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    v1.0.30
    OpenPayerPolicy UpdatesAdministrative/Operational PolicyConnecticut DSS LTSS Asset Review Update | OpenPay…
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    CurrentConnecticut Department of Social ServicesPolicy 14-01

    Transitioning Individuals Receiving Supplemental Security Income (SSI) or Community HUSKY C to Medicaid Long Term Services and Supports (LTSS)

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    This bulletin governs how Connecticut Department of Social Services staff review assets when individuals receiving SSI, community HUSKY C, or other Medicaid categories seek Medicaid Long Term Services and Supports, including nursing facility or waiver services. It establishes when an asset look-back may be waived and when workers must request information and conduct a review.

    Policy Summary
    PayerConnecticut Department of Social Services
    PolicyTransitioning Individuals Receiving SSI or Community HUSKY C to Medicaid LTSS
    Policy CodePolicy N/A
    Change TypeNew administrative and eligibility-processing procedures
    Effective DateImmediately
    Next Review DateN/A
    Key ActionFor SSI recipients who applied less than two years ago, send section N of the W-1LTC and conduct an asset review so the combined review period equals 60 months.
    SourceLink
    POLICY UPDATE CHANGES

    The bulletin establishes new asset review procedures for SSI and community HUSKY C recipients applying for Medicaid LTSS.

    2 yearsSSI receipt threshold for generally waiving the Medicaid LTSS look-back
    5 yearsCommunity HUSKY C receipt threshold for waiving asset information requests

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    60 months
    Total asset review period
    ImmediatelyEffective timing

    Medicaid LTSS Asset Review Eligibility

    Individuals Receiving SSI

    For individuals receiving SSI, determine how long the individual has been receiving SSI and whether 2 years have passed since the SSI application date.

    ONE of the following applies

    • ALL of the following

      • The individual is a recipient of SSI.
      • Two years or more have passed since the date the client applied for SSI.>= 2 years
      • No Medicaid LTSS asset look-back is required unless there is reason to believe an improper transfer occurred.

        For example, the application may indicate that the person lived at a residence for 20 years or lived at a previous address for a lengthy period, but does not own any property or did not transfer assets.

    • ALL of the following

      • The individual is a recipient of SSI.
      • Fewer than 2 years have passed since the date the client applied for SSI.< 2 years
      • Send the client Section N of the W-1LTC.
      • Conduct an asset review based on the procedures outlined in PIB 13-03.
      • Review the months before the SSI application so that the total review period, including the SSI look-back, equals 60 months.60 months total
      • Utilize all collateral sources when completing the review.

    Individuals Receiving Community HUSKY C and Other Categories of Medicaid

    Determine how long the individual has been receiving community HUSKY C, and review the EMS narrative and case file via ConneCT.

    ONE of the following applies

    • ALL of the following

      • The individual has been receiving community HUSKY C for 5 years or more.>= 5 years
      • Close the community HUSKY C and grant Medicaid LTSS.
      • Do not request asset information unless there is reason to believe an improper transfer occurred.

        For example, the application may indicate that the person lived at a residence for 20 years or lived at a previous address for a lengthy period, but does not own any property or did not transfer assets.

    • ALL of the following

    Asset Review Periods and Thresholds

    SSI Look-Back Waiver
    Waiver thresholdAt least 2 years since the client applied for SSI
    ExceptionThe waiver does not apply if there is reason to believe an improper transfer occurred
    Review actionNo Medicaid LTSS asset look-back is required when the threshold is met, unless an improper transfer is suspected
    Community HUSKY C Look-Back Waiver
    Waiver threshold5 years or more of community HUSKY C receipt
    ExceptionThe waiver does not apply if there is reason to believe an improper transfer occurred
    Review action

    Required Worker Actions by Recipient Category

    Documentation Required

    Waive the LTSS asset look-back after two years of SSI

    For an SSI recipient who applied for SSI at least two years ago, do not conduct a Medicaid LTSS asset look-back unless there is reason to believe an improper transfer occurred.

    Documentation Required

    Review assets when SSI began less than two years ago

    If fewer than two years have passed since the SSI application, send the client section N of the W-1LTC and conduct an asset review under PIB 13-03. Review the months before the SSI application so the total review period, including the SSI look-back, equals 60 months.

    Prior Authorization

    Transition long-term HUSKY C recipients to Medicaid LTSS

    Policy Summary
    PayerConnecticut Department of Social Services
    PolicyTransitioning Individuals Receiving SSI or Community HUSKY C to Medicaid LTSS
    Policy CodePolicy N/A
    Change TypeNew administrative and eligibility-processing procedures
    Effective DateImmediately
    Next Review DateN/A
    Key ActionFor SSI recipients who applied less than two years ago, send section N of the W-1LTC and conduct an asset review so the combined review period equals 60 months.
    SourceLink
    On This Page
    Medicaid LTSS Asset Review EligibilityAsset Review Periods and ThresholdsRequired Worker Actions by Recipient Category
  1. The client has received community HUSKY C for fewer than 5 years.< 5 years
  2. Send the client Section N of the W-1LTC.
  3. Conduct an asset review based on the applicable procedures.
  4. Review the months before the client began receiving community HUSKY C so that the total review period, including the time on assistance, equals 60 months.60 months total
  5. Utilize all collateral sources when completing the review.

  6. ALL of the following

    • The client has received another category of Medicaid that does not have an asset test.
    • Send the client Section N of the W-1LTC.
    • Conduct an asset review based on the procedures outlined in PIB 13-03.
    • The review period, including the time on assistance, equals 60 months.60 months total
    • Utilize all collateral sources when completing the review.
    7. Asset information is not requested when the threshold is met, unless an improper transfer is suspected
    Total Asset Review Period
    Total review period60 months
    SSI casesIncludes the applicable months before the SSI application, together with the SSI look-back period
    Medicaid assistance casesIncludes the applicable months before receipt of assistance, together with the time on assistance

    For a community HUSKY C recipient of five years or more, close community HUSKY C and grant Medicaid LTSS without requesting asset information, unless there is reason to believe an improper transfer occurred.

    Documentation Required

    Review assets when HUSKY C began less than five years ago

    If the client has received community HUSKY C for less than five years, send section N of the W-1LTC and conduct an asset review under the applicable procedures. Review the months before community HUSKY C began so the total review period, including the time on assistance, equals 60 months.

    Documentation Required

    Review assets for Medicaid categories without an asset test

    For an individual receiving a Medicaid category without an asset test, send section N of the W-1LTC and conduct an asset review under PIB 13-03. The review period, including the time on assistance, must total 60 months.

    Documentation Required

    Use all available collateral sources

    Workers must use all collateral sources when completing an asset review.