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210-RICR-50-00-6 TITLE 210 – EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES CHAPTER 50 – MEDICAID LONG-TERM SERVICES AND SUPPORTS SUBCHAPTER 00 – LONG-TERM SERVICES PART 6 – Medicaid Long-Term Services And Supports: Financial Eligibility 6.1 Overview and Purpose A. Financial eligibility for Medicaid Long-Term Services and Supports (LTSS) is determined using a multi-faceted process that considers countable income and resources at the time of application, the allocation of joint spousal resources from the point the need for LTSS began, and financial transactions over a look-back period of up to five (5) years. The purpose of this process is not only to assess whether an applicant meets the applicable income and resource limits, but also to ensure that Federal requirements that both prohibit self-impoverishment and protect against spousal impoverishment are met. B. The LTSS financial eligibility requirements differ somewhat depending on whether a person is a current Medicaid beneficiary or a new applicant. The method required by Federal Regulations for evaluating income and resources is linked to the applicable category of Medicaid coverage: modified adjusted gross income (MAGI) method for Affordable Care Act (ACA) expansion adults in Medicaid Affordable Care Coverage (MACC) category or the Supplemental Security Income (SSI) method for adults over age twenty-one (21) in the Integrated Health Care Coverage (IHCC) category. 6.2 Legal Authority A. This Part is promulgated pursuant to the following Federal and State authorities: 1. Federal Law – Sections 1902, 1903,1905, 1915, 1917, 1919, 1924, 1934, and 1940 of Title XIX of the U.S. Social Security Act, 42 U.S.C. §§ 1396- 1396w-8. 2. Federal Regulations – 42 C.F.R. Parts 435, 441, and 460. 3. The Rhode Island Medicaid State Plan and the Section 1115 waiver granted pursuant to § 1115 of the Social Security Act, 42 U.S.C. § 1315. B. State Authority – R.I. Gen. Laws Chapters 40-6; 40-8; 40-8.9; 40-8.10; and 42- 7.2.