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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page v Chapter 24 Long Term Care

24.8.5.A Introduction and Purpose .................................................................................71 24.8.5.B Definitions ........................................................................................................71 24.8.5.C Individuals Who May Receive the LTCIP Asset Disregard ................................72 24.8.5.D Verifications Required ......................................................................................72 24.8.5.D.1 Verification of Client’s Residency and Status of Policy-Issuing State at the Policy’s Issuance ............................................................................................................73 24.8.5.D.2 Verification of the Qualified LTCIP Policy ...................................................74 24.8.5.D.3 Verification of Qualified LTCIP Insurance Benefits Paid .............................75 24.8.5.E The Amount of the LTCIP Asset Disregard .......................................................75 24.8.5.F Applying the LTCIP Asset Disregard at Application and Redetermination ........76 24.8.5.F.1 Applying the Disregard at Application .........................................................76 24.8.5.F.2 Applying the Disregard at Redetermination .................................................77 24.9 NOTIFICATION AND FORMS ....................................................................................78 24.9.1 NOTIFICATION TO CLIENT, AUTHORIZED REPRESENTATIVE, OR NURSING FACILITY...............................................................................................................................78 24.10 CASE MAINTENANCE...............................................................................................81 24.10.1 NURSING FACILITY TRANSFER ........................................................................81 24.10.2 CHANGES REQUIRING REEVALUATION ..........................................................81 24.10.3 DISCHARGES AND CLOSURES ........................................................................81 24.11 BENEFIT REPAYMENT .............................................................................................82 24.11.1 CLIENT REPAYMENT .........................................................................................82 24.11.2 PROVIDER FRAUD .............................................................................................82 24.11.3 ESTATE RECOVERY ..........................................................................................82 24.12 ESTABLISHING APPLICANT AS AGED, BLIND, OR DISABLED AND THE MEDICAL NECESSITY FOR NURSING FACILITY CARE .......................................................83 24.12.1 ESTABLISHING MEDICAID CATEGORICAL RELATEDNESS ...........................83 24.12.2 ESTABLISHING MEDICAL NECESSITY, THE PAS ............................................83 24.12.2.A General Requirements ..................................................................................83 24.12.2.B When the PAS Must Be Completed ..............................................................84 24.12.2.C Date of PAS Examples .................................................................................85