us/statute/42/1396p/f/1

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(A) Notwithstanding any other provision of this subchapter, subject to subparagraphs (B) and (C) of this paragraph and paragraph (2), in determining eligibility of an individual for medical assistance with respect to nursing facility services or other long-term care services, the individual shall not be eligible for such assistance if the individual’s equity interest in the individual’s home exceeds $500,000.

(B) A State may elect, without regard to the requirements of section 1396a(a)(1) of this title (relating to statewideness) and section 1396a(a)(10)(B) of this title (relating to comparability), to apply subparagraph (A) by substituting for “$500,000”, an amount that exceeds such amount, but does not exceed $750,000.

(C) The dollar amounts specified in this paragraph shall be increased, beginning with 2011, from year to year based on the percentage increase in the consumer price index for all urban consumers (all items; United States city average), rounded to the nearest $1,000.

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Rules

statutory_home_equity_limit

Parameter

source: 42 U.S.C. 1396p(f)(1)(A)

- name: statutory_home_equity_limit
  kind: parameter
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: exceeds $500,000
  versions:
    - effective_from: '2011-01-01'
      formula: '500000'

maximum_state_substituted_home_equity_limit

Parameter

source: 42 U.S.C. 1396p(f)(1)(B)

- name: maximum_state_substituted_home_equity_limit
  kind: parameter
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: does not exceed $750,000
  versions:
    - effective_from: '2011-01-01'
      formula: '750000'

home_equity_limit_rounding_multiple

Parameter

source: 42 U.S.C. 1396p(f)(1)(C)

- name: home_equity_limit_rounding_multiple
  kind: parameter
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: rounded to the nearest $1,000
  versions:
    - effective_from: '2011-01-01'
      formula: '1000'

adjusted_statutory_home_equity_limit

Derived

source: 42 U.S.C. 1396p(f)(1)(C)

- name: adjusted_statutory_home_equity_limit
  kind: derived
  entity: Person
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              increased, beginning with 2011, from year to year based on the percentage increase in
              the consumer price index
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: rounded to the nearest $1,000
  versions:
    - effective_from: '2011-01-01'
      formula: >-
        floor(((statutory_home_equity_limit * (1 +
        cumulative_cpi_u_increase_rate_since_statutory_base_year)) /
        home_equity_limit_rounding_multiple) + 0.5) * home_equity_limit_rounding_multiple

adjusted_maximum_state_substituted_home_equity_limit

Derived

source: 42 U.S.C. 1396p(f)(1)(C)

- name: adjusted_maximum_state_substituted_home_equity_limit
  kind: derived
  entity: Person
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: The dollar amounts specified in this paragraph shall be increased
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: rounded to the nearest $1,000
  versions:
    - effective_from: '2011-01-01'
      formula: >-
        floor(((maximum_state_substituted_home_equity_limit * (1 +
        cumulative_cpi_u_increase_rate_since_statutory_base_year)) /
        home_equity_limit_rounding_multiple) + 0.5) * home_equity_limit_rounding_multiple

applicable_home_equity_limit

Derived

source: 42 U.S.C. 1396p(f)(1)(A)-(C)

- name: applicable_home_equity_limit
  kind: derived
  entity: Person
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(A)-(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              A State may elect ... by substituting for "$500,000", an amount that exceeds such
              amount, but does not exceed $750,000
  versions:
    - effective_from: '2011-01-01'
      formula: >-
        if state_elects_higher_home_equity_limit:
        min(max(state_substituted_home_equity_limit_amount, adjusted_statutory_home_equity_limit),
        adjusted_maximum_state_substituted_home_equity_limit) else:
        adjusted_statutory_home_equity_limit

paragraph_1_home_equity_bar_waived_for_hardship

Derived

source: 42 U.S.C. 1396p(f)(4)

- name: paragraph_1_home_equity_bar_waived_for_hardship
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396p(f)(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: paragraph (1) is waived in the case of a demonstrated hardship
  versions:
    - effective_from: '2011-01-01'
      formula: demonstrated_hardship_waiver_granted

paragraph_1_home_equity_bar_exception_applies

Derived

source: 42 U.S.C. 1396p(f)(2)

- name: paragraph_1_home_equity_bar_exception_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396p(f)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              Paragraph (1) shall not apply ... if ... spouse ... or ... child ... is lawfully
              residing in the individual's home
  versions:
    - effective_from: '2011-01-01'
      formula: |-
        spouse_lawfully_resides_in_individual_home
        or child_under_age_21_lawfully_resides_in_individual_home
        or child_blind_lawfully_resides_in_individual_home
        or child_permanently_and_totally_disabled_lawfully_resides_in_individual_home
        or child_disabled_as_defined_in_section_1382c_lawfully_resides_in_individual_home

is_medicaid_long_term_care_home_equity_eligible

Derived

source: 42 U.S.C. 1396p(f)(1)-(4)

- name: is_medicaid_long_term_care_home_equity_eligible
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396p(f)(1)-(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              the individual shall not be eligible ... if the individual's equity interest ...
              exceeds $500,000
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: Paragraph (1) shall not apply
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: paragraph (1) is waived in the case of a demonstrated hardship
  versions:
    - effective_from: '2011-01-01'
      formula: |-
        individual_home_equity_interest <= applicable_home_equity_limit
        or paragraph_1_home_equity_bar_exception_applies
        or paragraph_1_home_equity_bar_waived_for_hardship

▸citations (2)

References

This rule cites 2 other rules.

