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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 53 Chapter 24 Long Term Care

Decision for Request of Undue Hardship Waiver form (DFA-NL-UH-2). The Committee forwards the DFA-NL-UH-2 to the individual, with a copy to the Supervisor and Worker. The decision of the Committee to deny the request can be overturned by a State Hearings Officer, therefore a DFA-FH-1 is sent. The local office must notify the BMS Policy Unit when a hearing request regarding the Committee’s decision is received, and also advise the Regional Attorney. A member of the Committee will be available, via telephone, to participate in a Fair Hearing regarding the denial of the DFA-UH-5, but not to discuss the ineligibility for LTC services for reasons other than those related to excessive home equity, trust, and/or transfer issues. 24.8.2.B.8 Transfer of Resources Previously Disregarded by LTCIP Asset Disregard If an individual in the Nursing Facility coverage group with income less than 300% of the SSI payment for one person transfers an asset that was previously disregarded by the LTCIP Asset Disregard, the transfer is not subject to a transfer penalty since the asset was previously disregarded. If the individual obtains an additional countable asset that causes him to exceed the allowable asset amount, he must verify additional payments made to him or on his behalf by the LTCIP Policy in addition to the amount of payments that were previously used to disregard the assets that were transferred. The amount of the individual’s estate that was protected from Estate Recovery is reduced by the same amount as the value of the asset that was transferred. LTCIP Example: Mr. Sunflower is in a nursing facility and applies for Medicaid on November 1, 2016. Mr. Sunflower’s income is less than 300% of the SSI payment for one person but he has $12,000 in individual assets consisting of $5,000 in an accessible money market and $5,000 in stocks. He verifies ownership of a $100,000 Qualified LTICP Policy issued after July 1, 2010, the date West Virginia implemented the LTCIP. He can also show insurance payments for a previous nursing facility stay in the amount of $10,000 to the nursing facility after July 1, 2010. The Worker disregards his money market and stocks and Medicaid eligibility is effective November 1, 2016. At redetermination, Mrs. Sunflower reports transferring the stock to their son. The transfer is not subject to a penalty since the asset was previously disregarded. However, since insurance payments verified as paid by the LTCIP Policy on behalf of Mr. Sunflower were applied to disregard the value of the stock, and resulted in Mr. Sunflower being eligible for and receiving Medicaid, these same