Current through all regulations passed and filed through September 16, 2024
(A) This rule
describes the qualified long-term care partnership (QLTCP) program.
(B) Definitions.
(1) "Estate recovery" means the program set
forth in rule
5160:1-2-07 of the
Administrative Code.
(2) "Qualified
long-term care partnership" (QLTCP) means the program established under section
5164.86 of the Revised Code,
under which an individual's assets or resources are disregarded in eligibility
determinations and at estate recovery in the amount of insurance benefit
payments made to or on behalf of the individual who is a beneficiary of a QLTCP
policy.
(C) A QLTCP
policy is one that meets all of the following requirements:
(1) On the date the policy was issued, the
state in which the insured resided had in place an approved state plan
amendment which provides, pursuant to
42 U.S.C.
1396p(b) (as in effect
October 1, 2023), for the
disregard of assets or resources in an amount equal to the insurance benefit
payments made to or on behalf of an individual who is a beneficiary of a QLTCP
policy; and
(2) The policy is a
qualified long-term care insurance policy, as defined in
26 U.S.C.
7702B(b) (as in effect
October 1, 2023); and
(3) The policy meets the requirements set
forth by the Ohio department of insurance in section
3923.41 of the Revised Code, or,
when
purchased outside Ohio, meets the requirements of an approved state plan
amendment, as described in paragraph (C)(1) of this rule, in the state of
purchase.
(D) Upon the
request for, or renewal of, a determination of eligibility for medicaid payment
of long-term care (LTC) services, an individual's resources
shall be
disregarded up to the dollar amount of insurance benefit payments made to or on
behalf of the individual who is a beneficiary of a QLTCP policy.
(1) The administrative agency shall determine
eligibility for medical assistance in accordance with the rules contained in
Chapters 5160:1-1 to 5160:1-6 of the Administrative Code.
(2) An individual may request a determination
of eligibility for medicaid payment of LTC services before exhausting the
benefits of a QLTCP policy. When an individual requests and is determined eligible
for medicaid payment of LTC services before the QLTCP policy is exhausted, the
QLTCP insurer must make payment for medical care to the maximum extent of
the
insurer's liability before medicaid funds may be used to pay providers
for covered LTC services.
(3)
When an
individual has requested and been determined eligible for medicaid payment of
LTC services, then the individual accumulates additional resources, the
individual continues to be eligible for medicaid payment of LTC services to the
extent that the total value of all disregarded resources does not exceed the
individual's QLTCP disregard plus the applicable resource limit.
(4) A QLTCP disregard cannot reduce patient
liability or cost of care.
(5)
Proof of the amount of QLTCP benefits paid on behalf of
the individual who is applying for or receiving medical assistance must be
provided to the administrative agency to verify the amount of the resource
disregard.
(6)
The QLTCP disregard is only available to the individual
on whose behalf the qualifying QLTCP benefits were paid.
(E) Improper transfers of assets,
as described in rule
5160:1-6-06 of the
Administrative Code, are treated as follows when there is a QLTCP disregard.
(1)
When an individual
becomes eligible for medicaid payment of LTC services through the application
of a QLTCP disregard, then the individual makes a transfer of disregarded assets
that would otherwise be considered an improper transfer, no restricted medicaid
coverage period (RMCP) applies. The disregarded
value of the transferred asset continues to be considered part of the
individual's QLTCP disregard.
(2)
When an
individual becomes eligible for medicaid payment of LTC services through the
application of a QLTCP disregard after making a transfer that would otherwise
be considered an improper transfer:
(a)
When the
value of the individual's remaining countable assets plus the value of the
transferred assets is less than or equal to the individual's QLTCP disregard
plus the applicable resource limit, no RMCP applies.
The disregarded value of the transferred asset is considered part of the
individual's QLTCP disregard.
(b)
When the
value of the individual's remaining countable assets plus the value of the
transferred assets is greater than the individual's QLTCP disregard plus the
applicable resource limit:
(i) The
individual's remaining QLTCP disregard is determined by adding the individual's
original QLTCP disregard amount to the applicable resource limit, then
subtracting the individual's current countable resources and any amounts that
had previously been transferred without an
RMCP as a result of a QLTCP disregard.
(ii) The individual's remaining QLTCP
disregard is subtracted from the amount that would otherwise have been
considered improperly transferred. The difference is the amount improperly
transferred; an
RMCP is calculated for
the difference in accordance with rule
5160:1-6-06.5 of the
Administrative Code.