Sec. 17b-261. (Formerly Sec. 17-134b). Medicaid. Eligibility. Assets. Waiver from federal law.
Sec. 17b-261. (Formerly Sec. 17-134b). Medicaid. Eligibility. Assets. Waiver
from federal law. (a) Medical assistance shall be provided for any otherwise eligible
person whose income, including any available support from legally liable relatives and
the income of the person's spouse or dependent child, is not more than one hundred forty-three per cent, pending approval of a federal waiver applied for pursuant to subsection (d)
of this section, of the benefit amount paid to a person with no income under the temporary
family assistance program in the appropriate region of residence and if such person is
an institutionalized individual as defined in Section 1917(c) of the Social Security Act,
42 USC 1396p(c), and has not made an assignment or transfer or other disposition of
property for less than fair market value for the purpose of establishing eligibility for
benefits or assistance under this section. Any such disposition shall be treated in accordance with Section 1917(c) of the Social Security Act, 42 USC 1396p(c). Any disposition
of property made on behalf of an applicant or recipient or the spouse of an applicant or
recipient by a guardian, conservator, person authorized to make such disposition pursuant to a power of attorney or other person so authorized by law shall be attributed to
such applicant, recipient or spouse. A disposition of property ordered by a court shall
be evaluated in accordance with the standards applied to any other such disposition for
the purpose of determining eligibility. The commissioner shall establish the standards
for eligibility for medical assistance at one hundred forty-three per cent of the benefit
amount paid to a family unit of equal size with no income under the temporary family
assistance program in the appropriate region of residence. Except as provided in section
17b-277, the medical assistance program shall provide coverage to persons under the
age of nineteen with family income up to one hundred eighty-five per cent of the federal
proverty level without an asset limit and to persons under the age of nineteen and their
parents and needy caretaker relatives, who qualify for coverage under Section 1931 of
the Social Security Act, with family income up to one hundred eighty-five per cent of
the federal poverty level without an asset limit. Such levels shall be based on the regional
differences in such benefit amount, if applicable, unless such levels based on regional
differences are not in conformance with federal law. Any income in excess of the applicable amounts shall be applied as may be required by said federal law, and assistance shall
be granted for the balance of the cost of authorized medical assistance. All contracts
entered into on and after July 1, 1997, pursuant to this section shall include provisions
for collaboration of managed care organizations with the Nurturing Families Network
established pursuant to section 17a-56. The Commissioner of Social Services shall provide applicants for assistance under this section, at the time of application, with a written
statement advising them of (1) the effect of an assignment or transfer or other disposition
of property on eligibility for benefits or assistance, (2) the effect that having income
that exceeds the limits prescribed in this subsection will have with respect to program
eligibility, and (3) the availability of, and eligibility for, services provided by the Nurturing Families Network established pursuant to section 17a-56. Persons who are determined ineligible for assistance pursuant to this section shall be provided a written statement notifying such persons of their ineligibility and advising such persons of the
availability of HUSKY Plan, Part B health insurance benefits.
(b) For the purposes of the Medicaid program, the Commissioner of Social Services
shall consider parental income and resources as available to a child under eighteen years
of age who is living with his or her parents and is blind or disabled for purposes of the
Medicaid program, or to any other child under twenty-one years of age who is living
with his or her parents.
(c) For the purposes of determining eligibility for the Medicaid program, an available asset is one that is actually available to the applicant or one that the applicant has
the legal right, authority or power to obtain or to have applied for the applicant's general
or medical support. If the terms of a trust provide for the support of an applicant, the
refusal of a trustee to make a distribution from the trust does not render the trust an
unavailable asset. Notwithstanding the provisions of this subsection, the availability of
funds in a trust or similar instrument funded in whole or in part by the applicant or the
applicant's spouse shall be determined pursuant to the Omnibus Budget Reconciliation
Act of 1993, 42 USC 1396p. The provisions of this subsection shall not apply to special
needs trust, as defined in 42 USC 1396p(d)(4)(A).
(d) The transfer of an asset in exchange for other valuable consideration shall be
allowable to the extent the value of the other valuable consideration is equal to or greater
than the value of the asset transferred.
(e) The Commissioner of Social Services shall seek a waiver from federal law to
permit federal financial participation for Medicaid expenditures for families with incomes of one hundred forty-three per cent of the temporary family assistance program
payment standard.
