<html> <head> <title>Rule 67:46:05:09 Calculating period of ineligibility.</title> <META NAME="Keywords" Content="Administrative Rules 67:46:05:09"> <META NAME="Description" Content="Administrative Rules 67:46:05:09 Calculating period of ineligibility."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:46:05:09.&nbsp;&nbsp;Calculating period of ineligibility.</b> The department shall establish a period of ineligibility for long-term care services if an asset has been disposed of for the purpose of establishing Medicaid eligibility. The period of ineligibility is determined by dividing the uncompensated value of the transferred assets by the monthly state-wide average of long-term care costs for private pay individuals for the state's current fiscal year.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The department shall impose a partial month period of ineligibility if the sum arrived at in the above calculation results in a partial month remainder, rounded up to a whole day.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 16 SDR 10, effective July 23, 1989; 16 SDR 203, effective May 27, 1990; transferred from §&nbsp;67:16:20:02.04, effective August 23, 1992; 19 SDR 141, effective March 25, 1993; 21 SDR 162, effective March 23, 1995; 22 SDR 188, effective July 8, 1996; 31 SDR 107, effective February 1, 2005.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-3.1">28-6-3.1.</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-3.1">28-6-3.1.</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Cross-References:</b> Disposal of resources for purposes of establishing eligibility, §&nbsp;67:46:05:06; Facility's average per diem charge, §&nbsp;67:16:04:58.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:46:05:09.01 Repealed.</title> <META NAME="Keywords" Content="Administrative Rules 67:46:05:09.01"> <META NAME="Description" Content="Administrative Rules 67:46:05:09.01 Repealed."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:46:05:09.01.&nbsp;&nbsp;Ineligibility when assets transferred before July 1, 1994.</b>Repealed.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 21 SDR 162, effective March 23, 1995; repealed, 30 SDR 193, effective June 13, 2004.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:46:05:09.02 Ineligibility if assets transferred.</title> <META NAME="Keywords" Content="Administrative Rules 67:46:05:09.02"> <META NAME="Description" Content="Administrative Rules 67:46:05:09.02 Ineligibility if assets transferred."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 15 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; text-align:justify; font-size:12.0pt; font-family:"Times New Roman",serif; color:black;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:#954F72; text-decoration:underline;} .MsoChpDefault {font-size:10.0pt; color:black;} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US link=blue vlink="#954F72"> <div class=WordSection1> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:46:05:09.02.&nbsp;&nbsp;Ineligibility if assets transferred.</b> If an asset is disposed of for the purpose of establishing Medicaid eligibility and the asset was disposed of for less than fair market value within the look-back periods established in &#167;&nbsp;67:46:05:06.01, the period of ineligibility is determined under the provisions of &#167;&nbsp;67:46:05:09.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The department shall apportion the number of months of ineligibility equally between the individual receiving home and community based or nursing facility services and the individual's spouse who is applying for home and community based or nursing facility services if the following conditions exist:</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;Both the individual and the individual's spouse are residing in a nursing facility or receiving home and community based waiver services or if one spouse is in a nursing facility and the other is receiving home and community based waiver services;</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;The department had previously determined that the individual residing in a nursing facility or receiving home and community based waiver services was ineligible because of a transfer and the individual is currently serving out a period of ineligibility; and</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;The spouse would otherwise be eligible for nursing facility or home and community based waiver services except for the period of ineligibility.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If more than one transfer occurs, the periods of ineligibility are consecutive. If a period of ineligibility is in effect and a transfer occurs, the period of ineligibility for the additional transfer is added to the period of ineligibility already in effect.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If the individual is an applicant, the period of ineligibility begins the date the applicant is eligible for nursing facility or home and community based waiver services but for the period of ineligibility or the date after a prior period of ineligibility has ended, whichever is later. If the individual is a recipient, the period of ineligibility begins with the date the applicant became eligible for nursing facility or home and community based waiver services, the first day of the month after the transfer occurred, or the date after a prior period of ineligibility has ended, whichever is later.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 21 SDR 162, effective March 23, 1995; 30 SDR 193, effective June 13, 2004; 31 SDR 107, effective February 1, 2005; 33 SDR 44, effective August 31, 2006; 41 SDR 93, effective December 3, 2014; 43 SDR 31, effective September 12, 2016.</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-3.1">28-6-3.1.</A></p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-3.1">28-6-3.1.</A></p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Cross-References:</b></p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disposal of resources for purposes of establishing eligibility, &#167;<span style='font-family:"Times",serif'>&nbsp;</span>67:46:05:06.</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lengthening look-back period for all disposals to five years, 42 U.S.C. &#167;&nbsp;1396p(c)(1)(B)(i).</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Authority for states to accumulate multiple transfers into one penalty period, 42 U.S.C. &#167;&nbsp;1396p(c)(1)(H).</p> <p class=MsoNormal>&nbsp;</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 67:46:05:09.03 Repealed.</title> <META NAME="Keywords" Content="Administrative Rules 67:46:05:09.03"> <META NAME="Description" Content="Administrative Rules 67:46:05:09.03 Repealed."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 15 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; text-align:justify; font-size:12.0pt; font-family:"Times New Roman",serif;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:purple; text-decoration:underline;} .MsoChpDefault {font-size:10.0pt;} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US link=blue vlink=purple> <div class=WordSection1> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:46:05:09.03.&nbsp;&nbsp;Assets disposed of to establish eligibility -- Ineligibility for services.</b> Repealed.</p> <p class=MsoNormal>&nbsp;</p> <p class=MsoNormal>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 21 SDR 162, effective March 23, 1995; 41 SDR 93, effective December 3, 2014; 46 SDR 50, effective October 10, 2019.</p> <p class=MsoNormal>&nbsp;</p> </div> </body> </html>