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North Carolina Department of Health and Human Services North Carolina Medicaid Division of Health Benefits AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2240 TRANSFER OF ASSETS__________________________________ REVISED 06/30/2026 - CHANGE NO. 09-26

I. INTRODUCTION

When an applicant/beneficiary (a/b) requests institutional services, a transfer of assets evaluation must be completed. Transfers of real or personal property, or any other asset for less than current market value must be reviewed to determine if a sanction should be imposed. A sanction is a penalty period during which some services related to institutional coverage will not be paid by Medicaid. If a sanction is imposed the a/b is ineligible for certain Medicaid covered services.

This section contains the policy and procedures for determining the following:

• Which a/bs are subject to the transfer of assets regulations,

• Medicaid covered services subject to the transfer of assets regulations, • The lookback date and lookback period,

• Time frames for completing the transfer of asset evaluation,

• Assets subject to the transfer of assets regulations, • How to determine if a non-allowable transfer has occurred, • How to determine the sanction period,

• When to impose a transfer of assets sanction,

• The applicant/beneficiary (a/b) notification procedures. Transfer of asset regulations do not apply to all Medicaid covered services. An a/b under a transfer of assets sanction may be eligible for other services covered by the North Carolina Medicaid program.

II. POLICY PRINCIPLE

When an a/b, an a/b’s financially responsible spouse, or their legal representative gives away or sells an asset, for less than current market value, the a/b may be ineligible for payment of institutional services or in-home health services and supplies. This includes any direct or indirect method of disposing of an interest in an asset whether or not the asset would have been considered excluded or exempt at the time of its disposal or transfer. The period of ineligibility is also called a sanction. Do not delay approval of institutional services for the transfer of asset evaluation at initial request. If all other eligibility criteria are met, approve LTC, CAP, or PACE and continue