(a) Any transfer or assignment of assets resulting in the imposition of a penalty period shall be presumed to be made with the intent, on the part of the transferor or the transferee, to enable the transferor to obtain or maintain eligibility for medical assistance. This presumption may be rebutted only by clear and convincing evidence that the transferor's eligibility or potential eligibility for medical assistance was not a basis for the transfer or assignment.
(b) Any transfer or assignment of assets resulting in the establishment or imposition of a penalty period shall create a debt, as defined in section 36a-645, that shall be due and owing by the transferor or transferee to the Department of Social Services in an amount equal to the amount of the medical assistance provided to or on behalf of the transferor on or after the date of the transfer of assets, but said amount shall not exceed the fair market value of the assets at the time of transfer. The Commissioner of Social Services, the Commissioner of Administrative Services and the Attorney General shall have the power or authority to seek administrative, legal or equitable relief as provided by other statutes or by common law.
(c) The Commissioner of Social Services may waive the imposition of a penalty period when the transferor (1) in accordance with the provisions of section 3025.25 of the department's Uniform Policy Manual, suffers from dementia at the time of application for medical assistance and cannot explain transfers that would otherwise result in the imposition of a penalty period; or (2) suffered from dementia at the time of the transfer; or (3) was exploited into making such a transfer due to dementia. Waiver of the imposition of a penalty period does not prohibit the establishment of a debt in accordance with subsection (b) of this section.
(d) (1) For purposes of this subsection, an “institutionalized individual” means an individual who has applied for or is receiving (A) services from a long-term care facility, (B) services from a medical institution that are equivalent to those services provided in a long-term care facility, or (C) home and community-based services under a Medicaid waiver.
(2) An institutionalized individual shall not be penalized for the transfer of an asset if the entire amount of the transferred asset is returned to the institutionalized individual. A transferee may return any portion of a transferred asset to the transferor. If any transferred asset is returned to the transferor, the Department of Social Services shall adjust the penalty period to the extent permitted by federal law, provided the ending date of the penalty period as originally determined by the department shall not change. The department shall consider the entire amount of the returned asset to be available to the transferor only from the date of return of the transferred asset, and shall not determine the transferor to be ineligible in the month the transferred asset is returned, provided the transferor reduced the returned asset in accordance with federal law.
(3) If there are multiple transfers of assets to the same or different transferees, a return of anything less than the total amount of the transferred assets from all of the separate transferees shall not constitute a return of the entire amount of the transferred assets and shall represent a partial return.
(4) The conveyance and subsequent return of an asset for the purpose of shifting costs to the Medicaid program shall be regarded as a trust-like device. Such asset shall be considered available for the purpose of determining Medicaid eligibility. The conveyance and subsequent return of an asset made exclusively for a purpose other than to qualify for the payment of long-term care services under the Medicaid program shall not be regarded as a trust-like device.
(e) The Commissioner of Social Services, pursuant to section 17b-10, shall implement the policies and procedures necessary to carry out the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided notice of intent to adopt regulations is published in the Connecticut Law Journal not later than twenty days after implementation. Such policies and procedures shall be valid until the time final regulations are effective.
(June Sp. Sess. P.A. 01-2, S. 4, 69; June Sp. Sess. P.A. 01-9, S. 129, 131; June 30 Sp. Sess. P.A. 03-3, S. 62; P.A. 04-16, S. 7; P.A. 05-209, S. 4; 05-280, S. 40; P.A. 11-44, S. 104; P.A. 13-218, S. 1.)
History: June Sp. Sess. P.A. 01-2 effective July 1, 2001; June Sp. Sess. P.A. 01-9 revised effective date of June Sp. Sess. P.A. 01-2 but without affecting this section; June 30 Sp. Sess. P.A. 03-3 designated existing provisions as Subsec. (a), added Subsec. (b) providing that transfer of assets resulting in imposition of a penalty period is presumed to be made with intent of allowing transferor to remain eligible for medical assistance, added Subsec. (c) re transfers resulting in imposition of a penalty period creating a debt due and owing to the department, added Subsec. (d) permitting commissioner to grant financial relief to nursing facility that demonstrates severe financial hardship due to imposition of transfer of assets penalties, added Subsec. (e) permitting commissioner to waive transfer of assets penalty period when transferor suffers from dementia or was exploited into making transfer, added Subsec. (f) providing that department, when determining medical assistance eligibility, shall review transfers of assets involving real property occurring in the 60 months preceding the date the individual applied for medical assistance and that federal law governs transfers of assets not involving real