Eligibility Policy Manual

Transmittal #46

Subject: Partial Transfer Penalty Periods

Implementation Date: October 1, 2007

When determining the period of ineligibility for an uncompensated transfer, the amount of the transfer is divided by the private pay rate to get full months of ineligibility for long term care services.  Currently, fractional amounts are dropped and there are no partial months of ineligibility.

The Deficit Reduction Act of 2005 requires the States to impose partial (or fractional) months of ineligibility due to uncompensated transfers.

This change in policy is effective with all uncompensated transfers that are made on or after October 1, 2007.

For uncompensated transfers that are made on or after October 1, 2007, a partial month penalty period is assessed based on the carry-over amount of the transfer. In addition, a prorated share of cost is determined based on the number of days in the partial month that a customer is eligible for full ALTCS policy.

The manual is revised to incorporate these changes as follows:

MS 907.00.A (Transfer Penalty Overview) is revised to add that for transfers made on or after October 1, 2007, the penalty period may end in a partial month of ineligibility for long term care services.

MS 907.03, formerly titled Private Pay Rate, is now titled Partial Month Penalties for Transfers Made On or After October 1, 2007 and a new MS 907.04 now provides information about the private pay rates.

MS 907.03 provides detailed information on how to calculate the partial month penalty period (i.e., determining the number of days of ineligibility based on the carry-over amount) and how to calculate the prorated share of cost for the days of eligibility in the partial month.

Please note that ACE is not programmed at this time to:

• Determine the partial month period of ineligibility for long term care services
• Notify the customer and/or representative of the penalty period
•  Post the partial month's period of ineligibility (period in which the customer is eligible for ALTCS acute care services only) to PMMIS
• Calculate and override the share of cost for the number of days the customer is eligible for full long term care benefits during the partial month

ACE will continue to determine the period of ineligibility by dropping the carry-over amount.

Therefore, manual processes need to be followed using the Partial Month and Share of Cost Worksheet, DE-118.

For detailed instructions on how to process partial transfer penalty months, see How to Process Partial Transfer Penalty Months.

If you have any questions regarding this transmittal, please contact Dan McKeever at 602-417-4455 or Mary Coons at 602-417-4136.