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1994 SESSION

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HB 1323 Spousal support orders and eligibility for medical assistance.

Introduced by: Robert S. Bloxom | all patrons    ...    notes | add to my profiles

SUMMARY:

Spousal support orders and eligibility for medical assistance services. Establishes criteria and definitions to guide courts in entering spousal support orders when the order will have the effect of rendering either spouse eligible for medical assistance services or for accelerating eligibility for medical assistance services.

Prior to entering any such order, the court will be required to determine that an institutionalized spouse makes available the maximum allowable income contribution (as currently set in Medicaid law) to the community spouse ( i.e., the non-institutionalized spouse). If the community spouse alleges that more then the maximum allowable income contribution is needed for maintenance because of exceptional circumstances resulting in significant financial duress, the court may order an additional amount of the couple's resources to be transferred to the community spouse in order to generate that needed amount of additional income.

When the court decides to enter a spousal support order, the amount of additional resources to be allowed to the community spouse to generate the court-established income must be the greater of (i) the resources necessary to generate monthly income to the community spouse in an amount sufficient to increase the community spouse's income to the court-established monthly income allowance, based on the current earnings of the resources, or (ii) the amount necessary to purchase a single premium annuity that would generate monthly income to the community spouse in an amount sufficient to increase the community spouse's income to the court-established monthly income allowance. Definitions of institutionalized spouse, community spouse, and significant financial duress are provided.

Whenever a Medicaid eligibility determination is made for a married individual placed in a nursing home or receiving home and community-based long-term care, a resource assessment must be conducted, i.e., a calculation of the money and property owned by the couple at the time the individual began receiving long-term care services. All resources are counted, except for the home, all adjoining property, all household goods, and one automobile.

The community spouse is allowed to keep all of the couple's resources up to $14,532. If the couple's combined resources exceed $14,532, but are less than $145,320, the community spouse may keep one-half of all resources, up to a maximum of $72,660. All resources over the $145,320 limit plus the institutionalized spouse's one-half share up to the limit ($72,660 or one-half of $145,320) are counted as available resources when determining Medicaid eligibility for the institutionalized spouse.

In a number of instances, courts have been requested to enter spousal support orders for the community spouses that require the transfer of additional resources over the Medicaid allowances to the community spouse. In determining the amount of additional resources to transfer, courts have, in some cases, approved additional amounts based upon very low earning rates for various valuable property, e.g., three percent. Virginia courts have entered support orders upon community spouse petitions for resource allowances ranging from $145,000 to more than $250,000.


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