Page 13

MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD

Division of Welfare and Supportive Services F-420 Medical Assistance Manual TRANSFER OF ASSETS 23 Oct 01 MTL 04/23 ANNUITIES Note: Even if an annuity is determined to meet the conditions above and the purchase is not treated as a transfer, if the annuity or the income stream from the annuity is transferred, except to a spouse or to another individual for the sole benefit of the spouse, child, or trust, that transfer may be subject to penalty.

Send all documents of the life estate, promissory note, loan, mortgage, and/or annuity to the Chief of Eligibility and Payments for review.

F-425 HOME AND COMMUNITY BASED WAIVER (HCBW) AND MILLER TRUST (QIT)

Section 1917 of the Social Security Act established that a Qualified Income Trust (QIT), also known as a Miller Trust*, may be used by individuals applying for or receiving Home and Community Based Waiver (HCBW) services to reduce the amount of countable income when determining eligibility for the HCBW program. Because a HCBW customer is not assessed a patient liability, the HCBW customer may not be able to spend all income deposited in the QIT monthly. No patient liability expense may cause income to accumulate in a QIT for a HCBW customer. HCBW customer with a QIT require regular accounting to verify proper payments of allowable expenses as outlined in 42 CFR 435.725 (i.e., personal needs allowance, spousal/family allowance and certain unreimbursed medical expenses) and income deposited into the QIT. If any accumulation occurs in the QIT, the HCBW customer must be evaluated for transfer of asset penalty.

*Note: A QIT, or Miller Trust, helps an individual living in a long-term care or HCBW setting to potentially qualify for Medicaid if his or her income exceeds the allowable income limit.

F-430 RESOURCES

For the purposes of this section, the definition of resources is the same definition used by the (SSI) program, except that the home is not excluded for any institutionalized individuals.

F-435 PURSUING A POSSIBLE TRANSFER

If the individual follows the appropriate steps and provides a rebuttal to the presumption of transfer, but is unsuccessful in rebutting the presumption of transfer, the individual may request an undue hardship waiver if the request is made within twenty (20) days after the adverse decision of the Chief of Eligibility and Payments or the Hearing Officer on the presumption of transfer issue.

F-435.1 Transfer/Disposal of Asset Notification (Form 2601)

Send Form 2601-EE to applicant to inform the individual the Division presumes the asset was transferred to become/remain eligible for Medicaid LTC or HCBW Services. The amount of the uncompensated value is the amount of the transfer. Allow 20 days