Page 311

107 STAT. 622 PUBLIC LAW 103-66—AUG. 10, 1993 PART n-^ELIGIBILITY SEC. 13611. TRANSFERS OF ASSETS; TREATMENT OF CERTAIN TRUSTS. (a) PERIODS OF INEUGIBILITY FOR TRANSFERS OF ASSETS.— (1) IN GENERAL.—Section 1917(cXl) (42 U.S.C. 1396p(cXl)) is amended to read as follows: ''(IXA) In order to meet the requirements of this subsection for purposes of section 1902(aX18), the State plan must provide that if an institutionalized individual or the spouse of such an individvial (or, at the option of a State, a noninstitutionalized individual or the spouse of such an individual) disposes of assets for less than fair market value on or after the look-back date specified in subparagraph (BXi), the individual is ineUgible for medical assistance for services described in subparagraph (CXi) (or, in the case of a noninstitutionalized individual, for the services described in subparagraph (CXii)) during the period beginning on Uie date specified in subparagraph (D) and equal to the number of months specified in subparagraph (E). "(BXi) The look-back date specified in this subparagraph is a date that is 36 months (or, in the case of pajmients from a trust or portions of a trust that are treated as assets disposed of by the individual pursuant to paragraph (3XAXiii) or (3XBXii) of subsection (d), 60 months) before the date specified in clause (ii). ''(ii) The date specified in this clause, with respect to— ''(I) an institutionalized individual is the first date as of which the individual both is an institutionalized individual and has applied for medical assistance under the Stete plan, or "(ID a noninstitutionalized individual is the date on which the individual applies for medical assistance under the Stete plan or, if later, the date on which the individual disposes of assete for less than fair market value. "(CXi) The services described in this subparagraph with respect to an institutionalized individual are the following: "(I) Nursing facility services. "(II) A level of care in any institution equivalent to that of nursing facility services. "(Ill) Home or commimity-based services furnished under a waiver granted under subsection (c) or (d) of section 1915. "(ii) The services described in this subparagraph with respect to a noninstitutionalized individual are services (not including anv services described in clause (i)) that are described in paragraph (7), (22), or (24) of section 1905(a), and, at the option of a Stete, other loi^-term care services for which medical assistcmce is other- wise available under the Stete plan to individuals requiring long- term care. "(D) The date spjecified in this subparagraph is the first day of the first month during or after which assete have been transferred for less than fair market value and which does not occur in any other periods of ineligibiHty under this subsection. "(EXi) With respect to an institutionalized individual, the num- ber of months of ineligibility under this subparagraph for an individ- ual shall be equal to— "(I) the total, cumidative uncompensated value of all assete transferred by the individual (or mdividual's spouse) on or