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If there is a specified plan to spend the excess to the allowable limit without violating the transfer of property law, a suspension may be appropriate. If the member is eligible before the end of the suspension period, eligibility is to be reinstated without a reapplication. If after the suspension period the recipient remains ineligible, Medicaid must be discontinued (timely notice is required.) It is the member’s responsibility to verify how the resources/assets were spent and that they are under the resource limit for Medicaid. For more information on resource limits, see IHCPPM 3005.10.00 and 3005.25.00.

Note that change processing rules apply (see IHCPPM 2220.00.00 – 2220.20.00).

Example 1: A long-term care member (nursing home or HCBS waiver) is over resources and get suspended. They verify within 60 days that they appropriately spent the resources, then the Medicaid (MA) can be reopened ongoing without a new application. If they verify within 60 days, then the worker will process the unsolicited documents, and the case will be reopened. • 03/01 – The Medicaid (MA) is suspended • 04/30 – Verification is received that the member was under the resource limit as of 04/01 with verification that the funds were used to privately pay the nursing home • Based on change processing rules and that the verification was received on 04/30, the Medicaid (MA) can be reopened 05/01

Example 2: A long-term care member (nursing home or HCBS waiver) is over resources, they get suspended for up to 60 days. • 03/01 – The Medicaid (MA) is suspended • 05/01 – Verifications were not received by the due date, so the Medicaid (MA) is closed • 05/05 – Verifications are received after the closure; the Medicaid (MA) remains closed

Example 3: A long-term care member (nursing home or HCBS waiver) is over resources, they get suspended for up to 60 days. Prior to the suspension date, verification is received that the member is below the resource limit; no funds were given away or transferred. • 02/14 – Suspension notice is sent with suspension beginning 03/01 • 02/21 – Verifications are received showing that the member is under the resource limit (no funds were given away or transferred) • 03/05 – Worker pulls the task and sees that the verifications are in the ECF prior to the effective date; Medicaid (MA) is reinstated effective 03/01