Look-Back Date and Look-Back Period
3258. TRANSFERS OF ASSETS FOR LESS THAN FAIR MARKET VALUE
3258.4 Look-Back Date and Look-Back Period.--The look-back
date is the earliest date on which a penalty for transferring
assets for less than fair market value can be assessed. Penalties can be
assessed for transfers which take place on or after the look-back date.
Penalties cannot be assessed for transfers which take place prior to the
look-back date. The look-back date varies for individuals transferring
assets, depending on whether they are institutionalized, and there are
special rules for some trusts, as described in subsection E.
A. Institutionalized Individual.-- For an individual in an
institution, the look-back date is 36 months prior to the baseline date.
The baseline date is the first date as of which the individual was:
o Institutionalized; and,
o Applied for medical assistance under the State plan.
When an individual is already a Medicaid recipient and becomes
institutionalized, the baseline date is the date upon which both of the
above conditions are met, that is, the first day of
institutionalization.
B. Noninstitutionalized Individual.--For a
noninstitutionalized individual, the look-back date is 36 months prior
to the baseline date, which is the date the individual:
o Applies for medical assistance under the State plan;
or, if later,
o The date on which the individual disposes of assets for less
than fair market value.
C. Multiple Periods of Institutionalization and Multiple
Applications.--When an individual has multiple periods of
institutionalization or has made multiple applications for Medicaid
(whether or not they are successful), the look-back date is based on a
baseline date that is the first date upon which the individual
has both applied for Medicaid and is institutionalized. Similarly, if a
noninstitutionalized individual has applied for Medicaid more than once
and has made more than one transfer of assets, the baseline date is that
date on which the individual has first applied for Medicaid or, if
later, made the first transfer of assets for less than fair market value
after applying. Thus, each individual has only one look-back date,
regardless of the number of periods of institutionalization,
applications for Medicaid, periods of eligibility, or transfers of
assets.
D. Look-Back Period.--The look-back period is the
period that begins with the look-back date and ends with the baseline
date. This can be 36 or 60 months, depending on whether certain kinds of
trusts are involved. (See subsection E for look-back periods involving
trusts.) The look-back period is the period of time prior to the
baseline date during which a previous transfer of assets for less than
fair market value can be penalized. However, it is important to note
that transfers which occur after the baseline date are also subject to
penalty if they are made for less than fair market value.
NOTE: The 36 month look-back periods described above do not become
fully effective until August 11, 1996. Prior to that date, a
36 month look-back period actually begins at some time
before the date transfers are covered by these rules. While
the 36 month look-back period is effective for transfers
made on or after August 11, 1993, any transfers actually
made before that date are treated under the rules described
in §3250. Thus, the look-back period is phased in over the
36-month period ending August 11, 1996.
EXAMPLE 1: Institutionalized Individual
An individual is institutionalized on February 13, 1997. He/she applies
for Medicaid on April 7, 1997. The look-back date is the date 36 months
prior to the baseline date, when both initiating requirements are met,
i.e., institutionalization and application for Medicaid. That
date is April 7, 1997. Thus, the look-back date is April 7, 1994. The
look-back period is from April 7, 1994, through April 7, 1997.
EXAMPLE 2: Institutionalized Individual
An individual is institutionalized on February 13, 1995. He/she applies
for Medicaid on April 7, 1995. The look-back date is 36 months prior to
April 7, 1995, or April 7, 1992. However, because the transfer
provisions of OBRA 1993 apply only to transfers made on or after August
11, 1993, any transfers made prior to August 11, 1993, are treated under
the rules in §3250.
EXAMPLE 3: Noninstitutionalized Individual
An individual applies for Medicaid on February 13, 1997. On April 7,
1997, he/she transfers an asset for less than fair market value. The
look-back date in this case is April 7, 1994, 36 months prior to the
baseline date on which he/she transferred the asset. If the asset had
been transferred before February 13, 1997 (the date of application for
Medicaid), the baseline date would have been February 13, 1997 (the date
of application). The look-back period would begin February 13, 1994, and
extend to February 13, 1997.
E. Look-Back Period for Transfers of Assets Involving
Trusts.--When an individual establishes a revocable trust a portion
of which is disbursed to someone other than the grantor or for the
benefit of the grantor, that portion is treated as a transfer of assets
for less than fair market value. When an individual establishes an
irrevocable trust in which all or a portion of the trust cannot be
disbursed to or on behalf of the individual, that portion is treated as
a transfer of assets for less than fair market value. When a portion of
a trust is treated as a transfer, the look-back period discussed in
subsection D is extended to 60 months from:
o The date the individual applied for Medicaid and was
institutionalized; or,
o For a noninstitutionalized individual, the date the individual
applied for Medicaid or, if later, the date the transfer was made.
When a trust is irrevocable but some or all of the trust can be
disbursed to or for the benefit of the individual, the look-back period
applying to disbursements which could be made to or for the individual
but are made to another person or persons is 36 months.
When the trust is revocable, the transfer is considered to take place on
the date upon which the payment to someone other than the grantor was
made. If the trust is irrevocable, the transfer is considered to have
been made as of the date the trust was established or, if later, the
date upon which payment to the grantor was foreclosed.
When an individual places assets into an irrevocable trust and can still
benefit from those assets, the amount transferred is any of those assets
which have been paid out for a purpose other than to or for the benefit
of the individual. When an individual places assets in an irrevocable
trust and can no longer benefit from some or all of those assets, that
unavailable portion of the trust is considered as transferred for less
than fair market value. The value of these assets is not reduced by any
payments from the trust which may be made from these unavailable assets
at a later date.
See §§3259ff. for a discussion of treatment of trusts in determining
eligibility for Medicaid.
See §3259.6 for rules which apply when assets which may involve a
transfer of assets for less than fair market value are placed in a
trust.