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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 18

2. Evaluation of Evidence Evaluate the individual’s evidence carefully keeping in mind the following consideration:

a. Did the individual make an effort to obtain a fair price? b. Regarding the compensation received: i. What percentage of the real value did the individual receive? ii. Why did the individual accept less than FMV? iii. Are the reasons the individual accepted less than FMV supported by factual evidence and was the individual’s action justified? iv. What was the timing of the transfer with the Medicaid application? Was it before the individual knew about TennCare Medicaid or the program’s resource limitation, or did the transfer take place just before the individual applied or just after being advised of ineligibility due to excess resources? Were the assets unreported and later transferred after eligibility was established, based on erroneous information provided by the individual or responsible/legal representative? 4. Hardship Hardship is considered to exist if the institutionalized individual has no available resources (other than the uncompensated value) in excess of the resource limit and application of the penalty would deprive the individual of medical care such that the individual’s health or life would be endangered or of loss of food, clothing, shelter, or other necessities of life.

Note: If the community spouse has available assets, he is legally obligated for the support of his spouse; therefore, hardship does not exist.

Requests for hardship must be filed within ninety (90) days of the date of application, or if filed later, no later than forty (40) days after the date of the denial or termination notice. A request for hardship can also be filed if an individual experiences a change in circumstances while serving a penalty period. TennCare will determine whether hardship exists and notify the individual within thirty (30) days of receiving a request for hardship. A hardship denial may be appealed within forty (40) days.