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3. No State payment – The State does not pay or otherwise reimburse any portion of the health expenses used for resource reduction. 4. Limits – To be used for resource reduction, the health expense must have been incurred during or after the retroactive period under Part 40-05-3 of this Title 4. Single use – The total amount or any portion of a health expense that is used for resource reduction must not be used for any other purpose in the determination of financial eligibility, including to meet an LTSS medically needy spenddown, or the post-eligibility treatment of income. 5. Adjustments – If a beneficiary submits an allowable health expense bill with a date that precedes the date eligibility is established through the resource reduction process, the State readjusts the date of eligibility if all the requirements set forth herein are met. 6.6 Transfer of Assets A. Section 1924 of the Social Security Act, 42 U.S.C. § 1396p, governs the treatment of assets in the Medicaid LTSS eligibility determination process. The law presumes transfers of assets for undiscernible or less than fair market value (FMV) prior to or at the time of applying for Medicaid LTSS coverage are transactions made for the principal purpose of gaining or maintaining eligibility. The law requires the States to treat all but a narrow range of these transactions as disqualifying transfers that result in a “penalty” period during which a person is ineligible for Medicaid LTSS coverage. For the purposes of this Section: 1. Assets – Includes all income and resources of an LTSS applicant and his or her spouse that is countable in the determination of Medicaid eligibility using the SSI method and the home (and associated land) when a person is seeking or receiving Medicaid LTSS. 2. Transfer – The conveyance of right, title, or interest in an asset from one person to another person or entity, the disclaiming, assignment or divestment of an income producing resource or other source of income, or disposal of a lump sum before it is treated as a countable resource or income. B. The State reviews asset transfers made by an LTSS applicant/beneficiary and/or the non-LTSS spouse in the five (5) year look back period prior to the first (1st) day of the month in which an application is filed. In determining whether a transfer is disqualifying, the State considers the date, amount of the asset, who is making the transfer, and the instrument used, as well FMV of the transaction, if discernable, as set forth below.