(f) To the extent permitted by federal law, Medicaid eligibility shall be extended
for one year to a family that becomes ineligible for medical assistance under Section
1931 of the Social Security Act due to income from employment by one of its members
who is a caretaker relative or due to receipt of child support income. A family receiving
extended benefits on July 1, 2005, shall receive the balance of such extended benefits,
provided no such family shall receive more than twelve additional months of such benefits.
(g) An institutionalized spouse applying for Medicaid and having a spouse living
in the community shall be required, to the maximum extent permitted by law, to divert
income to such community spouse in order to raise the community spouse's income to
the level of the minimum monthly needs allowance, as described in Section 1924 of the
Social Security Act. Such diversion of income shall occur before the community spouse
is allowed to retain assets in excess of the community spouse protected amount described
in Section 1924 of the Social Security Act. The Commissioner of Social Services, pursuant to section 17b-10, may implement the provisions of this subsection while in the
process of adopting regulations, provided the commissioner prints notice of intent to
adopt the regulations in the Connecticut Law Journal within twenty days of adopting
such policy. Such policy shall be valid until the time final regulations are effective.
(h) Medical assistance shall be provided, in accordance with the provisions of subsection (e) of section 17a-6, to any child under the supervision of the Commissioner of
Children and Families who is not receiving Medicaid benefits, has not yet qualified for
Medicaid benefits or is otherwise ineligible for such benefits because of institutional
status. To the extent practicable, the Commissioner of Children and Families shall apply
for, or assist such child in qualifying for, the Medicaid program.
(i) The Commissioner of Social Services shall provide Early and Periodic Screening, Diagnostic and Treatment program services, as required and defined as of December
31, 2005, by 42 USC 1396a(a)(43), 42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and
applicable federal regulations, to all persons who are under the age of twenty-one and
otherwise eligible for medical assistance under this section.
(1967, P.A. 759, S. 1(b); 1969, P.A. 730, S. 8; P.A. 78-192, S. 4, 7; P.A. 80-50; P.A. 81-214, S. 6; P.A. 85-505, S. 14,
21; 85-527; P.A. 86-363, S. 3; P.A. 87-390, S. 1, 4; P.A. 89-317, S. 1, 2; P.A. 92-233, S. 1; P.A. 93-262, S. 1, 87; 93-289,
S. 1-3; 93-435, S. 59, 95; May Sp. Sess. P.A. 94-5, S. 16, 30; P.A. 95-194, S. 30, 33; 95-351, S. 22, 30; P.A. 96-251, S.
9; P.A. 97-288, S. 3, 6; June 18 Sp. Sess. P.A. 97-2, S. 70, 165; October 29 Sp. Sess. P.A. 97-1, S. 19, 23; P.A. 99-279, S.
16, 45; June Sp. Sess. P.A. 00-2, S. 18, 53; June Sp. Sess. P.A. 01-2, S. 3, 69; June Sp. Sess. P.A. 01-9, S. 129, 131; P.A.
03-2, S. 10; 03-28, S. 2; 03-268, S. 7; June 30 Sp. Sess. P.A. 03-3, S. 63; P.A. 04-16, S. 6; P.A. 05-1, S. 1; 05-24, S. 1; 05-43, S. 1; 05-280, S. 1; P.A. 06-164, S. 3; 06-188, S. 49; 06-196, S. 134, 238, 289; P.A. 07-185, S. 3; June Sp. Sess. P.A.
07-2, S. 7.)
History: 1969 act deleted varying income limits and exclusions dependent upon marital status and number of dependents,
referring instead to income limits under federal law; P.A. 78-192 added provisions re increases in eligibility standards;
P.A. 80-50 added Subsec. (b); P.A. 81-214 added provisions re effect of transfer of property on eligibility for benefits in
Subsec. (a); P.A. 85-505 amended Subsec. (a) to allow the extension of benefits for 6 months for former recipients; P.A.
