Division of Medicaid

A. A time deposit is a contract between an individual and a financial institution whereby the individual agrees to leave funds on deposit for a specified period of time (six months, two years, five years, etc.) and the financial institution agrees to pay interest at a specified r…

A. The term "conservatorship account" refers to a financial account in which a person or institution has been appointed by a court to manage and preserve the assets of an individual which are held in the account. B. Absent evidence to the contrary, the funds are available for the…

A. A nursing home patient account is a financial account set up by the nursing home for the convenience of the patient. B. These accounts are similar to a checking and/or savings account. The facility holds funds belonging to the patient for the patient's use. C. For Medicaid pur…

A. The value of funds in an account set up to receive and hold charitable contributions (fundraisers) is counted if the name of the applicant/recipient is on the account and the funds are available to the applicant/recipient for support and maintenance. Notes 23 Miss. Code. R. 10…

A. Some or all of the contents of a safety deposit box may be countable as resources based on the appropriate policy applicable to the type of resource, i.e., stock certificated, coins, jewelry, life insurance policy, etc. B. If a recipient's possessions are stored in another per…

The three classifications of trusts are as follows: A. OBRA-93 Trusts: 1. Are trusts established on or after August 11, 1993, the date mandated by OBRA-93 Federal legislation. 2. Must meet certain criteria. If OBRA-93 criteria are not met, another trust policy applies. 3. Rules w…

A. Section 1917 of the Act provides that, for trust and transfer purposes, assets include both income and resources. B. Section 1917 of the Act further provides that income has the meaning given that term in Section 1612 of the Act and resources has the meaning given that term in…

When application of the Trust provisions would work an undue hardship, the provisions will not apply. A. Undue hardship exists when: 1. Application of the trust provisions would deprive the individual of medical care such that his/her health or his/her life would be endangered. 2…

In reviewing a trust: A. Trust documents, including amendments and the required number of accountings must be obtained; B. The type of trust, i.e., OBRA-93 Trust, Medicaid Qualifying Trust, or Standard Trust, must be determined; C. The trust must be determined to be revocable or …

A. The following types of trusts are treated as exceptions to the trust provisions outlined above provided the trust is established according to criteria specific to the trust type. The trust exceptions are:1. Special Needs Trust; 2. Pooled Trust; and 3. Income Trust. B. Funds en…

A. A Special Needs Trust (SNT) contains the assets of an individual under age sixty-five (65) who is disabled and which is established for the sole benefit of the disabled individual by a parent, grandparent, legal guardian of the individual, or a court. B. To qualify for an exce…

A. A pooled trust is a trust containing the assets of a disabled individual that meets the following conditions:1. The trust is established and managed by a non-profit entity that has been granted that status by the Internal Revenue Service (IRS); 2. A separate account is maintai…

The MS Division of Medicaid has established guidelines and restrictions regarding payments and distributions from a SNT or pooled trust that must be followed in order for either type of trust to meet or continue to meet the conditions for exception. Medicaid eligibility of the di…

A. The purpose of an Income Trust is to allow an individual with excess income who has exhausted all available resources to become eligible for Medicaid. The trust may be used only for income belonging to the individual. No resources (assets) may be used to establish or augment t…

A. The Long Term Care Income Trust Agreement will be discussed and provided to the long term care client subject to an Income Trust. LONG-TERM CARE INCOME TRUST THE _______________ INCOME TRUST WHEREAS, __________________________, hereinafter referred to as the Settlor, now has a…

A. Trusts, guardianships/conservatorships are often complex documents involving state law and legal principles. B. Trust documents must be referred to the state office for clearance whenever an individual or spouse either creates a trust or is the beneficiary of one. 1. Pertinent…

A. Introduction. 1. The definitions in this rule apply to any/all types of trusts. 2. Each type of trust has definitions which are specific to that trust classification that are discussed under other rules. B. Trust Definitions 1. A trust is a property interest whereby property i…

A. Introduction. 1. Section 13611 of the Omnibus Budget Reconciliation Act of 1993 (P.L. 103-66) amended Section 1917(d) of the Social Security Act to revise the treatment of trusts effective with trusts established after the date of enactment of OBRA-93, which was August 11, 199…

The following apply to any individual who establishes a trust, and who is an applicant for or recipient of Medicaid: A. An individual is considered to have established a trust if his or her assets (regardless of how little) were used to form part or all the corpus of the trust an…

A. The entire corpus of a revocable trust is counted as an available resource to the individual. Any income earned by the trust and paid into the trust is also an available resource. B. Any payments from the trust made to or for the benefit of the individual are counted as income…

A. In the case of an irrevocable trust, where there are any circumstances under which payment can be made to or for the benefit of the individual from all or a portion of the trust, the following rules apply to that portion. 1. Payments from income or from the corpus made to or f…

A. Payments are considered to be made to the individual when any amount from the trust, including an amount from the corpus or income produced by the corpus, is paid directly to the individual or to someone acting on his/her behalf, e.g., a guardian or legal representative. B. Pa…

In determining whether payments can or cannot be made from a trust to or for an individual, any restrictions on payments must be taken into account, such as use restrictions, exculpatory clauses, or limits on trustee discretion that may be included in the trust. A. Example: If an…

A. Annuities - General (Applies Regardless of Purchase Date) 1. An annuity is defined as a contract or agreement by which one receives fixed, non-variable payments on an investment for a lifetime or a specified number of years. a) An individual may buy an annuity by making paymen…

