An official State of Texas website.
Revision 09-4; Effective December 1, 2009
As part of Public Law 109-171, Deficit Reduction Act (DRA) of 2005, policy regarding transfer of assets changed when the DRA was signed into law on Feb. 8, 2006. The implementation of the DRA in Texas was effective Oct. 1, 2006.
Transfer of assets policy in Texas before the DRA, based on the Omnibus Budget Reconciliation Act (OBRA) of 1993 (Public Law 103-66), continues with these areas as exceptions found in the DRA transfer of assets rules:
- look-back period;
- penalty start date;
- purchase of life estates;
- purchase of promissory notes, loans or mortgages; and
- undue hardship.
As part of the DRA, there was a major change to the value of a home and eligibility for Medicaid. See Section F-3600, Substantial Home Equity, and Section F-3700, Continuing Care Retirement Communities.
The transfer of assets rules after the DRA are found in Section I-1100, Texas Administrative Code Rules. The transfer of assets policy in Texas before the DRA, based on OBRA 1993 (Public Law 103-66) are found in Section I-9000, Pre-DRA Rules.
I-1310 Persons Impacted by Transfer of Assets
Revision 09-4; Effective December 1, 2009
Transfer of assets policy applies when assets are transferred by a person who resides in an institutional setting (for example, a Medicaid certified long-term care facility) or is receiving home and community-based waiver services through a Home and Community-Based Services waiver, or by the person’s spouse or someone else acting on the person’s behalf.
Transfer of assets policy does not apply to the mandatory groups of MEPD programs such as Pickle. See Section A-1000, General Information, and Section A-2000, Mandatory Coverage Groups, for information. Transfer of assets policy also does not apply to the Medicare Savings programs such as QMB, SLMB, etc.
Under transfer of assets policy, recipients residing in a Medicaid long-term care facility remain eligible for all other Medicaid benefits and continue to receive Medicaid benefits other than vendor payment for the length of the penalty period. However, a person residing in a state supported living center is denied Medicaid for any penalty period resulting from an uncompensated transfer of assets. This is because the only benefit provided under a MEPD program for a person in a state supported living center is vendor payments.
If a person applying for a Home and Community-Based Services waiver requires receipt of waiver services to be eligible for Medicaid, then the person is ineligible for all Medicaid benefits. Based on pre-DRA transfer of assets policy, the Home and Community-Based Services waiver person is ineligible for the length of the penalty period. Based on post-DRA, the Home and Community-Based Services waiver person is ineligible until the transfer does not appear during the look-back period.
Denial of a Home and Community-Based Services waiver based on an uncompensated transfer does not disqualify the person for pure Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary (SLMB) benefits. If all eligibility criteria for QMB or SLMB are met, HHSC staff can certify the person for QMB or SLMB, as appropriate.
In spousal situations, if assets are transferred to a third party before institutionalization or by the community spouse, HHSC does not include the uncompensated amount of the transfer in calculating the spousal protected resource amount or countable resources upon application for Medicaid.
I-1320 Applications and Other Actions on or After Oct. 1, 2006
Revision 09-4; Effective December 1, 2009
Post-DRA transfer of assets policy impacts any person who applies for Medicaid in an institutional setting on or after Oct. 1, 2006. Post-DRA transfer of assets policy also impacts any person who is Medicaid eligible in the community and requests a program transfer for Medicaid in an institutional setting on or after Oct. 1, 2006. This includes:
Applicants — For applications filed on or after Oct. 1, 2006, consider both pre-DRA and post-DRA policy for an institutional program or waiver services.
Program transfer requests — For program transfer requests from any Medicaid program to an institutional program or waiver services on or after Oct.1, 2006, consider both pre-DRA and post-DRA policy.
Redeterminations — For redeterminations of institutional or waiver services worked on or after Oct.1, 2006, consider both pre-DRA and post-DRA policy.
Reported changes — For reported changes worked on or after Oct.1, 2006, consider both pre-DRA and post-DRA policy for institutional or waiver services.
Note: Pre-DRA or post-DRA transfer of assets policies regarding penalty do not apply to an individual who has had continuous Medicaid coverage before March 1, 1981. This includes any person who is Medicaid eligible in the community and requests a program transfer to an institutional program or waiver services and who has had continuous Medicaid coverage before March 1, 1981.
I-1330 Transfer Transaction Date
Revision 09-4; Effective December 1, 2009
If the transfer transaction date is:
- before Feb. 8, 2006, use pre-DRA policy in determining eligibility for vendor payment and waiver services, regardless of the application file date/program transfer or the date of the case manager action for an existing case; or
- on or after Feb. 8, 2006, use pre-DRA and post-DRA policy in determining eligibility for vendor payment and waiver services based on application file date/program transfer or the date of the case manager action for an existing case.