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Chapter: 1600 Assets Program: MSSI, SFP 53

3. the support or services are to be provided for the life of the individual, using the life expectancy tables in Appendix A-14.

To establish the value of support and maintenance for the individual's life, use the following formula:

Multiply the yearly fair market value (FMV) of the support and/or maintenance times the life expectancy factor corresponding to the individual's age (as of the last birthday) at the time the asset was transferred.

Contact with an outside source in the same locality will usually be necessary to determine value. The case record must:

1. state how the value was determined; and 2. include a copy of the agreement or a statement from the person receiving the transferred asset showing the type, frequency, and duration of the support or services. 1640.0615 Uncompensated Value/Notifying the Individual (MSSI) Whenever the individual disposes of income or assets within the transfer look-back period and does not receive fair compensation, he is potentially ineligible for Medicaid institutional care, HCBS, or PACE for a period of time. The ineligibility period is dependent on the amount of the uncompensated value of the transferred funds.

The uncompensated value (UV) of the transferred funds is determined by subtracting the compensation received after the transfer from the fair market value of the transferred asset or income at the time of the transfer (less any outstanding loans, mortgages or other encumbrances on the asset).

Whenever the UV exceeds the average monthly private pay nursing home rate (refer to Appendix A-35), the individual is potentially ineligible for at least one month of nursing home care or HCBS. You must send CF-ES Form 2264 to the individual to offer him the opportunity to dispute the presumption that the asset was transferred to establish eligibility.

Notification of uncompensated value due to transfers of income or assets is not required and the application may be processed immediately if:

1. the individual is ineligible for other reasons; or 2. the total uncompensated value of the transferred assets is less than the private nursing home rate; or 3. the period of ineligibility has elapsed; or 4. the transfer was considered allowable.

When notification is required, you must allow the individual the full 15 days to respond to the rebuttal notice. If the individual does not respond within 15 days, the uncompensated value must be considered in determining eligibility.

You must record the individual's written statement or remarks on CLRC. 1640.0616 Rebuttal of Presumption (MSSI) To rebut the presumption that the transfer was for the purpose of becoming Medicaid eligible, the individual must establish that the transfer was done exclusively for some other purpose than establishing eligibility. If the individual had some other purpose for transferring the asset but establishing eligibility was a factor in the decision to transfer the asset, the presumption is not successfully rebutted.