SSI-Related Medicaid Resource Eligibility Criteria  


  • 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 (850)410-3479