HF 476 (LSB 1170HV (1) 85)

HOUSE FILE 476

BY  COMMITTEE ON HUMAN RESOURCES

(SUCCESSOR TO HSB 47)

A BILL FOR

An Act relating to the transfer of assets under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 249F.1, Code 2013, is amended by adding the following new subsection:
   NEW SUBSECTION.  01.
  a.  “Fair consideration” means full and adequate consideration which is, under all circumstances, equivalent to the value of the property transferred and which is honest, reasonable, and free of suspicion. A determination of fair consideration is separate and distinct from and independent and exclusive of any prior value determination relating to the medical assistance application or ongoing medical assistance participation of the transferor.
   b.  For the purposes of determining fair consideration in transfers of a life estate or remainder interests, the determination shall be made in accordance with rules adopted by the department of human services pursuant to chapter 17A.  The rules shall specify the computation to be utilized in such determination, which shall be based on the program operations manual system life estate table published by the United States social security administration, and shall not include subjective considerations such as the health and personal circumstances of the life estate holder.
    Sec. 2.  Section 249F.1, subsection 2, paragraph a, Code 2013, is amended to read as follows:
   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
 
within five years prior to the application for medical assistance by the transferor, while the transferor is receiving medical assistance, or within five years prior to application for medical assistance by the transferor
 
after the transferor is no longer receiving medical assistance but has an existing medical assistance debt. 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”.
    Sec. 3.  Section 249F.1, subsection 2, paragraph b, subparagraph (5), Code 2013, is amended by striking the subparagraph.
    Sec. 4.  Section 249F.2, Code 2013, is amended to read as follows:
   249F.2  Creation of debt.
   A transfer of assets creates a debt due and owing to the department of human services from the transferee in an amount equal to medical assistance provided to or on behalf of the transferor, on or after the date of the transfer of assets, but not exceeding the fair market value of
 
consideration of the assets at the time of the transfer.
EXPLANATION
   This bill relates to transfers of assets under the medical assistance (Medicaid) program.
   The bill defines “fair consideration” for the purposes of determining whether an asset was transferred for less than the fair consideration amount.
   The bill amends the definition of “transfer of asset” to include a transfer made after the transferor is no longer receiving Medicaid, but has an existing Medicaid debt.
   The bill eliminates, as an exception to the definition of a “transfer of asset”, transfers of less than $2,000 on an aggregated basis during the five-year period prior to application for medical assistance by the transferor.