Monday - October 13, 2008 _________________Providing Aide to Those in Nursing or Assisted Living Homes in North Dakota

Senator Seymour,



While there are general eligibility requirements for Medicaid in the North Dakota Century Code, due to the complexity of calculating all the possible income and asset criteria, the specific asset and income requirements are contained in the Department of Human Services’ administrative rules. Earlier this week I sent you information regarding disqualifying transfers and medical assistance (Medicaid) eligibility.



Here are the North Dakota Century Code sections regarding medicaid eligibility:





50-24.1-02.6. Medical assistance benefits - Eligibility criteria.





1. The department shall provide medical assistance benefits to otherwise eligible persons who are:



a. Medically needy persons who have countable income that does not exceed an amount determined under subsection 2; and



b. Minors who have countable income that does not exceed an amount determined under subsection 3.



2. The department of human services shall establish an income level for medically needy persons at an amount, no less than required by federal law, that, consistent with the requirements of subsection 3, is the greatest income level achievable without exceeding legislative appropriations for that purpose.



3. The department of human services shall establish income levels for minors, based on the age of the minors, at amounts, no less than required by federal law, that provide an income level for all minors born before September 30, 1983, equal to one hundred percent of the federal poverty level in the month for which eligibility for medical assistance benefits is being determined and that do not exceed legislative appropriations for that purpose.



4. The department of human services shall provide medical assistance benefits to children and families coverage groups and pregnant women without consideration of assets.





50-24.1-22. Long-term care facility information.





A long-term care facility may request that an applicant for admission, a resident of the facility, or the applicants or residents legal representative furnish financial information regarding income and assets, including information regarding any transfers or assignments of income or assets. A long-term care facility may deny admission to an applicant for admission who is unable to verify a viable payment source.



Source. S.L. 2005, ch. 431, 1.



50-24.1-23. Long-term care facility resident - Medical assistance eligibility.





An individual is not ineligible for medical assistance if application of disqualifying transfer provisions would deprive the individual of nursing care and services and the individual makes a satisfactory showing that:



1. For periods after the return, all income or assets constituting the disqualifying transfer have been transferred or assigned back to the individual and the individual is otherwise eligible for medical assistance; or



2. Compensation equal to the fair market value of the income or asset at time of transfer is paid to, or on behalf of, the individual for nursing care and services provided by a long-term care facility and the individual is otherwise eligible for medical assistance.



Source. S.L. 2005, ch. 431, 1.



Here is a link to information provided by the Department of Human Services regarding Medicaid eligibility:



http://www.nd.gov/dhs/services/medicalserv/medicaid/eligible.html





I hope this information is helpful to your constituent