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1157 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) have decreased in value due to an individual’s action to spend or gift the resources, then the amount of excluded resources due to the QPP payments is reduced accordingly. For example, if the individual had $140,000 excluded resources due to QPP payments but you find at redetermination that $60,000 has been spent, then only the remaining $80,000 in resources continues to be excluded. In addition, the EAU must be notified of the reduced amount of excluded resources (See the Estate Administration Claim Exclusion below). Estate administration claim exclusion (461-160-0855 and 461-135-0835) An individual who utilizes a QPP is also eligible for the amount that was excluded in the eligibility determination, to be excluded from the estate administration claim, when the individual passes away. This is true as long as the individual did not transfer or spend all or part of the amount that was excluded prior to their death. The resources excluded due to QPP payments are not subject to transfer of asset disqualifications, so the individual may spend the resources or gift them away without a penalty (461-140-0220). If all or part of the amount of resources are spent or gifted away, however, the individual’s estate will no longer be protected from collection for that amount of resources. It is very important for the eligibility worker to designate the amount of resources excluded by QPP payments in a case note, and by notifying the Estate Administration by the “Remarks” section of the MSC 0647 so that the same amount will be protected from the estate claim process. If the worker later learns that the individual has gifted all or part of the amount of excluded resources, the worker should add a case note so that Estate Administration can adjust ODHS|OHA’s claim accordingly. Example 8: In example 6 for Howard above, there is $121,500 total countable resources and $120,000 is excluded due to the receipt of QPP payments. The worker adds a case note and sends a MSC 0647 (indicating the amount of the QPP protection in the “Remarks” section) to Estate Administration to exclude $120,000 from the estate claim process. At application, Howard owned a home that was excluded, $40,000 RV, $65,000 CD, $13,000 savings and the remaining $3500 was in a checking account (there was also an excluded life insurance plan to cover burial). The eligibility worker determines that $40,000 RV + $65,000 CD + $13,000 savings + $2000 checking = $120,000 excluded due to QPP payments. The home is excluded because Howard lives there and the remaining $1500 in the checking account is less than the $2000 resource limit. Before passing away Howard gives the RV and the CD away to a family member and the worker notes this in the case note. Therefore, when Howard dies the estate consists of the home, $13,000 savings and $3500 checking. Because Howard gifted $40,000 + $65,000 = $105,000 before passing away, the QPP Estate Administration protection of $120,000 is reduced by $105,000 to $15,000. Example 9: Marjorie has exhausted a $180,000 QPP prior to applying for Medicaid nursing facility services. Marjorie now has $1800 countable cash resources and an excluded home with equity value of $270,000 (the home is listed for sale). The worker adds a case note that Marjorie is eligible for $180,000 to be excluded due to QPP payments, sends a MSC 0647 (indicating the amount of the QPP exclusion in the “Remarks” section) to Estate Administration and finds Marjorie eligible because the home is an excluded resource and the remaining countable resources are $1800. Marjorie passes away and the home never sells. When the estate claim is made, the most ODHS|OHA could collect from the home equity would be $270,000 minus $180,000 excluded due to QPP payments = $90,000 and the $1800 cash to reimburse ODHS|OHA for the cost of Marjorie’s medical care. If an individual receives Medicaid benefits before the receipt of QPP payments, those benefits are not protected in the Estate Administration collection process. Example 10: Stanley is an individual who had a stroke at age 55 and was eligible for Medicaid services. Stanley