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48 TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE 3. After transfer of assets, the occurrence of unexpected loss of income which would have precluded Medicaid eligibility. The presumption that an asset was transferred to establish Medicaid eligibility is successfully rebutted only if the applicant demonstrates that the asset was transferred exclusively for some other purpose. If the claimant had some other purpose for transferring the asset, and establishing Medicaid eligibility seems to have also been a factor in the decision to transfer, the presumption is not rebutted. The decision should be documented in the case record. It should be signed by the social worker and countersigned by the supervisor. If the transfer has been proven to be exclusively for some purpose other than establishing Medicaid eligibility, the transfer has no effect on eligibility. The uncompensated value is not counted toward the resource limit. 20360 Conditional Medicaid Coverage While Disposing of Resources Effective September 1, 1987 "conditional" Medicaid coverage for nursing home care can be approved for applicants who need Medicaid services while they are disposing of non-liquid resources, e.g., property. There are strict limits on the amount of time allowed for sale of resources and the applicant must sign a statement agreeing to the conditions before an application can be approved. Under conditional eligibility, excess resources are treated as a "conditional exclusion" and are not counted during the conditional benefit period. However, there is no "conditional exclusion for spousal impoverishment cases. These resources count because they meet the spousal definition of countable resources. They should be counted in the spousal resource calculation. 8 DE Reg. 1312 (3/1/05) 20360.1 Disposal/Exclusion Periods 1. Beginning Date of the Conditional Medicaid Coverage A social worker can exclude the resource that causes someone to be ineligible for Medicaid and approve Medicaid coverage when: a. all other eligibility criteria are met; b. the applicant or authorized representative signs Form 412 "Agreement to Sell Property"; and c. documentation of individual's effort to sell is obtained within 30 days of the date of the Agreement to Sell Property. 2. Length of Conditional Benefits Period There is a 9-month time limit on the period for which Conditional Medicaid benefits are payable; however, this period may be extended. 3. Ending Date The Conditional Benefit Period ends when the individual: a. disposes of the excess non-liquid resources, i.e. property goes to settlement; or b. stops making good faith efforts to dispose of them; or c. requests cancellation of Medicaid coverage. If an individual becomes ineligible for one or more months despite exclusion of the resources to be sold (due to income, other resources, failure to file for other benefits, etc.) conditional Medicaid benefits are not payable for such month(s). However, the 9 month disposal/exclusion period continues to run. 20360.2 Effective Date of Eligibility Resources to be sold cannot be excluded until Form 412 "Agreement to Sell Property" has been signed and dated by the applicant or authorized representative. Medicaid eligibility cannot be effective prior to the date that Form 412 is signed and there can be no retroactive coverage. Property listed with a realtor prior to or at time of application cannot be excluded until the agreement is signed and dated. 20360.3 Follow-Up Contacts During the Disposal/Exclusion Period Contact the owner or his authorized representative (by phone, if possible) on the following schedule: 1) 30 days following the date conditional benefits were authorized. 2) every 90 days thereafter until the end of the 9 month period. 20360.3.1 Purpose of Contact 1) Remind the individual of the responsibility for selling the property; 2) Document the efforts being made to accomplish a sale; 3) Document whether there has been any offer to buy since the prior contact and, if such an offer has been made and refused, obtain the individual's explanation for refusal; and 4) Document (when there have not been continuing reasonable efforts to sell) whether there was good cause.