Montana Code 53-6-166. Period of ineligibility for medical assistance when assets disposed of for less than fair market value — undue hardship exception — department to adopt rules
53-6-166. Period of ineligibility for medical assistance when assets disposed of for less than fair market value — undue hardship exception — department to adopt rules. (1) The department shall, in accordance with 42 U.S.C. § 1396p, as may be amended, and implementing federal regulations and policies, impose upon an applicant or recipient a period of ineligibility for medical assistance under this part when the applicant or recipient or the spouse of either directly or indirectly disposes of any assets for less than fair market value during the applicable 3-year, 5-year, or other period provided by 42 U.S.C. § 1396p, as may be amended, or by other federal law.
Terms Used In Montana Code 53-6-166
- Applicant: means a person:
(a)who has submitted an application for determination of medicaid eligibility to a medicaid agency on the person's own behalf or on behalf of another person; or
(b)on whose behalf an application has been submitted. See Montana Code 53-6-155
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-6-155
- Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
- Recipient: means a person:
(a)who has been determined by a medicaid agency to be eligible for medicaid benefits, whether or not the person actually has received any benefits; or
(b)who actually receives medicaid benefits, whether or not determined eligible. See Montana Code 53-6-155
(2)A period of ineligibility for medical assistance may not be imposed upon an applicant or recipient under this section to the extent that the department determines, in accordance with procedures specified by department rule, that the denial of eligibility would cause an undue hardship as defined by department rule.
(3)The department shall adopt rules that are consistent with 42 U.S.C. § 1396p, as may be amended, and that implement federal regulations and policies to implement this section. The rules adopted under this section must include but are not limited to rules addressing the following:
(a)a description of the circumstances considered to constitute an undue hardship;
(b)the procedures by which an individual may seek an undue hardship exception;
(c)the persons entitled to an undue hardship exception; and
(d)notice and opportunity for a hearing regarding imposition of a period of ineligibility or denial of an undue hardship exception.
(4)Nothing in 53-6-143, 53-6-144, 53-6-165, 53-6-167 through 53-6-169, 53-6-171 through 53-6-189, or this section is intended to prohibit the department from adopting rules consistent with federal law that provide for a period of ineligibility for public assistance programs other than medical assistance when an applicant or recipient directly or indirectly disposes of assets for less than fair market value.