transferred resources prior to February 1, 2003, and were found eligible either before or after February 1, 2003;

(b)           when it is determined by the agency's judgment that the applicant/recipient is a victim of fraud.

 

History Note:        Authority G.S. 108A‑54; 108A‑58; P.L. 100‑360; P.L. 100‑485; 42 U.S.C. 1396p(c); 42 C.F.R. 435.121; 42 C.F.R. 435.840; 42 C.F.R. 435.841; 42 C.F.R. 435.845; S.L. 2002-126;

Eff. September 1, 1984;

Amended Eff. December 1, 1991; August 1, 1990;

Temporary Amendment Eff. April 21, 2003; March 1, 2003;

Amended Eff. August 1, 2004.