property, added Subsec. (g) permitting commissioner to establish threshold limits re annual asset transfers not subject to penalty and added Subsec. (h) requiring commissioner to implement policies and procedures necessary to carry out purposes of section while in the process of adopting regulations, effective August 20, 2003; P.A. 04-16 made technical changes in Subsec. (h); P.A. 05-209 deleted former Subsec. (a) re authority of commissioner to seek waiver of federal law for establishing penalty period for transfers of assets for less than fair market value, deleted former Subsec. (d) re commissioner's authority to grant financial relief to nursing homes experiencing severe financial hardship due to imposition of revised transfer of asset penalty period, deleted former Subsec. (e) re commissioner's authority to waive penalty period when transferor suffers from dementia, deleted former Subsec. (f) re 60-month penalty period for transfers of assets involving real property, deleted former Subsec. (g) re commissioner's authority to set threshold limits for transfers not subject to imposition of penalty period, and redesignated existing Subsecs. (b), (c) and (h) as new Subsecs. (a), (b) and (c), respectively, effective July 6, 2005; P.A. 05-280 added new Subsec. (c) re commissioner's authority to waive penalty period when transferor suffers from dementia and redesignated existing Subsec. (c) as new Subsec. (d), effective July 13, 2005; P.A. 11-44 added new Subsec. (d) re return or partial return of an asset and redesignated existing Subsec. (d) as Subsec. (e), effective June 13, 2011; P.A. 13-218 amended Subsec. (d) to add new Subdiv. (1) defining “institutionalized individual”, to designate existing provision re institutionalized individual not to be penalized as Subdiv. (2) and amend same to delete provision re partial asset return not to result in reduced penalty period and add provisions re return of portion of transferred asset, to redesignate existing Subdiv. (1) as Subdiv. (3) and amend same to add “and shall represent a partial return”, to delete former Subdiv. (2) re availability of entire amount of returned asset, to redesignate existing Subdiv. (3) as Subdiv. (4) and amend same to add provision re conveyance and subsequent return of asset for a purpose other than to qualify under Medicaid not to be regarded as a trust-like device, and to delete former Subdiv. (4) re definition of “institutionalized individual”, effective July 1, 2013.
Structure Connecticut General Statutes
Chapter 319v - Medical Assistance
Section 17b-220. (Formerly Sec. 17-292g). - Reimbursement of medical providers.
Section 17b-221. (Formerly Sec. 17-292h). - Regulations. Reimbursement of hospitals.
Section 17b-221a. - Revenue from Riverview Hospital to be used to pay Medicaid claims.
Section 17b-222. (Formerly Sec. 17-294). - “Humane institution” defined. Daily report.
Section 17b-223. (Formerly Sec. 17-295). - Support in humane institutions.
Section 17b-224. (Formerly Sec. 17-295b). - Liability of patient for per capita cost of care.
Section 17b-225. (Formerly Sec. 17-295c). - Availability of patient information to certain agencies.
Section 17b-226a. - Provider billing rates for goods and services.
Section 17b-227. (Formerly Sec. 17-297). - Payment for services in state humane institutions.
Section 17b-229. (Formerly Sec. 17-299). - Liability for prior charges.
Section 17b-230. (Formerly Sec. 17-300). - Claim of state on death of institution patient.
Section 17b-231. (Formerly Sec. 17-301). - Refund for support of persons in state institutions.
Section 17b-237. (Formerly Sec. 17-310). - State aid toward support of children at center.
Section 17b-238. (Formerly Sec. 17-311). - State payments to hospitals.
Section 17b-239b. - Chronic disease hospitals. Prior authorization procedures. Regulations.
Section 17b-239c. - Interim disproportionate share payments to short-term general hospitals.
Section 17b-239d. - Payments for outpatient hospital services.
Section 17b-239e. - Hospital rate plan. Supplemental pools and payments. Quality measures.
Section 17b-241b. - Rate for private psychiatric residential treatment facilities.
Section 17b-243. (Formerly Sec. 17-313a). - Payments to rehabilitation centers.
Section 17b-245a. - Payments to federally qualified health centers.
Section 17b-245e. - Telehealth services provided under the Medicaid program. Report.
Section 17b-249. (Formerly Sec. 17-317). - Support of mentally ill persons accused of crime.
Section 17b-252. (Formerly Sec. 17-12q). - Connecticut Partnership for Long-Term Care.
Section 17b-256e. - Reports re potential participants in affordable pharmaceutical drug program.
Section 17b-256f. - Eligibility for Medicare savings programs. Regulations.
Section 17b-257b. - Alien eligibility for state medical assistance. Regulations.
Section 17b-257d. - Notice of terminating alien's state medical assistance.
Section 17b-257e. - Postpartum care for women without legal immigration status. Income eligibility.
Section 17b-258. (Formerly Sec. 17-12jj). - Health insurance assistance for unemployed persons.
Section 17b-259. (Formerly Sec. 17-274). - Medically necessary services.
Section 17b-260. (Formerly Sec. 17-134a). - Acceptance of federal grants for medical assistance.
Section 17b-260c. - Medicaid waiver to provide coverage for family planning services.
Section 17b-261. (Formerly Sec. 17-134b). - Medicaid. Eligibility. Assets. Waiver from federal law.
Section 17b-261b. - Program eligibility determined by department. Spousal support.
Section 17b-261c. - Medical assistance. Changes in circumstances.
Section 17b-261d. - Disease management initiative. Implementation. Annual report.
