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Aged, Blind and Disabled Manual Policy Manual Number: 125.010 Section: Institutional Medicaid Chapter: Transfer of Assets and Penalty Periods

January 5, 2026 Division of TennCare 14

d. Penalty Periods for Assets Transferred On or After 02/08/2006 i. The DRA of 2005 The DRA of 2005 made the following changes to asset transfers occurring on or after 02/08/2006:

1. The look-back period for all transferred assets is 60 months; and 2. For applicants, the penalty period begins on the date on which the individual is eligible for TennCare Medicaid and would otherwise be receiving institutional level of care services but for the application of the penalty period.

ii. Penalty Period Start Date 1. Nursing Facility Individuals For Nursing Facility individuals the start date for the penalty period is the later of:

a. The date the individual is eligible for Institutional Medicaid and would have been eligible for CHOICES if not for an improper transfer, or b. The first day of the month in which the assets were transferred.

2. HCBS Individuals For HCBS individuals that would be eligible for CHOICES if not for an improper transfer, the start date for the penalty period is the later of:

a. The date the individual would have been eligible for Institutional Medicaid (based on receipt of waivered services, i.e., CHOICES) if not for an improper transfer, or b. The first day of the month in which the assets were transferred.

3. Other Considerations The penalty period cannot begin until the expiration of any existing period of ineligibility. There is no limit on the maximum months of ineligibility. Once a penalty period begins, it will continue to run uninterrupted even if the individual subsequently stops receiving institutional level of care services.

Penalty periods for more than one transferred asset will run consecutively, not concurrently. Any uncompensated value from multiple transfers is added to the initial uncompensated value if penalty periods overlap to determine the consecutive penalty period.