Under the transfer of resources provisions in 1917(c) of the Social Security Act (the Act), you must restrict Medicaid coverage to an otherwise eligible institutionalized individual if he/she or his/her spouse transfers resources for less than fair market value:
- Individual is not eligible for LTC during sanction period
- For a time period that hasn't been looked at yet AND
- For the people that do NOT have hardship AND
- For the included time period (look-back period)
- Determine if there are any invalid transfers that fall in the look-back period AND
- For every countable asset transferred by the following individuals:
- Determine if the asset is countable or excluded
- If asset is countable determine whether asset transfer is allowed under transfer of assets rules
- Sum the uncompensated values
- Calculate the ineligibility period
- If there is uncompensated value, determine Sanction Period
- Determine Sanction Start/End Date
- Penalty periods are applied consecutively for multiple transfers not concurrently.