SSI-Related Medicaid Resource Eligibility Criteria

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Economic Self-Sufficiency Program

RULE NO: RULE TITLE
65A-1.712: SSI-Related Medicaid Resource Eligibility Criteria

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 35 No. 30, July 31, 2009 issue of the Florida Administrative Weekly.

TEXT OF THE PROPOSED RULE CHANGE:

65A-1.712 SSI-Related Medicaid Resource Eligibility Criteria.

(3) Transfer of Resources and Income. According to 42 U.S.C. § 1396p(c) (2006), incorporated by reference, if an individual, the spouse, or their legal representative, disposes of resources or income for less than fair market value on or after the look back date, the Department must presume that the disposal of resources or income was to become Medicaid eligible and impose a period of ineligibility for nursing facility care services, institutional hospice or HCBS waiver services. The Department will mail a notice to individuals who report a transfer for less than fair market value (Form CF-ES 2264, 02/2007, Notice of Determination of Assets (Or Income) Transfer, incorporated herein by reference), advising of the opportunity to rebut the presumption and of the opportunity to request and support a claim of undue hardship per subparagraph (c)5. below. If the Department determines the individual is eligible for Medicaid on all other factors of eligibility except the transfer, the individual will be approved for general Medicaid services (not long-term care services) and advised of their penalty period (Form 2358, 02/2007, Medicaid Transfer Disposition Notice, incorporated herein by reference.). Transfers of resources or income made prior to (first day of month following effective date) are subject to a 36 month look back period The look back period is 36 months prior to the date of application, except in the case of a trust treated as a transfer in which case the look back period is 60 months prior to the date of application. Transfers of resources or income made on or after (first day of month following effective date) are subject to a 60 month look back period. All applications for nursing home and waiver based Medicaid programs (except in the case of a trust treated as a transfer) are subject to an asset transfer look back period as provided for below.

 

If the application is received:

The look back period is:

Prior to November 1, 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 May 2011 June 2011 July 2011 August 2011 September 2011 October 2011 November 2011 December 2011 January 2012 February 2012 March 2012 April 2012 May 2012 June 2012 July 2012 August 2012 September 2012 On or after October 1, 2012

36 months prior to the month of application 37 months prior to the month of application 38 months prior to the month of application 39 months prior to the month of application 40 months prior to the month of application 41 months prior to the month of application 42 months prior to the month of application 43 months prior to the month of application 44 months prior to the month of application 45 months prior to the month of application 46 months prior to the month of application 47 months prior to the month of application 48 months prior to the month of application 49 months prior to the month of application 50 months prior to the month of application 51 months prior to the month of application 52 months prior to the month of application 53 months prior to the month of application 54 months prior to the month of application 55 months prior to the month of application 56 months prior to the month of application 57 months prior to the month of application 58 months prior to the month of application 59 months prior to the month of application 60 months prior to the month of application

 

(6) Copies of the forms and materials incorporated by reference in this rule are available from the ACCESS Florida Headquarters Office at 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700. Forms are also available or on the Department’s web site at http://www.dcf.state.fl.us/DCFForms/Search/DCFFormSearch.aspx.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS. History–New 10-8-97, Amended 1-27-99, 4-1-03, 9-28-04, 8-10-06(1)(a), (f), 8-10-06(1)(f), 8-10-06(3)(g)1., 11-1-07,________.

 

IF REQUESTED WITHIN 7 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: November 4, 2009, 2:00 p.m.

PLACE: 1317 Winewood Boulevard, Building 3, Room 455, Tallahassee, FL 32399

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Pat Whitford, Economic Self-Sufficiency Services, phone [phone]