As used in this chapter, unless the context otherwise requires:
1.“Department” means the department of health and human services.
2.“Medical assistance” means “mandatory medical assistance”, “optional medical
assistance”, “discretionary medical assistance”, or “Medicare cost sharing” as each is defined
in section 249A.2 which is provided to an individual pursuant to chapter 249A and Tit. XIX
of the federal Social Security Act.
3.
a.“Transfer of assets” means any transfer or assignment of a legal or equitable
interest in property, as defined in section 702.14, from a transferor to a transferee for less
than fair consideration, made while the transferor is receiving medical assistance or within
five years prior to application for medical assistance by the transferor. Any such transfer or
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As used in this chapter, unless the context otherwise requires:
1. “Department” means the department of health and human services.
2. “Medical assistance” means “mandatory medical assistance”, “optional medical
assistance”, “discretionary medical assistance”, or “Medicare cost sharing” as each is defined
in section 249A.2 which is provided to an individual pursuant to chapter 249A and Tit. XIX
of the federal Social Security Act.
3. a. “Transfer of assets” means any transfer or assignment of a legal or equitable
interest in property, as defined in section 702.14, from a transferor to a transferee for less
than fair consideration, made while the transferor is receiving medical assistance or within
five years prior to application for medical assistance by the transferor. Any such transfer or
assignment is presumed to be made with the intent, on the part of the transferee; transferor;
or another person acting on behalf of a transferor who is an actual or implied agent,
guardian, attorney-in-fact, or person acting as a fiduciary, of enabling the transferor to
obtain or maintain eligibility for medical assistance or of impacting the recovery or payment
of a medical assistance debt. This presumption is rebuttable only by clear and convincing
evidence that the transferor’s eligibility or potential eligibility for medical assistance or the
impact on the recovery or payment of a medical assistance debt was no part of the reason of
the transferee; transferor; or other person acting on behalf of a transferor who is an actual
or implied agent, guardian, attorney-in-fact, or person acting as a fiduciary for making or
accepting the transfer or assignment. A transfer of assets includes a transfer of an interest
in the transferor’s home, domicile, or land appertaining to such home or domicile while the
transferor is receiving medical assistance, unless otherwise exempt under paragraph “b”.
b. However, transfer of assets does not include the following:
(1) Transfers to or for the sole benefit of the transferor’s spouse, including a transfer to
a spouse by an institutionalized spouse pursuant to section 1924(f)(1) of the federal Social
Security Act.
(2) Transfers to or for the sole benefit of the transferor’s child who is blind or has a
disability as defined in section 1614 of the federal Social Security Act.
(3) Transfer of a dwelling, which serves as the transferor’s home as defined in 20 C.F.R.
§416.1212, to a child of the transferor under twenty-one years of age.
(4) Transfer of a dwelling, which serves as the transferor’s home as defined in 20 C.F.R.
§416.1212, after the transferor is institutionalized, to either of the following:
(a) A sibling of the transferor who has an equity interest in the dwelling and who was
residing in the dwelling for a period of at least one year immediately prior to the date the
transferor became institutionalized.
(b) A child of the transferor who was residing in the dwelling for a period of at least two
years immediately prior to the date the transferor became institutionalized and who provided
care to the transferor which permitted the transferor to reside at the dwelling rather than in
an institution or facility.
(5) Transfers of less than two thousand dollars. However, all transfers by the same
transferor during the five-year period prior to application for medical assistance by the
transferor shall be aggregated. If a transferor transfers property to more than one transferee
during the five-year period prior to application for medical assistance by the transferor, the
two thousand dollar exemption shall be divided equally between the transferees.
§249F.1, TRANSFER OF ASSETS — MEDICAL ASSISTANCE DEBT 2
(6) Transfers of assets that would, at the time of the transferor’s application for medical
assistance, have been exempt from consideration as a resource if retained by the transferor,
pursuant to 42 U.S.C. §1382b(a), as implemented by regulations adopted by the secretary of
the United States department of health and human services, excluding the home and land
appertaining to the home.
(7) Transfers to a trust established solely for the benefit of the transferor’s child who is
blindorpermanentlyandtotallydisabledasdefinedinthefederalSocialSecurityAct, section
1614, as codified in 42 U.S.C. §1382c.
(8) Transfers to a trust established solely for the benefit of an individual under sixty-five
years of age who is disabled, as defined in the federal Social Security Act, section 1614, as
codified in 42 U.S.C. §1382c.
4. “Transferee” means the person who receives a transfer of assets.
5. “Transferor” means the person who makes a transfer of assets.