85-527 amended Subsec. (a) by replacing "the minimum income permissible under federal law" with 120% "of the standard
of need"; P.A. 86-363 included children under 18 years of age who are living with their parents and are blind or disabled
in group for which parental income shall be considered under Subsec. (b); P.A. 87-390 changed the limit from 120% to
133%, added language on division of property and transfer of the interest in a house between spouses, and added requirement
for a written statement advising applicants of the effect of an assignment, transfer or other disposition of property on
eligibility; P.A. 89-317 amended Subsec. (a) to require that a person be institutionalized, as defined in the Social Security
Act, to be eligible for medical assistance, changed the time from which a transfer of assets will be permitted from 24
months to 30 months prior to the date of application and 30 months prior to the date of institutionalization and to require
treatment of any disposition of assets in accordance with Section 1917 (c) of the Social Security Act, 42 U.S.C. 1396p (c);
P.A. 92-233 amended Subsec. (a) by adding provisions re attribution of property disposed of on behalf of an applicant or
his spouse by a guardian, conservator or authorized representative and disposition of property ordered by a court; P.A. 93-262 and 93-435 authorized substitution of commissioner and department of social services for commissioner and department
of income maintenance, effective July 1, 1993; P.A. 93-289, Sec. 1 required that the medical assistance program provide
coverage to persons under the age of 6 and Sec. 2 was added editorially by the Revisors as Subsec. (c) requiring the
department of income maintenance to submit a report, effective July 1, 1993; May Sp. Sess. P.A. 94-5 removed the time
limit on transfers of assets and extended coverage to children under the age of 19 born after September 30, 1983, rather
than children under 6, effective July 1, 1994; Sec. 17-134b transferred to Sec. 17b-261 in 1995; P.A. 95-194 amended
Subsec. (a) by changing the eligibility for medical assistance from an income which is not more than 133% of the standard
of need established pursuant to Sec. 17b-104 to an income which is not more than 142% of the benefit amount paid to a
person with no income under the AFDC program in the appropriate region of residence and by requiring the commissioner
to establish the standards for eligibility for medical assistance at 133% of the benefit amount paid to a family unit of equal
size with no income under the AFDC program in the appropriate region of residence, added Subdiv. (d) requiring the
commissioner to seek a waiver to permit federal financial participation for Medicaid expenditures and made technical
changes, effective July 1, 1995; P.A. 95-351 replaced 142% with 143% as the highest allowable percentage of income for
the provision of medical assistance and made a technical change, effective July 1, 1995; P.A. 96-251 amended Subsec. (c)
by requiring that on and after October 1, 1996, reports be submitted to the legislative committee on human services and
to legislators upon request and by adding provisions re submission of report summaries to legislators; P.A. 97-288 amended
Subsec. (a) to require that contracts entered into after July 1, 1997, include provisions for collaboration of managed care
organizations with the program established under Sec. 17a-56, effective July 1, 1997; June 18 Sp. Sess. P.A. 97-2 amended
Subsec. (a) by extending Medicaid coverage, on and after July 1, 1998, from persons under the age of 19 born after September
30, 1983, to persons under the age of 19 born after September 30, 1981, or if possible, within available appropriations, born
after June 30, 1980, with family income up to 185% of the federal poverty level without an asset limit, replaced references
to aid to families with dependent children with temporary family assistance, and made technical and conforming changes,
effective July 1, 1997; Oct. 29 Sp. Sess. P.A. 97-1 amended Subsec. (a) to provide that on and after January 1, 1998, the
medical assistance program shall provide coverage to persons under the age of 19 and deleted reference to "born after June
30, 1981, or if possible within available appropriations, born after June 30, 1980", effective October 30, 1997; P.A. 99-279 amended Subsec. (a) to require extension of coverage under the medical assistance program to parents of children
enrolled in the HUSKY Plan, Part A and to their needy caretaker relatives who qualify for coverage under Section 1931
of the Social Security Act and made technical changes, effective July 1, 2000; June Sp. Sess. P.A. 00-2 amended Subsec.
(a) by deleting "born after September 30, 1981," changing "July 1, 2000," to "January 1, 2001," changing the family
income level for eligibility for medical assistance from 185% to 150% of federal poverty level, and adding provision re
providing coverage upon the request of a person or upon a redetermination of eligibility, effective July 1, 2000; June Sp.
Sess. P.A. 01-2 made technical changes for purposes of gender neutrality in Subsec. (b), added new Subsecs. (c) and (d)
re availability and transfer of assets, and redesignated existing Subsecs. (c) and (d) as Subsecs. (e) and (f), effective July
1, 2001; June Sp. Sess. P.A. 01-9 revised effective date of June Sp. Sess. P.A. 01-2 but without affecting this section; P.A.