42 USC § 1396a (a)(1)inferredUS Federal › Statutes › Title 42 › § 1396a › (a)(1)
42 USC § 1396a (a)(10)(B)inferredUS Federal › Statutes › Title 42 › § 1396a › (a)(10)(B)

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us/statute/42/1396p/f/1 · Axiom

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statutes/42/1396p/f.yaml

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Rules

statutory_home_equity_limit

Parameter

source: 42 U.S.C. 1396p(f)(1)(A)

- name: statutory_home_equity_limit
  kind: parameter
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: exceeds $500,000
  versions:
    - effective_from: '2011-01-01'
      formula: '500000'

maximum_state_substituted_home_equity_limit

Parameter

source: 42 U.S.C. 1396p(f)(1)(B)

- name: maximum_state_substituted_home_equity_limit
  kind: parameter
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: does not exceed $750,000
  versions:
    - effective_from: '2011-01-01'
      formula: '750000'

home_equity_limit_rounding_multiple

Parameter

source: 42 U.S.C. 1396p(f)(1)(C)

- name: home_equity_limit_rounding_multiple
  kind: parameter
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: rounded to the nearest $1,000
  versions:
    - effective_from: '2011-01-01'
      formula: '1000'

adjusted_statutory_home_equity_limit

Derived

source: 42 U.S.C. 1396p(f)(1)(C)

- name: adjusted_statutory_home_equity_limit
  kind: derived
  entity: Person
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              increased, beginning with 2011, from year to year based on the percentage increase in
              the consumer price index
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: rounded to the nearest $1,000
  versions:
    - effective_from: '2011-01-01'
      formula: >-
        floor(((statutory_home_equity_limit * (1 +
        cumulative_cpi_u_increase_rate_since_statutory_base_year)) /
        home_equity_limit_rounding_multiple) + 0.5) * home_equity_limit_rounding_multiple

adjusted_maximum_state_substituted_home_equity_limit

Derived

source: 42 U.S.C. 1396p(f)(1)(C)

- name: adjusted_maximum_state_substituted_home_equity_limit
  kind: derived
  entity: Person
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: The dollar amounts specified in this paragraph shall be increased
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: rounded to the nearest $1,000
  versions:
    - effective_from: '2011-01-01'
      formula: >-
        floor(((maximum_state_substituted_home_equity_limit * (1 +
        cumulative_cpi_u_increase_rate_since_statutory_base_year)) /
        home_equity_limit_rounding_multiple) + 0.5) * home_equity_limit_rounding_multiple

applicable_home_equity_limit

Derived

source: 42 U.S.C. 1396p(f)(1)(A)-(C)

- name: applicable_home_equity_limit
  kind: derived
  entity: Person
  dtype: Money
  unit: USD
  period: Year
  source: 42 U.S.C. 1396p(f)(1)(A)-(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              A State may elect ... by substituting for "$500,000", an amount that exceeds such
              amount, but does not exceed $750,000
  versions:
    - effective_from: '2011-01-01'
      formula: >-
        if state_elects_higher_home_equity_limit:
        min(max(state_substituted_home_equity_limit_amount, adjusted_statutory_home_equity_limit),
        adjusted_maximum_state_substituted_home_equity_limit) else:
        adjusted_statutory_home_equity_limit

paragraph_1_home_equity_bar_waived_for_hardship

Derived

source: 42 U.S.C. 1396p(f)(4)

- name: paragraph_1_home_equity_bar_waived_for_hardship
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396p(f)(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: paragraph (1) is waived in the case of a demonstrated hardship
  versions:
    - effective_from: '2011-01-01'
      formula: demonstrated_hardship_waiver_granted

paragraph_1_home_equity_bar_exception_applies

Derived

source: 42 U.S.C. 1396p(f)(2)

- name: paragraph_1_home_equity_bar_exception_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396p(f)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              Paragraph (1) shall not apply ... if ... spouse ... or ... child ... is lawfully
              residing in the individual's home
  versions:
    - effective_from: '2011-01-01'
      formula: |-
        spouse_lawfully_resides_in_individual_home
        or child_under_age_21_lawfully_resides_in_individual_home
        or child_blind_lawfully_resides_in_individual_home
        or child_permanently_and_totally_disabled_lawfully_resides_in_individual_home
        or child_disabled_as_defined_in_section_1382c_lawfully_resides_in_individual_home

is_medicaid_long_term_care_home_equity_eligible

Derived

source: 42 U.S.C. 1396p(f)(1)-(4)

- name: is_medicaid_long_term_care_home_equity_eligible
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396p(f)(1)-(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: >-
              the individual shall not be eligible ... if the individual's equity interest ...
              exceeds $500,000
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: Paragraph (1) shall not apply
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396p/f
            excerpt: paragraph (1) is waived in the case of a demonstrated hardship
  versions:
    - effective_from: '2011-01-01'
      formula: |-
        individual_home_equity_interest <= applicable_home_equity_limit
        or paragraph_1_home_equity_bar_exception_applies
        or paragraph_1_home_equity_bar_waived_for_hardship

▸citations (2)

References

This rule cites 2 other rules.

42 USC § 1396a (a)(1)inferredUS Federal › Statutes › Title 42 › § 1396a › (a)(1)
42 USC § 1396a (a)(10)(B)inferredUS Federal › Statutes › Title 42 › § 1396a › (a)(10)(B)