Starting August 11, 1993, the participant is subject to a
penalty if he transfers his income or resources for less than fair market
value. The asset transfer penalty applies to Medicaid services received October
1, 1993 and later. Excluded resources, other than the home and associated
property, are not subject to the asset transfer penalty. Asset transfers
subject to penalty under these rules may be voided and set aside by court
action as provided in Section
56218, Idaho Code. The asset
transfer penalty applies to a Medicaid participant in long-term care or HCBS. A
participant in long-term care is a patient in a nursing facility or a patient
in a medical institution, requiring and receiving the level of care provided in
a nursing facility. (3-17-22)
01.
Rebuttable Presumption. Unless a transfer meets the requirements
of Section
841 of these rules, it is presumed
that the transfer was made for the purpose of qualifying for
Medicaid. The
asset transfer penalty is applied unless the participant shows that the
asset
transfer would not have affected his eligibility for Medicaid or the transfer
was made for another purpose than qualifying for Medicaid. (3-17-22)
02.
Contract for Services Provided by a
Relative. A contract for personal services to be furnished to the
participant by a relative is presumed to be made for the purpose of qualifying
for
Medicaid. The
asset transfer penalty applies unless the participant shows
that: (3-17-22)
a. A written contract for
personal services was signed before services were delivered. The contract must
require that payment be made after services are rendered. The contract must be
dated and the signatures notarized. Either party must be able to terminate the
contract; and (3-17-22)
b. The
contract must be signed by the participant or a legally authorized
representative through a power of attorney, legal guardianship or
conservatorship. A representative who signs the contract must not be the
provider of the personal care services under the contract; and
(3-17-22)
c. Compensation for
services rendered must be comparable to rates paid in the open market.
(3-17-22)
03.
Transfer of Income or Resources. Transfer of income or resources
includes reducing or eliminating the participant's ownership or control of the
asset. (3-17-22)
04.
Transfer
of Income or Resources by a Spouse. A transfer by the participant's
spouse of either spouse's income or resources, before eligibility is
established, subjects the participant to the asset transfer penalty. After the
participant's eligibility is established, a transfer by the spouse of the
spouse's own income or resources does not subject the participant to the asset
transfer penalty. (3-17-22)
05.
Transfer of Certain Notes and Loans. Funds used to purchase a
promissory note, loan, or mortgage are considered a transferred
asset which
subjects the participant to a period of ineligibility. The amount of the
asset
transfer of such note, loan or mortgage is the outstanding balance due on the
date of the Medicaid application, unless the note, loan or mortgage meets the
following: (3-17-22)
a. Has a repayment term
that is actuarially sound; (3-17-22)
b. Provides for payments to be made in equal
amounts during the term of the loan with no deferral and no balloon payments;
and (3-17-22)
c. Prohibits the
cancellation of the balance upon the death of the lender.
(3-17-22)
