Page 47
47
the transfer of assets evaluation is pending,
a. Notify the a/b and authorized representative, if applicable:
(1) Of eligibility for institutional services, and (2) That evaluation for transfer of assets is still pending. b. Once the evaluation of the transfer is complete: (1) If the evaluation later reveals no sanctions, send a DSS-8110 adequate notice notifying the a/b, and authorized representative, if applicable, of continued coverage.
(2) If the evaluation reveals a non-allowable transfer and a sanction period, follow procedures in XIII B. below to notify the a/b and authorized representative, if applicable, of their right to rebut. 3. If the a/b is found eligible for PLA Medicaid, is requesting assistance for a subsequent period of institutional services because they were terminated for failure to provide transfer of assets information and evaluation of a transfer of assets is pending, (remember a new institutional services period cannot be approved until the transfer of assets evaluation is completed):
a. Notify the a/b and authorized representative, if applicable: (1) Of eligibility for non-institutional services, and (2) That eligibility for institutional services is still pending. This is a manual notice. b. Once the evaluation of the transfer is complete: (1) If the evaluation later reveals no sanctions, send a revised DSS-8110 notice authorizing eligibility for nursing home cost of care, CAP or PACE.
(2) If the evaluation reveals a non-allowable transfer and a sanction period, follow procedures in XIII.B. below.
B. Notifying Individual of Sanction and Right to Rebut
1. If the transfer of assets evaluation reveals that a non-allowable transfer has occurred and the sanction length can be determined, use the DHB-5097, Request for Information, and the DHB-5161, Transfer of Asset Below Current Market Value, to notify the a/b and authorized representative, if applicable:
a. They are ineligible for institutional services and/or in-home health services and supplies, due to transfer of assets.