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Chapter: 1800 Income Program: MSSI, SFP 12 Funds deposited into a qualified income trust are not subject to transfer penalties provided they are paid out of the trust for medical care for the individual. When such payments are made, the individual is considered to have received fair compensation for income placed in the trust account up to the amount paid for the medical care and to the extent medical care costs are at fair market value. If the individual's patient responsibility exceeds the Medicaid cost of care, the eligibility specialist must determine if fair compensation is received for income transferred into the income trust. If necessary, the eligibility specialist must refer the case to the Region or Circuit Program Office for review and clearance.

If the individual's patient responsibility is less than the Medicaid rate, the eligibility specialist does not need to look at the disbursements (unless funds are paid to the individual, in which case the funds must be counted as their income). All income must be verified at the source, including income placed into the trust.

Using Form CF-ES 2356, Third Party Recovery Transmittal, fax or send a copy of the approved qualified income trust to the AHCA Third Party Liability vendor.

When inquiries are received regarding the settlement of remaining funds in the trust after the individual's death, staff can advise callers to make checks payable to Florida Medicaid and send to the AHCA Third Party Liability vendor (refer to Form CF-ES 2356 for the mailing address). The correspondence must clearly identify the individual by including a note with the individual's full name and Social Security number or Medicaid number.

An individual may choose to revoke an income trust at the time of their discharge from a Medicaid facility if the trust document allows them to do so. If revoked, Florida Medicaid must receive reimbursement (following above instructions) prior to any other beneficiary. 1840.0111 Transfer of Income (MSSI) The following policy applies to Institutional Care Program (ICP), institutionalized Hospice and Home Community Based Services (HCBS) and PACE. Transfer policies apply to transfers of income as well as assets. For example, if an individual receives an inheritance on or after 10/01/93, and transfers it in the month received, or if an individual transfers a stream of income, (i.e. income received on a regular basis, such as a pension) or the right to a stream of income, the transfer of asset provisions will apply and a possible period of ineligibility may be imposed. When a stream of income or the right to a stream of income is transferred make a determination of the total amount of income expected to be transferred during the individual’s life, based on an actuarial projection of the individual’s life expectancy, and calculate the penalty on the basis of the projected total income. Refer to transfer of assets policy in Chapter 1600.

Note: Transfers of income into a qualified income trust are not considered transfers without fair compensation unless the trust document does not allow monthly disbursement of all funds for the benefit of the individual. 1840.0112 Payments to Joint Owners (MSSI, SFP) Payment to joint owners is one payment made to two or more individuals.

A document, such as a single or combined Social Security check for a couple or to a parent on behalf of two or more children, indicating the amount due each owner is generally sufficient verification of ownership.

In the absence of specific documentation, divide the income minus allowable expenses by the number of beneficiaries to determine the income amount for each individual.