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    OpenPayerPolicy UpdatesAdministrative/Operational PolicyNorth Dakota Transfer Assets Policy | OpenPayer
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    CurrentNorth Dakota Department of Health & Human ServicesPolicy 23-0039

    Transfer of Assets

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    This policy establishes when a penalty period begins and how penalty periods are calculated for individuals who transfer assets without adequate compensation. It applies to North Dakota Medicaid determinations involving institutionalized and non-institutionalized individuals seeking or receiving payment for long-term care services.

    Policy Summary
    PayerNorth Dakota Department of Health & Human Services
    PolicyTransfer of Assets
    Policy CodePolicy 23-0039
    Change TypeNo material change
    Effective DateJan 1, 2024
    Next Review DateNot specified
    Key ActionDetermine and impose the applicable Medicaid penalty period for an uncompensated transfer of assets using the stated penalty date and nursing facility cost methodology.
    SourceLink
    POLICY UPDATE CHANGES

    No material clinical or coverage changes in this revision.

    1st day of monthDefault penalty-period start
    2Circumstances addressed
    Statewide averageInstitutionalized calculation
    Same methodNon-institutionalized method

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    Transfer-of-Assets Penalty Rules

    Transfer-of-Assets Penalty Rules

    The penalty period for an uncompensated transfer of assets begins and is calculated based on the individual's Medicaid and institutional-care circumstances.

    The beginning date of each penalty period imposed for an uncompensated transfer of assets is the first date of the month in which the asset was transferred.
    For an individual applying for Medicaid payment of long-term-care services, the penalty period begins on the first date of the month following the month of transfer, when the individual is eligible for medical assistance under the State Plan and would otherwise receive institutional-level-of-care services covered by Medicaid based on an approved application.
    For an individual receiving Medicaid payment for long-term-care services, the penalty period begins on the first day of a month following advance notice of the penalty period, no later than the first day of the month following three full calendar months from the date the transfer was reported or discovered, and not during another transfer-of-assets ineligibility period.
    For an institutionalized individual, the penalty is determined using the average monthly cost of nursing facility services in the state to a private patient; North Dakota equalizes private-pay and Medicaid rates.
    For a non-institutionalized individual, the penalty period is determined using the same method as for an institutionalized individual, including the average monthly cost of nursing facility services.

    Penalty Period Calculation Basis

    Penalty period calculation basis
    Calculation basisAverage monthly cost to a private patient of nursing facility services in North Dakota
    Geographic basisAverage monthly costs of nursing facility services in the state
    Rate relationshipNorth Dakota has equalization of rates between private pay and Medicaid

    Apply the Transfer-of-Assets Penalty

    Billing Rule

    Apply the transfer-of-assets penalty

    Determine and impose the applicable Medicaid penalty period for an uncompensated transfer of assets. For applicants, use the first day of the month following the month of transfer when the individual is eligible for medical assistance under the State Plan and would otherwise receive Medicaid-covered institutional-level-of-care services; for current long-term-care recipients, begin the penalty after advance notice, no later than the first day of the month following three full calendar months from the date the transfer was reported or discovered, and not during another transfer-of-assets ineligibility period.

    • The default penalty date is the first day of the month in which the asset was transferred.
    • For institutionalized individuals, calculate the penalty using the average monthly cost of nursing facility services in North Dakota; private-pay and Medicaid rates are equalized.
    • For non-institutionalized individuals, use the same penalty-period method, including the average monthly nursing facility cost.

    Key Definitions

    Penalty period
    DefinitionThe period during which Medicaid long-term care services are subject to ineligibility because of an uncompensated transfer of assets
    Applies toIndividuals whose uncompensated transfer of assets results in Medicaid long-term-care ineligibility
    Beginning dateThe first date of the month in which the asset was transferred, subject to the applicable penalty-date rules
    Uncompensated transfer of assets
    DefinitionAn asset transfer for which the individual did not receive adequate compensation
    ConsequenceThe transfer results in a Medicaid long-term-care penalty period
    Policy Summary
    PayerNorth Dakota Department of Health & Human Services
    PolicyTransfer of Assets
    Policy CodePolicy 23-0039
    Change TypeNo material change
    Effective DateJan 1, 2024
    Next Review DateNot specified
    Key ActionDetermine and impose the applicable Medicaid penalty period for an uncompensated transfer of assets using the stated penalty date and nursing facility cost methodology.
    SourceLink
    On This Page
    Transfer-of-Assets Penalty RulesPenalty Period Calculation BasisApply the Transfer-of-Assets PenaltyKey Definitions
    Penalty-date rule
    The beginning date of the penalty period is the first date of the month in which the asset was transferred, subject to applicable circumstances