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1145 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) The individual must provide or cooperate in obtaining sufficient medical documentation for ODHS|OHA to determine eligibility. Other resources Presumptive Medicaid Disability Determination Team (PMDDT) and State Family Pre-SSI (SFPSS) Referrals: Walks through the Presumptive Medicaid Disability Determination Team (PMDDT) and State Family Pre-SSI referral process within ONE. Each referral is separate in the document. SFPSS referrals are completed by family coaches. Treatment of annuities This worker guide is intended to help workers with the determination as to whether the purchase of an annuity is a disqualifying transfer of assets for less than fair market value for individuals applying for or receiving long-term- care. Remember, to ensure that you have detailed information about the annuity necessary for making an eligibility determination, make a copy of the entire annuity for the case file. You will need to know not only the date and amount of the purchase, amount it pays out, etc., but also who is named as the remainder beneficiary, for example. Note: When the OSIPM annuity rule, OAR 461-145-0022(10), says that an annuity purchased after 7-1-06 must name as the first remainder beneficiary ODHS|OHA “for up to the total amount of medical benefits paid on behalf of the individual,” this means that the state will recover all sums allowed under the ruling by the Court of Appeals for the Ninth Circuit, in Hutcherson v. Arizona Health Care Cost Containment Sys. Admin. (9th Cir., 2012): The state’s right to recover against a community spouse’s annuity for the institutionalized spouse’s medical costs is not limited to the amount the state paid for the institutionalized spouse’s medical costs as of the date of the community spouse’s death. Rather, the state can be reimbursed from the annuity for the cost of the medical assistance paid on the institutionalized spouse’s behalf after the community spouse’s death, as well. For this reason, CAREFULLY REVIEW the policy to see how ODHS|OHA is named as beneficiary. The following language is NOT ACCEPTABLE: “The Oregon Department of Human Services to the extent of medical benefits provided to my spouse; the primary beneficiary’s claim amount ends on the date of death of the owner/annuitant.” If you find such limiting language: • OAR 461-145-0022(11): Under the circumstances set forth in the rule at (11), to the extent to which there is a disqualifying transfer of assets under this section, the annuity is not counted as a resource. See (11) for an explanation of when there is a disqualifying transfer, and how to calculate its length. • OAR 461-145-0022(12): The annuity is counted as a resource when it does not meet all of the requirements of section (10)(b) or (10)(c) of the rule. Click here for Annuity flowchart. Annuities purchased by individuals (or their spouses) before January 1, 2006 Calculate a disqualification if the annuity pays out beyond the expected lifetime of the annuitant (individual or community spouse). Example 1