Disqualifying Transfer Provisions 510-05-80-10

(Revised 1/1/08 ML #3120)

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(N.D.A.C. Section 75-02-02.1-33.1)

 

  1. An individual is ineligible for nursing care services if the individual or the spouse of the individual disposes of assets or income for less than fair market value on or after the look-back date. (Transfers by a parent do not affect a child’s coverage of nursing facility services and vice versa.)

  2. The look-back date for income or asset transfers made before February 8, 2006 (other than for transfers to or from a trust) is a date that is thirty-six months before the date on which the individual is both receiving nursing care services and has applied for benefits under this chapter, without regard to the action taken on the application.

  3. The look-back date for income or assets transferred on or after February 8, 2006, or transferred to an irrevocable trust, or from a revocable or irrevocable trust, established by an applicant, a recipient, their spouse, or any one acting on their behalf, other than by will, is a date that is 60 months before the date on which the individual is both receiving nursing care services and has applied for benefits under this chapter, without regard to the action taken on the application.

  4. Once a look-back date is established for an individual, it will always be the look-back date for that individual.

Example: Mr. Green entered LTC and applied for Medicaid in January 2000. Since he is both receiving nursing care and has applied for Medicaid, his look-back date is established as January 1997. Mr. Green left LTC in March 2001, closed his Medicaid case, and made a large transfer. In May 2004, he enters LTC again and reapplies for Medicaid. The March 2001 transfer (38 months ago) was made on or after the look-back date (January 1997), so is considered.

  1. Each individual establishes their own look-back date.

Example: Mr. and Mrs. Brown make a large disqualifying transfer that causes 70 months of ineligibility. At the same time, Mr. Brown enters LTC and applies for Medicaid. He is ineligible because the disqualifying transfer was made on or after his look-back date. Mrs. Brown enters LTC 48 months later. The disqualifying transfer was made prior to her look-back date (36 months). Mrs. Brown can be eligible for Medicaid coverage of her LTC costs while Mr. Brown is still ineligible.

  1. A transfer is complete when the individual (or the individual's spouse) making the transfer has no lawful means of undoing the transfer or requiring a restoration of ownership.

  2. The provisions of this section do not apply in determining eligibility for Medicare Savings Programs.