Potential Redetermination When Moving to a New State

In Dullard v. Minnesota Department of Human Services, 529 N.W.2d 438, 443 (Minn. App. 1995), Minnesota was allowed to reevaluate eligibility after a couple moved from Illinois to Minnesota. There, Illinois (like Georgia) allowed the Community Spouse to keep the maximum CSRA, while Minnesota (like Tennessee) applied a formula resulting in a lower CSRA. The Minnesota Court concluded “the correct interpretation of the statute is that when an institutionalized spouse moves from another state to Minnesota during a continuous period of institutionalization, Minnesota may conduct its own asset assessment, but that it may only consider the assets of the couple as of the first continuous period of institutionalization in the other state.” The State Medicaid Manual is inconclusive in determining whether this was the correct approach. State Medicaid Manual § 3262.2(A) appears to preclude reevaluation, which State Medicaid Manual § 3262.6 appears to permit it.

In one case we litigated, Greenhouse v. Dep’t, a Georgia nursing home resident moved to Tennessee. Georgia allows the Community Spouse to keep the maximum Community Spouse Resource Allowance, but Tennessee does not. When the resident was moved from a Georgia facility to a Tennessee facility, eligibility was redetermined and denied. After eligibility had been established in Georgia, the Community Spouse invested a portion of her CSRA in a limited offering/private placement that could not be sold. Unfortunately, Tennessee determined the couple was over-resourced and denied eligibility. On appeal, the Commissioner’s designee found there was no intent to transfer the resource for less than fair market value because, at the time of the transaction, it was not contemplated that the resident would be admitted to a Tennessee facility. Although this case was won, it demonstrates obsticles that arise when Medicaid residents cross state lines.

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