Section 17b-261e. - Mobile field hospital: HUSKY Health program coverage.
Section 17b-261f. - Mobile field hospital account.
Section 17b-261i. - Administrative services for Medicaid recipients. Regulations.
Section 17b-261j. - Easy Breathing model in HUSKY Health program.
Section 17b-261l. - Treatment of reverse annuity mortgage loan proceeds under Medicaid. Regulations.
Section 17b-261o. - Imposition of penalty period when undue hardship exists. Exception.
Section 17b-261t. - Contents of Medicaid benefits cards.
Section 17b-261v. - Parent or needy caretaker relative. Review of Medicaid coverage options.
Section 17b-262. (Formerly Sec. 17-134d). - Regulations. Admissions to nursing home facilities.
Section 17b-263c. - Medical homes. Regulations.
Section 17b-264. (Formerly Sec. 17-134e). - Extension of other public assistance provisions.
Section 17b-265b. - Reimbursement rates for pathologists.
Section 17b-265c. - Medicaid and Medicare dually eligible pilot program.
Section 17b-265g. - Health insurer. Duties owed to the state and Commissioner of Social Services.
Section 17b-266a. - Contract with pharmacy benefits management organization.
Section 17b-268. (Formerly Sec. 17-134i). - Withdrawal of member of group providing services.
Section 17b-269. (Formerly Sec. 17-134j). - Bonding of officers and employees.
Section 17b-270. (Formerly Sec. 17-134k). - Liability of agency and its officers.
Section 17b-271. (Formerly Sec. 17-134l). - Termination of agreement.
Section 17b-272. (Formerly Sec. 17-134m). - Personal fund allowance.
Section 17b-274b. - Pharmaceutical purchasing initiative. Annual report.
Section 17b-274e. - Prescription drugs. Utilization of cost-efficient dosages.
Section 17b-274f. - Step therapy program for Medicaid prescription drugs.
Section 17b-275. (Formerly Sec. 17-134r). - Physician and pharmacy lock-in procedure.
Section 17b-276b. - Nonemergency medical transportation services. Prior authorization.
Section 17b-276c. - Payment for medically necessary mode of transportation service.
Section 17b-277b. - Healthy Start program. Plan. Review.
Section 17b-277c. - Medicaid coverage for donor breast milk. Requirements. Regulations.
Section 17b-278a. - Coverage for treatment for smoking cessation.
Section 17b-278b. - Medical assistance for breast and cervical cancer.
Section 17b-278f. - Amendment to state Medicaid plan to provide treatment for tuberculosis.
Section 17b-278g. - Medical assistance for eyeglasses and contact lenses. Regulations.
Section 17b-278h. - Medical assistance for chiropractic services. Regulations.
Section 17b-278j. - Complex rehabilitation technology. Definitions. Report.
Section 17b-278k. - Electronic transmission of prescriptions for durable medical equipment.
Section 17b-280c. - Methadone maintenance. Minimum rates.
Section 17b-281b. - Used durable medical equipment. Payments to vendors or suppliers.
Section 17b-281c. - Authority of commissioner to modify medical equipment fee schedules.
Section 17b-282b. - Implementation of state-wide dental plan. Waiver.
Section 17b-282c. - Nonemergency dental services. Regulations.
Section 17b-282d. - Commissioner to modify nonemergency dental services. Regulations.
Section 17b-282e. - Orthodontic services for Medicaid recipients under twenty-one years of age.
Section 17b-282f. - Mobile dental clinics. Medicaid coverage areas. Regulations.
Section 17b-284. (Formerly Sec. 17-134ff). - Medical assistance for certain employed persons.
Section 17b-286. - Medicaid management information system. Reports.
Section 17b-288. - Organ transplant account. Regulations.
Section 17b-290. - Definitions.
Section 17b-291. - Children's health insurance plan.
Section 17b-292a. - Information for redetermination of eligibility under HUSKY Plan.
Section 17b-292b. - Prenatal care under HUSKY B. Unborn child option. Income eligibility.
Section 17b-293. - Minimum benefit coverage under HUSKY Plan, Part B.
Section 17b-294. - HUSKY Plus programs.
Section 17b-294a. - HUSKY Plus program. Administration. Eligibility. Regulations.
Section 17b-295. - Cost-sharing requirements under HUSKY B.
Section 17b-297. - Outreach programs for HUSKY Plan, Part A and Part B.
Section 17b-299. - Applications. Approval.
Section 17b-300. - Notification of member's change of circumstance.
Section 17b-301. - Recovery of payment for false statement, misrepresentation or concealment.
Section 17b-303. - Income disregard. Application for federal waiver.
Section 17b-304. - Regulations.
Section 17b-306a. - Child health quality improvement program. Purpose and scope. Annual reports.
Section 17b-307. - Primary care case management pilot program.
Section 17b-311. - Charter Oak Health Plan.
Section 17b-312. - Medicaid waiver to seek federal funds to support the Covered Connecticut program.
Section 17b-313. - Innovation waiver for health care expansion.