A. An annuity purchased before February 8, 2006, by or for an individual using that individual's assets will be considered a transfer of assets unless both of the following are met: 1. The annuity produces a net annual return of at least 6% of its equity value; and 2. Pays out pr…

The transfer penalty period for the purchase of an annuity prior to 02/08/2006 is calculated based on the value of the payments that would be beyond the actuarial life expectancy of the annuitant. A. Divide the purchase price of the annuity by the number of payout years. This equ…

The Deficit Reduction Act of 2005 (DRA), P.L. 109-171 adds new requirements to the Medicaid statute with respect to the treatment of annuities purchased on or after the date of enactment, February 8, 2006, by or on behalf of an annuitant who has applied for Medicaid for nursing f…

A determination must be made on whether the purchase of annuities, other than qualifying IRS annuities, is treated as a transfer of assets for less than fair market value. A. If the expected return on the annuity is commensurate with a reasonable estimate of the life expectancy o…

A. General. 1. Section 13611 of the Omnibus Budget Reconciliation Act of 1993 (P.L. 103-66), herein referred to as OBRA-93, amended Section 1917(c)(1) of the Social Security Act to revise transfer of assets policy previously described in the Medicare Catastrophic Coverage Act (MC…

A. The provisions in this section are applicable to any trust or similar legal device established on or after March 1, 1987, through August 10, 1993, that meet MQT criteria. If MQT criteria are not met, defer to Standard Trust policy. 1. A Medicaid Qualifying Trust is a trust or …

A. Standard trust policy is applicable to trusts or conservatorships established prior to March 1, 1987, and/or trusts that do not meet the criteria of OBRA-93 or MQT trusts, regardless of the date established. Testamentary trusts where the Medicaid client is the beneficiary are …

A. Chapters 1 - 10 discuss sources and treatment of income in the Aged, Blind and Disabled (ABD) programs. Eligibility for the ABD Medicaid programs is based on the rules used to decide eligibility for Supplemental Security Income (SSI). In accordance with 42 CFR 435.601, Medicai…

A. Countable income is defined as follows:1. Countable income is what remains after:a) Eliminating all amounts that are not income; and 2. Applying all appropriate exclusions. B. Countable income is the sum of a month's countable earned and unearned income, which is subtracted fr…

A. The appropriate need standard used to test income depends on the coverage group for which the client is applying. B. Medicaid need standards are based on the following: 1. SSI Federal Benefit Rates (FBR) set by SSI policy and subject to increase in January of each year. SSI FB…

A. Deeming is defined as follow:1. The term "deeming" identifies the process of considering another person's income and resources to be available for meeting a Medicaid client's basic needs. 2. Deemed income and resources are attributed to an eligible individual whether or not th…

A. In-kind income is defined as follows:1. In-kind income is any income other than cash income. a) To meet the definition of income, the in-kind item received by the individual must be: 1) Food or shelter; or 2) Something the individual can sell or convert to obtain food or shelt…

A. In-kind items may be provided as remuneration for employment, as follows:1. Wages may include the value of food and/or shelter (ISM), or other items received in lieu of cash for individuals in SSI-related categories only. 2. In-kind payment of food or shelter to the following …

A. The Affordable Care Act (ACA) requires that state Medicaid programs use modified adjusted gross income or MAGI-based methodology for determining the income of an individual and the individual's household. MAGI methodology and rules are required in determining eligibility for M…

A. MAGI and household income are defined in section 36B(d)(2)(A) and (B) of the Internal Revenue Code (IRC). The treatment of income is based on IRS tax rules, except for specified exceptions. B. Modified adjust gross income, as amended by the ACA, has the literal meaning of inco…

A. MAGI based income rules require that financial eligibility is based on household income for FCC related programs. B. Household income is the sum of the MAGI-based income of every individual included in the individual's household minus as amount equivalent to five (5) percentag…

A. The following are exceptions to using IRS rules for determining MAGI-based income for a household. 1. Income received in a lump sum, whether recurring or non-recurring, is counted in the month received. Recurring lump sum payments are not averaged. 2. Scholarships, awards or f…

A. Current monthly income counts in determining eligibility for Medicaid and CHIP for new applicants and for recipients at the time of an annual review. Notes 23 Miss. Code. R. 104-11.5 42 CFR §435.603 (Rev. 2012)

A. The following is not an exhaustive list of income that does not count but represents the types more commonly encountered. If not addressed herein, IRS tax rules provide the governing policy.1. Alimony is deducted from the income of the payer and is therefore a type of non-coun…

A. The following are payments excluded from income that originate from a specific program that provides assistance payments.1. Home Affordable Modification Program (HAMP). Pay-for-Performance Success Payments under the HAMP are not taxable income and are not countable. 2. Hardest…

A. The following income is partially countable and partially excluded under the conditions specified for each type of payment. 1. Foster Care Provider payments received from a state, political subdivision, or qualified foster care placement agency for providing care to qualified …

A. The following is not an exhaustive list of the types of income that counts but is meant to cover the types most commonly encountered If not addressed herein, IRS tax rules provide the governing policy.1. Employee Compensation includes all things received in payment for persona…

A. The ACA mandates that states rely heavily on electronic data sources to verify income. Data sources include IRS tax return data for households that file taxes, the Social Security Administration (SSA) for benefits paid through SSA and state data sources such as the MS Departme…