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F-435.3 Division of Welfare and Supportive Services TRANSFER OF ASSETS Medical Assistance Manual UNDUE HARDSHIP 23 Oct 01 MTL 04/23 d. The customer has exercised all reasonable efforts and all possible avenues to recover and/or access the assets by returning the assets to his/her ownership or to receive further compensation; and

e. Without Medicaid, the customer would be forced to go without life sustaining medical care as determined by an individual licensed to practice medicine in the State of Nevada.

Upon receipt of the information, send the hardship request to the Chief of Eligibility and Payments requesting a decision on whether undue hardship exists and include a Form 6009 with the following information:

a. The name and case number of the applicant/recipient;

b. The application date;

c. The date the customer began receiving LTC or HCBW Services; and

d. A brief description of the circumstances of the transfer and why it would be an undue hardship if the penalty were imposed.

A decision whether a transfer of assets occurred or an undue hardship waiver is granted will be made within 45 days from the date the Form 6009 and all pertinent information is received by the Chief of Eligibility and Payments, unless extenuating circumstances exist. An adverse determination may be appealed if received by the hearing officer within 90 days from the date of the transfer of assets or undue hardship decision.

If the individual’s request for an undue hardship waiver is received timely, continue through to the decision-making process by the Chief of Eligibility and Payments.

F-435.4 Return of Assets

If all assets transferred for less than fair market value are returned to the individual, no penalty for transferring assets can be assessed. Full Medicaid eligibility must be restored for any months a penalty was assessed if the return of assets does not cause ineligibility for other reasons.

If counting the returned income/assets results in the individual being ineligible for some or all of the months of the penalty period (because of excess income/resources), do not restore full Medicaid for months that would now be ineligible due to the excess income/resource.