Page 27

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued October 21, 2025 Page 27 of I-1670 Replacing January 27, 2025 Revised/added text indicated by underscore Deleted text indicated by “**”

Convincing evidence must be presented showing the specific purpose that the asset was transferred.

Consider all statements and documentation provided by the applicant/beneficiary.

If it is determined that the applicant/beneficiary had some other reason for transferring the asset, but any expectation of establishing eligibility could reasonably be inferred to be a factor in the individual's decision to transfer the asset, the presumption that the transfer was exclusively for some other purpose is not successfully rebutted. The penalty period does apply.

If the applicant/beneficiary provides convincing evidence that the disposal was solely for some purpose other than to establish eligibility for Medicaid, the presumption is successfully rebutted. The penalty period does not apply.

Supervisory review and concurrence is required and shall be documented for all successful rebuttals.

If the supervisor is unable to reach a decision, refer a summary of pertinent facts to the Eligibility Program Operations in State Office for a decision.

Notification

Send notice of right to apply for an undue hardship exception. See H-860 Undue Hardship and Undue Hardship Exception. After the undue hardship notice expires, a final notice of decision may be sent.

Imposition of a penalty period for new applicants for Medicaid requires a denial notice. Send written notification of the decision to the applicant/beneficiary or responsible person.

At the time the penalty specified in the denial notice is exhausted, verify that assets are below the resource limit and that there has been no further transfer of resources for less than fair market value during the penalty period before vendor payment can be approved.

If a penalty period is imposed on an individual who is already eligible for Medicaid, the State must provide a 10-day adverse action notice.