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North Carolina Department of Health and Human Services Division of Medical Assistance Medicaid Eligibility Unit AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2245

UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS

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MA-2245 UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS REISSUED 11/01/11 – CHANGE NO. 17-11

I. UNDUE HARDSHIP

An applicant/recipient (a/r) may have coverage authorized for institutional services if imposition of the transfer of asset sanction causes an undue hardship. The a/r has already been unsuccessful in demonstrating that a transfer of assets was made for a purpose other than to establish or retain Medicaid eligibility (rebuttal process). A transfer of asset sanction is also known as a penalty period.

The transfer of assets penalty is waived if the a/r demonstrates to the director or director’s designee that the sanction would cause an undue hardship.

Undue hardship relates to the a/r. Undue hardship does not apply to relatives, responsible parties of the a/r or the facility. Undue hardship also does not exist when the imposition of the penalty period causes the a/r an inconvenience or restricts his lifestyle.

II. POLICY RULES

A. Undue hardship exists:

1. When imposition of a penalty period due to the asset transfer would deprive the a/r of:

a. Medical care such that the a/r’s health or life would be endangered, or

b. Food, clothing, shelter, or other necessities of life.

Other necessities of life including basic life sustaining utilities, including water, heat, electricity, phone, and other items or activities without which the individual’s health or life would be endangered.

And

2. No other income or assets are currently available to the a/r to provide for medical care or food, clothing, shelter, or other necessities of life.

And

3. The a/r or some other person acting on the a/r’s behalf is making a good faith effort to pursue all reasonable means to recover the transferred asset or the fair market value of the transferred asset which may include: