Bill Text: NY A01163 | 2013-2014 | General Assembly | Introduced
Bill Title: Establishes resource level requirements for the family health plus program.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2014-01-08 - referred to health [A01163 Detail]
Download: New_York-2013-A01163-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
1163
2013-2014 Regular Sessions
I N A S S E M B L Y
(PREFILED)
January 9, 2013
___________
Introduced by M. of A. GANTT -- read once and referred to the Committee
on Health
AN ACT to amend the social services law, in relation to establishing
resource level requirements for the family health plus program
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Subparagraph (iii) of paragraph (a) of subdivision 2 of
2 section 369-ee of the social services law, as added by chapter 1 of the
3 laws of 1999 and as further amended by section 104 of part A of chapter
4 62 of the laws of 2011, is amended to read as follows:
5 (iii) does not have equivalent health care coverage under insurance or
6 equivalent mechanisms, as defined by the commissioner in consultation
7 with the superintendent of financial services; AND FOR PURPOSES OF THIS
8 SUBPARAGRAPH, MEDICARE PROVIDED PURSUANT TO PART A OF TITLE XVIII OF THE
9 FEDERAL SOCIAL SECURITY ACT SHALL BE DEEMED TO NOT BE AN EQUIVALENT
10 HEALTH CARE COVERAGE UNDER INSURANCE OR AN EQUIVALENT MECHANISM;
11 S 2. Subparagraph (iii) of paragraph (a) of subdivision 2 of section
12 369-ee of the social services law, as amended by section 68 of part C of
13 chapter 58 of the laws of 2009 and as further amended by section 104 of
14 part A of chapter 62 of the laws of 2011, is amended to read as follows:
15 (iii) does not have equivalent health care coverage under insurance or
16 equivalent mechanisms, as defined by the commissioner in consultation
17 with the superintendent of financial services; AND FOR PURPOSES OF THIS
18 SUBPARAGRAPH, MEDICARE PROVIDED PURSUANT TO PART A OF TITLE XVIII OF THE
19 FEDERAL SOCIAL SECURITY ACT SHALL BE DEEMED TO NOT BE AN EQUIVALENT
20 HEALTH CARE COVERAGE UNDER INSURANCE OR AN EQUIVALENT MECHANISM;
21 S 3. Paragraph (b) of subdivision 2 of section 369-ee of the social
22 services law, as amended by section 45-d of part C of chapter 58 of the
23 laws of 2008, and the opening paragraph as amended by section 59-c of
24 part C of chapter 58 of the laws of 2009, is amended to read as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03522-01-3
A. 1163 2
1 (b) Subject to the provisions of paragraph (d) of this subdivision, in
2 order to establish eligibility under this subdivision, which shall ALSO
3 be determined [without] WITH regard to resources, an individual shall
4 provide such documentation as is necessary and sufficient to initially,
5 and annually thereafter, determine an applicant's eligibility for cover-
6 age under this title. Such documentation shall include, but not be
7 limited to the following, if needed to verify eligibility:
8 (i) paycheck stubs; or
9 (ii) written documentation of income from all employers; or
10 (iii) other documentation of income (earned or unearned) as determined
11 by the commissioner, provided however, such documentation shall set
12 forth the source of such income; and
13 (iv) proof of identity and residence as determined by the commission-
14 er.
15 The commissioner of health may verify the accuracy of the information
16 provided by the individual pursuant to this paragraph by matching it
17 against information to which the commissioner of health has access
18 including under subdivision eight of section three hundred sixty-six-a
19 of this article.
20 S 4. Section 369-ee of the social services law is amended by adding
21 two new subdivisions 2-c and 2-d to read as follows:
22 2-C. EXEMPT RESOURCES. (A) THE FOLLOWING RESOURCES SHALL BE EXEMPT AND
23 SHALL NOT BE TAKEN INTO CONSIDERATION IN DETERMINING A PERSON'S ELIGI-
24 BILITY FOR MEDICAL CARE, SERVICES AND SUPPLIES AVAILABLE UNDER THIS
25 TITLE:
26 (I) A HOMESTEAD WHICH IS ESSENTIAL AND APPROPRIATE TO THE NEEDS OF THE
27 HOUSEHOLD;
28 (II) ESSENTIAL PERSONAL PROPERTY;
29 (III) A BURIAL FUND, TO THE EXTENT ALLOWED AS AN EXEMPT RESOURCE UNDER
30 THE CASH ASSISTANCE PROGRAM TO WHICH THE APPLICANT IS MOST CLOSELY
31 RELATED;
32 (IV) SAVINGS IN AMOUNTS EQUAL TO AT LEAST ONE-HALF OF THE INCOME
33 AMOUNT PERMITTED UNDER SUBPARAGRAPH SEVEN OF PARAGRAPH (A) OF SUBDIVI-
34 SION TWO OF SECTION THREE HUNDRED SIXTY-SIX OF THIS ARTICLE, PROVIDED,
35 HOWEVER, THAT THE AMOUNTS FOR ONE AND TWO PERSON HOUSEHOLDS SHALL NOT BE
36 LESS THAN THE AMOUNTS PERMITTED TO BE RETAINED BY HOUSEHOLDS OF THE SAME
37 SIZE IN ORDER TO QUALIFY FOR BENEFITS UNDER THE FEDERAL SUPPLEMENTAL
38 SECURITY INCOME PROGRAM;
39 (V) HEALTH INSURANCE PREMIUMS.
40 NO OTHER RESOURCES, INCLUDING FEDERAL OLD-AGE, SURVIVORS AND DISABILI-
41 TY INSURANCE, STATE DISABILITY INSURANCE OR OTHER PAYROLL DEDUCTIONS,
42 WHETHER MANDATORY OR OPTIONAL, SHALL BE EXEMPT AND ALL OTHER RESOURCES
43 SHALL BE TAKEN INTO CONSIDERATION AND REQUIRED TO BE APPLIED TOWARD THE
44 PAYMENT OR PARTIAL PAYMENT OF THE COST OF MEDICAL CARE AND SERVICES
45 AVAILABLE UNDER THIS SECTION, TO THE EXTENT PERMITTED BY FEDERAL LAW.
46 (B) (I) IN ESTABLISHING STANDARDS FOR DETERMINING ELIGIBILITY FOR AND
47 AMOUNT OF SUCH ASSISTANCE, THE DEPARTMENT OF HEALTH SHALL TAKE INTO
48 ACCOUNT ONLY SUCH RESOURCES, IN ACCORDANCE WITH FEDERAL REQUIREMENTS, AS
49 ARE AVAILABLE TO THE APPLICANT OR RECIPIENT AND AS WOULD NOT BE REQUIRED
50 TO BE DISREGARDED OR SET ASIDE FOR FUTURE NEEDS, AND THERE SHALL BE A
51 REASONABLE EVALUATION OF ANY SUCH RESOURCES. THE DEPARTMENT OF HEALTH
52 SHALL NOT CONSIDER THE AVAILABILITY OF AN OPTION FOR AN ACCELERATED
53 PAYMENT OF DEATH BENEFITS OR SPECIAL SURRENDER VALUE PURSUANT TO PARA-
54 GRAPH ONE OF SUBSECTION (A) OF SECTION ONE THOUSAND ONE HUNDRED THIRTEEN
55 OF THE INSURANCE LAW, OR AN OPTION TO ENTER INTO A VIATICAL SETTLEMENT
56 PURSUANT TO THE PROVISIONS OF ARTICLE SEVENTY-EIGHT OF THE INSURANCE
A. 1163 3
1 LAW, AS AN AVAILABLE RESOURCE IN DETERMINING ELIGIBILITY FOR AN AMOUNT
2 OF SUCH ASSISTANCE, PROVIDED, HOWEVER, THAT THE PAYMENT OF SUCH BENEFITS
3 SHALL BE CONSIDERED IN DETERMINING ELIGIBILITY FOR AND AMOUNT OF SUCH
4 ASSISTANCE. THERE SHALL NOT BE TAKEN INTO CONSIDERATION THE FINANCIAL
5 RESPONSIBILITY OF ANY INDIVIDUAL FOR ANY APPLICANT OR RECIPIENT OF
6 ASSISTANCE UNDER THIS SECTION UNLESS SUCH APPLICANT OR RECIPIENT IS SUCH
7 INDIVIDUAL'S SPOUSE OR SUCH INDIVIDUAL'S CHILD WHO IS UNDER TWENTY-ONE
8 YEARS OF AGE. IN DETERMINING THE ELIGIBILITY OF A CHILD WHO IS CATEGORI-
9 CALLY ELIGIBLE AS BLIND OR DISABLED, AS DETERMINED UNDER REGULATIONS
10 PRESCRIBED BY THE SOCIAL SECURITY ACT FOR MEDICAL ASSISTANCE, THE
11 RESOURCES OF PARENTS OR SPOUSES OF PARENTS ARE NOT CONSIDERED AVAILABLE
12 TO THAT CHILD IF HE OR SHE DOES NOT REGULARLY SHARE THE COMMON HOUSEHOLD
13 EVEN IF THE CHILD RETURNS TO THE COMMON HOUSEHOLD FOR PERIODIC VISITS.
14 (II) IN EVALUATING THE RESOURCES AVAILABLE TO AN APPLICANT FOR OR
15 RECIPIENT OF MEDICAL ASSISTANCE, FOR PURPOSES OF DETERMINING ELIGIBILITY
16 FOR AND THE AMOUNT OF SUCH ASSISTANCE, THE DEPARTMENT OF HEALTH MUST
17 CONSIDER ASSETS HELD IN OR PAID FROM TRUSTS CREATED BY SUCH APPLICANT OR
18 RECIPIENT, AS DETERMINED PURSUANT TO THE REGULATIONS OF THE DEPARTMENT
19 OF HEALTH, IN ACCORDANCE WITH THE PROVISIONS OF THIS SUBPARAGRAPH.
20 (A) IN THE CASE OF A REVOCABLE TRUST CREATED BY AN APPLICANT OR RECIP-
21 IENT, AS DETERMINED PURSUANT TO REGULATIONS OF THE DEPARTMENT OF HEALTH
22 THE TRUST CORPUS MUST BE CONSIDERED TO BE AN AVAILABLE RESOURCE.
23 (B) IN THE CASE OF AN IRREVOCABLE TRUST CREATED BY AN APPLICANT OR
24 RECIPIENT, AS DETERMINED PURSUANT TO REGULATIONS OF THE DEPARTMENT OF
25 HEALTH ANY PORTION OF THE TRUST CORPUS, AND OF THE INCOME GENERATED BY
26 THE TRUST CORPUS, FROM WHICH PAYMENT COULD BE MADE TO OR FOR THE BENEFIT
27 OF SUCH APPLICANT OR RECIPIENT MUST BE CONSIDERED TO BE AN AVAILABLE
28 RESOURCE.
29 (C) NOTWITHSTANDING THE PROVISIONS OF CLAUSES (A) AND (B) OF THIS
30 SUBPARAGRAPH, IN THE CASE OF AN APPLICANT OR RECIPIENT WHO IS DISABLED,
31 AS SUCH TERM IS DEFINED IN SECTION 1614(A)(3) OF THE FEDERAL SOCIAL
32 SECURITY ACT, THE DEPARTMENT OF HEALTH MUST NOT CONSIDER AS AVAILABLE
33 RESOURCES THE CORPUS OR INCOME OF THE FOLLOWING TRUSTS WHICH COMPLY WITH
34 THE PROVISIONS OF THE REGULATIONS AUTHORIZED BY CLAUSE (D) OF THIS
35 SUBPARAGRAPH:
36 (I) A TRUST CONTAINING THE ASSETS OF SUCH A DISABLED INDIVIDUAL WHICH
37 WAS ESTABLISHED FOR THE BENEFIT OF THE DISABLED INDIVIDUAL WHILE SUCH
38 INDIVIDUAL WAS UNDER SIXTY-FIVE YEARS OF AGE BY A PARENT, GRANDPARENT,
39 LEGAL GUARDIAN, OR COURT OF COMPETENT JURISDICTION, IF UPON THE DEATH OF
40 SUCH INDIVIDUAL THE STATE WILL RECEIVE ALL AMOUNTS REMAINING IN THE
41 TRUST UP TO THE TOTAL VALUE OF ALL MEDICAL ASSISTANCE PAID ON BEHALF OF
42 SUCH INDIVIDUAL; AND
43 (II) A TRUST CONTAINING THE ASSETS OF SUCH A DISABLED INDIVIDUAL
44 ESTABLISHED AND MANAGED BY A NON-PROFIT ASSOCIATION WHICH MAINTAINS
45 SEPARATE ACCOUNTS FOR THE BENEFIT OF DISABLED INDIVIDUALS, BUT, FOR
46 PURPOSES OF INVESTMENT AND MANAGEMENT OF TRUST FUNDS, POOLS THE
47 ACCOUNTS, PROVIDED THAT ACCOUNTS IN THE TRUST FUND ARE ESTABLISHED SOLE-
48 LY FOR THE BENEFIT OF INDIVIDUALS WHO ARE DISABLED AS SUCH TERM IS
49 DEFINED IN SECTION 1614(A)(3) OF THE FEDERAL SOCIAL SECURITY ACT BY SUCH
50 DISABLED INDIVIDUAL, A PARENT, GRANDPARENT, LEGAL GUARDIAN, OR COURT OF
51 COMPETENT JURISDICTION, AND TO THE EXTENT THAT AMOUNTS REMAINING IN THE
52 INDIVIDUAL'S ACCOUNT ARE NOT RETAINED BY THE TRUST UPON THE DEATH OF THE
53 INDIVIDUAL, THE STATE WILL RECEIVE ALL SUCH REMAINING AMOUNTS UP TO THE
54 TOTAL VALUE OF ALL MEDICAL ASSISTANCE PAID ON BEHALF OF SUCH INDIVIDUAL.
55 NOTWITHSTANDING ANY LAW TO THE CONTRARY, A NOT-FOR-PROFIT CORPORATION
56 MAY, IN FURTHERANCE OF AND AS AN ADJUNCT TO ITS CORPORATE PURPOSES, ACT
A. 1163 4
1 AS TRUSTEE OF A TRUST FOR PERSONS WITH DISABILITIES ESTABLISHED PURSUANT
2 TO THIS SUBCLAUSE, PROVIDED THAT A TRUST COMPANY, AS DEFINED IN SUBDIVI-
3 SION SEVEN OF SECTION ONE HUNDRED-C OF THE BANKING LAW, ACTS AS CO-TRUS-
4 TEE.
5 (D) THE DEPARTMENT OF HEALTH SHALL PROMULGATE SUCH REGULATIONS AS MAY
6 BE NECESSARY TO CARRY OUT THE PROVISIONS OF THIS SUBPARAGRAPH. SUCH
7 REGULATIONS SHALL INCLUDE PROVISIONS FOR: ASSURING THE FULFILLMENT OF
8 FIDUCIARY OBLIGATIONS OF THE TRUSTEE WITH RESPECT TO THE REMAINDER
9 INTEREST OF THE DEPARTMENT OF HEALTH OR STATE; MONITORING POOLED TRUSTS;
10 APPLYING THIS SUBDIVISION TO LEGAL INSTRUMENTS AND OTHER DEVICES SIMILAR
11 TO TRUSTS, IN ACCORDANCE WITH APPLICABLE FEDERAL RULES AND REGULATIONS;
12 AND ESTABLISHING PROCEDURES UNDER WHICH THE APPLICATION OF THIS SUBDIVI-
13 SION WILL BE WAIVED WITH RESPECT TO AN APPLICANT OR RECIPIENT WHO DEMON-
14 STRATES THAT SUCH APPLICATION WOULD WORK AN UNDUE HARDSHIP ON HIM OR
15 HER, IN ACCORDANCE WITH STANDARDS SPECIFIED BY THE SECRETARY OF THE
16 FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES. SUCH REGULATIONS MAY
17 REQUIRE NOTIFICATION OF THE DEPARTMENT OF THE CREATION OR FUNDING OF
18 SUCH A TRUST FOR THE BENEFIT OF AN APPLICANT FOR OR RECIPIENT OF MEDICAL
19 ASSISTANCE; NOTIFICATION OF THE DEPARTMENT OF HEALTH OF THE DEATH OF A
20 BENEFICIARY OF SUCH A TRUST WHO IS A CURRENT OR FORMER RECIPIENT OF
21 MEDICAL ASSISTANCE; IN THE CASE OF A TRUST, THE CORPUS OF WHICH EXCEEDS
22 ONE HUNDRED THOUSAND DOLLARS, NOTIFICATION OF THE DEPARTMENT OF HEALTH
23 OF TRANSACTIONS TENDING TO SUBSTANTIALLY DEPLETE THE TRUST CORPUS;
24 NOTIFICATION OF THE DEPARTMENT OF HEALTH OF ANY TRANSACTIONS INVOLVING
25 TRANSFERS FROM THE TRUST CORPUS FOR LESS THAN FAIR MARKET VALUE; THE
26 BONDING OF THE TRUSTEE WHEN THE ASSETS OF SUCH A TRUST EQUAL OR EXCEED
27 ONE MILLION DOLLARS, UNLESS A COURT OF COMPETENT JURISDICTION WAIVES
28 SUCH REQUIREMENT; AND THE BONDING OF THE TRUSTEE WHEN THE ASSETS OF SUCH
29 A TRUST ARE LESS THAN ONE MILLION DOLLARS, UPON ORDER OF A COURT OF
30 COMPETENT JURISDICTION. THE DEPARTMENT OF HEALTH, TOGETHER WITH THE
31 BANKING DEPARTMENT, SHALL PROMULGATE REGULATIONS GOVERNING THE ESTAB-
32 LISHMENT, MANAGEMENT AND MONITORING OF TRUST ESTABLISHED PURSUANT TO
33 SUBCLAUSE (II) OF CLAUSE (C) OF THIS SUBPARAGRAPH IN WHICH A
34 NOT-FOR-PROFIT CORPORATION AND A TRUST COMPANY SERVE AS CO-TRUSTEES.
35 (E) NOTWITHSTANDING ANY ACTS, OMISSIONS OR FAILURES TO ACT OF A TRUS-
36 TEE OF A TRUST WHICH THE DEPARTMENT OF HEALTH OR A LOCAL SOCIAL SERVICES
37 OFFICIAL HAS DETERMINED COMPLIES WITH THE PROVISIONS OF CLAUSE (C) AND
38 THE REGULATIONS AUTHORIZED BY CLAUSE (D) OF THIS SUBPARAGRAPH, THE
39 DEPARTMENT MUST NOT CONSIDER THE CORPUS OR INCOME OF ANY SUCH TRUST AS
40 AVAILABLE RESOURCES OF THE APPLICANT OR RECIPIENT WHO IS DISABLED, AS
41 SUCH TERM IS DEFINED IN SECTION 1614(A)(3) OF THE FEDERAL SOCIAL SECURI-
42 TY ACT. THE DEPARTMENT OF HEALTH'S REMEDY FOR REDRESS OF ANY ACTS, OMIS-
43 SIONS OR FAILURES TO ACT BY SUCH A TRUSTEE WHOSE ACTS, OMISSIONS OR
44 FAILURES ARE CONSIDERED BY THE DEPARTMENT OF HEALTH TO BE INCONSISTENT
45 WITH THE TERMS OF THE TRUST, CONTRARY TO APPLICABLE LAWS AND REGULATIONS
46 OF THE DEPARTMENT OF HEALTH, OR CONTRARY TO THE FIDUCIARY OBLIGATIONS OF
47 THE TRUSTEE SHALL BE THE COMMENCEMENT OF AN ACTION OR PROCEEDING UNDER
48 SUBDIVISION ONE OF SECTION SIXTY-THREE OF THE EXECUTIVE LAW TO SAFEGUARD
49 OR ENFORCE THE STATE'S REMAINDER INTEREST IN THE TRUST, OR SUCH OTHER
50 ACTION OR PROCEEDING AS MAY BE LAWFUL AND APPROPRIATE AS TO ASSURE
51 COMPLIANCE BY THE TRUSTEE OR TO SAFEGUARD AND ENFORCE THE STATE'S
52 REMAINDER INTEREST IN THE TRUST.
53 2-D. RESOURCE ELIGIBILITY REQUIREMENTS. (A) IN DETERMINING THE INITIAL
54 OR CONTINUING ELIGIBILITY OF ANY PERSON FOR ASSISTANCE UNDER THIS
55 SECTION, THERE SHALL BE INCLUDED IN THE AMOUNT OF RESOURCES CONSIDERED
56 AVAILABLE TO SUCH PERSON THE UNCOMPENSATED VALUE OF ANY RESOURCE TRANS-
A. 1163 5
1 FERRED, AND SUCH PERSON SHALL BE INELIGIBLE FOR SUCH ASSISTANCE FOR SUCH
2 PERIOD OR PERIODS AS SPECIFIED IN THIS SUBDIVISION.
3 (B) (I) A NONEXEMPT RESOURCE SHALL MEAN ANY RESOURCE WHICH IF RETAINED
4 BY SUCH PERSON WOULD NOT BE EXEMPT FROM CONSIDERATION UNDER THE
5 PROVISIONS OF SUBDIVISION TWO-C OF THIS SECTION;
6 (II) ANY TRANSFER OF A NONEXEMPT RESOURCE MADE WITHIN TWENTY-FOUR
7 MONTHS PRIOR TO THE DATE OF A PERSON'S APPLICATION FOR MEDICAL ASSIST-
8 ANCE SHALL BE PRESUMED TO HAVE BEEN MADE FOR THE PURPOSE OF QUALIFYING
9 FOR SUCH ASSISTANCE; HOWEVER, IF SUCH PERSON FURNISHES EVIDENCE TO
10 ESTABLISH THAT THE TRANSFER WAS EXCLUSIVELY FOR SOME OTHER PURPOSE, THE
11 UNCOMPENSATED VALUE SHALL NOT BE CONSIDERED AVAILABLE TO SUCH PERSON IN
12 DETERMINING HIS OR HER INITIAL OR CONTINUED ELIGIBILITY FOR MEDICAL
13 ASSISTANCE;
14 (III) THE UNCOMPENSATED VALUE OF ANY SUCH RESOURCE SHALL BE THE FAIR
15 MARKET VALUE OF SUCH RESOURCE AT THE TIME OF TRANSFER, MINUS THE AMOUNT
16 OF THE COMPENSATION RECEIVED BY THE PERSON IN EXCHANGE FOR THE RESOURCE;
17 (IV) EXCESS RESOURCES SHALL BE THE TOTAL OF A PERSON'S NONEXEMPT
18 RESOURCES ABOVE TWENTY THOUSAND DOLLARS;
19 (V) ANY PERSON DETERMINED TO HAVE RESOURCES IN EXCESS OF TWENTY THOU-
20 SAND DOLLARS SHALL BE INELIGIBLE FOR ASSISTANCE UNDER THIS SECTION
21 PURSUANT TO SUBPARAGRAPHS (VI) AND (VII) OF THIS PARAGRAPH;
22 (VI) ANY PERSON DETERMINED TO HAVE EXCESS RESOURCES OF FIFTEEN THOU-
23 SAND DOLLARS OR LESS BECAUSE OF THE APPLICATION OF THIS PARAGRAPH SHALL
24 REMAIN INELIGIBLE FOR ASSISTANCE UNDER THIS TITLE FOR A PERIOD OF TWEN-
25 TY-FOUR MONTHS FROM THE DATE OF THE TRANSFER, OR UNTIL SUCH PERSON CAN
26 DEMONSTRATE THAT HE OR SHE HAS INCURRED MEDICAL EXPENSES AFTER THE DATE
27 OF TRANSFER IN THE AMOUNT OF SUCH EXCESS ABOVE OTHERWISE ALLOWABLE
28 RESOURCES, WHICHEVER PERIOD IS SHORTER;
29 (VII) ANY PERSON DETERMINED TO HAVE EXCESS RESOURCES OF MORE THAN
30 FIFTEEN THOUSAND DOLLARS BECAUSE OF THE APPLICATION OF THIS PARAGRAPH
31 SHALL REMAIN INELIGIBLE FOR ASSISTANCE UNDER THIS SECTION FOR A PERIOD
32 WHICH EXCEEDS TWENTY-FOUR MONTHS, WHICH PERIOD SHALL BE DETERMINED BY
33 ADDING AN ADDITIONAL MONTH OF INELIGIBILITY FOR EACH TWO THOUSAND
34 DOLLARS IN EXCESS OF FIFTEEN THOUSAND DOLLARS, OR UNTIL SUCH PERSON CAN
35 DEMONSTRATE THAT HE OR SHE HAS INCURRED MEDICAL EXPENSES AFTER THE DATE
36 OF TRANSFER IN THE AMOUNT OF SUCH EXCESS ABOVE OTHERWISE ALLOWABLE
37 RESOURCES, WHICHEVER PERIOD IS SHORTER.
38 (C) ANY TRANSFER OF A RESOURCE BY A PERSON OR SUCH PERSON'S SPOUSE FOR
39 LESS THAN FAIR MARKET VALUE MADE WITHIN OR AFTER THE THIRTY MONTHS IMME-
40 DIATELY PRECEDING THE DATE OF APPLICATION FOR MEDICAL ASSISTANCE UNDER
41 THIS SECTION, SHALL RENDER THE PERSON INELIGIBLE FOR HEALTH CARE
42 SERVICES FOR A PERIOD OF TWENTY-FOUR MONTHS FROM THE DATE OF TRANSFER,
43 WHICH PERIOD SHALL BE DETERMINED BY ADDING AN ADDITIONAL MONTH OF INEL-
44 IGIBILITY FOR EACH TWO THOUSAND DOLLARS IN EXCESS OF FIFTEEN THOUSAND
45 DOLLARS, OR UNTIL SUCH PERSON CAN DEMONSTRATE THAT HE OR SHE HAS
46 INCURRED MEDICAL EXPENSES AFTER THE DATE OF TRANSFER IN THE AMOUNT OF
47 SUCH EXCESS ABOVE ALLOWABLE RESOURCES, WHICHEVER PERIOD IS SHORTER;
48 HOWEVER, A PERSON SHALL NOT BE INELIGIBLE FOR HEALTH CARE SERVICES SOLE-
49 LY BY REASON OF ANY SUCH TRANSFER TO THE EXTENT THAT:
50 (I) THE RESOURCE TRANSFERRED WAS A HOME AND TITLE TO THE HOME WAS
51 TRANSFERRED TO:
52 (A) THE SPOUSE OF SUCH PERSON; OR
53 (B) A CHILD OF SUCH PERSON WHO IS UNDER THE AGE OF TWENTY-ONE YEARS OR
54 CERTIFIED BLIND OR CERTIFIED PERMANENTLY AND TOTALLY DISABLED, AS
55 DEFINED BY SECTION TWO HUNDRED EIGHT OF THIS ARTICLE; OR
A. 1163 6
1 (C) A SIBLING OF SUCH PERSON WHO HAS AN EQUITY INTEREST IN SUCH HOME
2 AND WHO RESIDED IN SUCH HOME FOR A PERIOD OF AT LEAST ONE YEAR IMME-
3 DIATELY BEFORE THE DATE THE PERSON APPLIED FOR MEDICAL ASSISTANCE PURSU-
4 ANT TO THIS SECTION; OR
5 (D) A SON OR DAUGHTER OF SUCH PERSON WHO WAS RESIDING IN SUCH HOME FOR
6 A PERIOD OF AT LEAST TWO YEARS IMMEDIATELY BEFORE THE DATE SUCH PERSON
7 APPLIED FOR MEDICAL ASSISTANCE PURSUANT TO THIS SECTION, AND WHO
8 PROVIDED CARE TO SUCH PERSON WHICH PERMITTED SUCH PERSON TO RESIDE AT
9 HOME RATHER THAN IN AN INSTITUTION OR FACILITY; OR
10 (II) THE RESOURCE WAS TRANSFERRED TO OR FOR THE SOLE BENEFIT OF SUCH
11 PERSON'S SPOUSE, OR FROM SUCH PERSON'S SPOUSE TO OR FOR THE SOLE BENEFIT
12 OF SUCH PERSON, OR TO HIS OR HER CHILD WHO IS CERTIFIED BLIND OR CERTI-
13 FIED PERMANENTLY AND TOTALLY DISABLED; OR
14 (III) A SATISFACTORY SHOWING IS MADE THAT:
15 (A) THE PERSON OR SUCH PERSON'S SPOUSE INTENDED TO DISPOSE OF THE
16 RESOURCE EITHER AT FAIR MARKET VALUE, OR FOR OTHER VALUABLE CONSIDER-
17 ATION, OR
18 (B) THE RESOURCE WAS TRANSFERRED EXCLUSIVELY FOR A PURPOSE OTHER THAN
19 TO QUALIFY FOR MEDICAL ASSISTANCE; OR
20 (IV) DENIAL OF ELIGIBILITY WOULD WORK AN UNDUE HARDSHIP, AS DEFINED BY
21 THE COMMISSIONER WHICH DEFINITION SHALL INCLUDE THE INABILITY OF THE
22 PERSON OR SUCH PERSON'S SPOUSE TO RETRIEVE THE RESOURCE OR TO OBTAIN
23 FAIR MARKET VALUE THEREFOR DESPITE HIS OR HER BEST EFFORTS.
24 (D) THE COMMISSIONER SHALL PROMULGATE SUCH RULES AND REGULATIONS AS
25 MAY BE NECESSARY TO CARRY OUT THE PROVISIONS OF THIS SUBDIVISION.
26 S 5. This act shall take effect on the ninetieth day after it shall
27 have become a law; provided however that section one of this act shall
28 remain in effect until the approval of the commissioner of health pursu-
29 ant to subdivision 4 of section 79 of part C of chapter 58 of the laws
30 of 2005, when upon such date the provisions of section two of this act
31 shall take effect; and provided further that the commissioner of health
32 is authorized to promulgate any and all rules and regulations and take
33 any other measures necessary to implement this act on its effective date
34 on or before such date.
