7 AAC 100.604 - Recognized Medicaid trusts
(a) The following
three types of recognized Medicaid trusts are exceptions to the general trust
requirements in
7 AAC 100.602
for trusts:
(1) a qualifying income trust
authorized under
42 U.S.C.
1396 p(d)(4)(B) that meets the requirements
of
7 AAC
100.610;
(b) An applicant or recipient must submit a
recognized Medicaid trust document to the department for review and approval
before the department determines Medicaid eligibility. To be approved by the
department, in addition to meeting the applicable requirements of
7 AAC
100.610,
7 AAC
100.612, or
7 AAC 100.614, the
trust document must
(1) cite the federal
statute listed in (a) of this section applicable to the type of
trust;
(2) state that at the time
the trust is funded, the applicant or recipient will be either under 65 years
of age or 65 years of age or older, as applicable;
(3) for a special needs or pooled trust,
identify the date the beneficiary was last determined or redetermined blind
under
7 AAC 40.140(a) or disabled under
7 AAC 40.170(a);
(4) for a qualifying income trust, prohibit a
person from depositing into the trust anything other than the applicant's or
recipient's income;
(5) prohibit
the applicant or recipient from being a trustee or from having any ability,
access, or authority to manage or control the trust account;
(6) include a provision for reimbursing the
state in accordance with
7 AAC 100.608;
(7) identify the trustee, including a
co-trustee;
(8) identify procedures
for resignation of the trustee and for designating a successor trustee,
including a successor co-trustee; the procedure must require that, at least 30
days before the change, written notification of the change in trustee be sent
to the beneficiary, the beneficiary's authorized representative if applicable,
the department, and the court where the trust is registered; and
(9) identify on each page of the trust
document the person or organization that drafted the trust document.
(c) If the department approves a
recognized Medicaid trust, the trust and administration of the trust are
subject to review by the department, upon notice, to determine whether the
trust remains a valid trust for the purposes of meeting the requirements of a
recognized Medicaid trust. Upon request, the trustee shall provide the
department with the trust account number and the name of the financial
institution holding the trust account. The department will consider a trust to
be an invalid trust for the purposes of meeting the requirements of a
recognized Medicaid trust if
(1) the trust is
not registered with a court;
(2)
the trust account receives or uses the assets of another person, except as
provided under
7 AAC
100.614;
(3) the applicant or recipient functions as
the trustee or has any other ability, access, or authority to manage or control
the trust account;
(4) the trustee
fails to provide the department with all requested information necessary to
identify the trust account number and financial institution holding the trust
account;
(5) the trustee fails to
cooperate or interferes with the department's ability to track and monitor the
trust account, including failing to disclose or account for any payment from or
deposit into the trust account;
(6)
the applicant or recipient has a cost-of-care liability under
7 AAC 100.550 -
7 AAC 100.579, but the trustee fails to make payments toward
the cost-of-care liability;
(7) the
trustee fails to adhere to the terms of the trust as written; or
(8) the trustee fails to comply with the
requirements of (e) or (f) of this section.
(d) If the department determines that a trust
is invalid under (c) of this section, the department will redetermine the
applicant's or recipient's Medicaid eligibility, applying the provisions of
7 AAC 100.600 and
7 AAC 100.602
to any existing trust.
(e) If a
trustee decides, consistent with the trustee's fiduciary duty, that use of a
recognized Medicaid trust approved under this section is no longer needed to
maintain the beneficiary's Medicaid eligibility, the trustee shall notify in
writing the beneficiary, the beneficiary's authorized representative if one
exists, the department, and the court where the trust is registered in writing
no later than the first day of the month immediately preceding the month a
trust or trust account will no longer be funded. The trustee shall keep the
corpus of the trust intact until the trust is terminated and the state is
reimbursed in accordance with
7 AAC 100.608. If the trustee fails to notify the
department in accordance with this subsection, the department may find that the
trust is invalid under (c) of this section.
(f) If a trustee plans to resume use of an
unfunded recognized Medicaid trust, the trustee shall notify the department in
writing no later than the 15th day of the month immediately preceding the month
that use of the trust will resume. If the trustee fails to notify the
department in accordance with this subsection, the department may find the
applicant or recipient ineligible for Medicaid.
Notes
Authority:AS 47.05.010
AS 47.07.020
AS 47.07.040
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