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State of Maryland Medical Assistance Manual Revised April 2014

reported in a timely manner, the LDSS must adjust available income retroactively to the month the change was reported. D. Change in Resources A decrease in resources does not affect eligibility and requires no action by the LDSS other than recording it in the case record. An increase in resources affects eligibility if it results in resources that exceed the MA-2 standard. When resources exceed the MA-2 standard, close the case, cancel MA with timely notice, and cancel payment to the LTCF effective the same day the MA cancellation is effective. If an increase in resources which results in ineligibility is not reported in a timely manner, make a referral for investigation and recovery using DHMH 4243form, even if resources are subsequently reduced and eligibility is continued. This includes a situation where excess resources existed in a prior month or months of eligibility and were not reported until the resource had already been reduced to the MA-2 standard. A DHMH 4243 is also required if excess resources still exist and the case is closed. E. Proper Reduction of Excess Resources If an increase in resources which results in ineligibility is reported in a timely manner and resources are properly reduced within 30 days of the notice of ineligibility, eligibility may be continued without interruption. A disposal of resources for less than fair market value must be evaluated according to the procedures in Section 800. Resources that are spent on usual living or medical expenses are considered properly disposed. Resources that are used to reimburse the State for money paid out on behalf of the recipient are also considered properly disposed. Voluntary reimbursement procedures are applicable if all of the following conditions are met: • The excess resources were reported in a timely manner; • The program has paid, on the recipient’s behalf, medical expenses at least equal to the amount of the excess resources; and • The excess resources, in addition to two months of available income, are equal to or less than twice the average monthly cost of care. If all of the above conditions exist, take steps to close the case with timely notice. In addition to the DHMH 4235, complete the DES 100 and the DHMH 4342, Excess Resources Reimbursement Form. All three documents must be distributed to the recipient, representative, long term care facility, and case record. If the receipt portion of the DHMH 4342 is received indicating that the excess resources were paid to the Division of Recoveries within 30 days of the date that the DHMH 4235, DES 100, and DHMH 4342 were mailed, reopen the case effective the month of cancellation. If this condition is met, the recipient loses no program coverage.