03-2 amended Subsec. (a) by making a technical change and changing family income eligibility limit for parents and needy
caretaker relatives who qualify for medical assistance program coverage under Section 1931 of the Social Security Act
from 150% of the federal poverty limit to 100% of the federal poverty limit, and added new Subsec. (g), redesignated by
the Revisors as new Subsec. (f), re ineligibility on or after April 1, 2003, of all parent and needy caretaker relatives with
incomes exceeding 100% of the federal poverty level, effective February 28, 2003; P.A. 03-28 added new Subsec. (g) re
extended Medicaid eligibility; P.A. 03-268 deleted former Subsec. (e) re submission of annual report to General Assembly
re children receiving Medicaid services and doctors and dentists participating in state or municipally-funded programs
and redesignated existing Subsec. (f) as Subsec. (e); June 30 Sp. Sess. P.A. 03-3 added new Subsec. (h) requiring an
institutionalized spouse applying for Medicaid, who has a spouse living in the community, to divert income to the community spouse so as to raise the community spouse's income to the level of the minimum monthly needs allowance described
in Section 1924 of the Social Security Act, effective August 20, 2003; P.A. 04-16 amended Subsec. (g) by adding "one of
its members who is a caretaker relative is" re extended Medicaid eligibility and making a technical change; P.A. 05-1
added Subsec. (i) which extended transitional Medicaid benefits until June 30, 2005, for certain individuals who were to
lose coverage between March 31, 2005, and May 31, 2005, effective March 10, 2005; P.A. 05-24 added new Subsec. (i)
re provision of Medicaid coverage to a child under the supervision of the Commissioner of Children and Families, effective
July 1, 2005; P.A. 05-43 amended Subsec. (g) by eliminating "or a family with an adult who, within 6 months of becoming
ineligible under Section 1931 of the Social Security Act becomes employed", effective July 1, 2005; P.A. 05-280 amended
Subsec. (a) by increasing family income limit re eligibility determinations for medical assistance for parents and needy
caretakers of persons under the age of 19 from 100% to 150% of federal poverty level, deleted former Subsec. (f) re
ineligibility for medical assistance for parents and needy caretaker relatives with incomes exceeding 100% of federal
poverty level, redesignated Subsecs. (g) and (h) as Subsecs. (f) and (g), amended redesignated Subsec. (f) to reduce period
of transitional medical assistance from 2 years to 1 year, add provision re extension of assistance to family that becomes
ineligible "due to income from employment by" one of its members and provide that family receiving extended benefits
"shall receive the balance of such extended benefits, provided no such family shall receive more than 12 additional months
of such benefits", deleted former Subsec. (i) which had extended transitional medical assistance to June 30, 2005, for
certain individuals and added new Subsec. (h) re cost sharing requirements under the HUSKY Plan, effective July 1, 2005;
P.A. 06-164 amended Subsec. (a) to substitute "Nurturing Families Network" for "Healthy Families Connecticut Program",
insert Subdiv. (1) designator and insert Subdiv. (2) re written statement on services provided by the Nurturing Families
Network, effective July 1, 2006; P.A. 06-188 added Subsec. (j) re requirement to provide Early and Periodic Screening,
Diagnostic and Treatment program services, as required by federal law, to persons under age 21 who are otherwise eligible
for medical assistance, effective July 1, 2006; P.A. 06-196 made a technical change in Subsecs. (a) and (f), effective June
7, 2006, and inserted "and defined as of December 31, 2005," and made a technical change in Subsec. (j), effective July
1, 2006; P.A. 07-185 amended Subsec. (a) by increasing, except as provided in Sec. 17b-277, family income limits used
to determine eligibility for medical assistance for parents and needy caretaker relatives of persons under the age of 19 from
150% of federal poverty level to 185% of federal poverty level, by providing that commissioner shall advise applicants in
writing of effect that having income in excess of program limits will have with respect to program eligibility and availability
of HUSKY Plan, Part B benefits for persons determined not eligible for medical assistance, and by making conforming
changes, effective July 1, 2007; June Sp. Sess. P.A. 07-2 amended Subsec. (a) by requiring that medical assistance coverage
be provided to persons under 19 with family income up to 185% of federal poverty level without an asset limit, by deleting
provision requiring that commissioner, at the time application for assistance is made, provide a written statement re availability of HUSKY Plan, Part B, health insurance benefits to persons not eligible for assistance, and by adding provision
requiring that commissioner provide written statement at the time a person is determined ineligible for assistance, deleted
former Subsec. (h) re commissioner's authority to impose cost sharing requirements on parents and needy caretakers with
incomes in excess of 100% of federal poverty level, and redesignated existing Subsecs. (i) and (j) as Subsecs. (h) and (i),
effective July 1, 2007.
Annotations to former section 17-134b:
Cited. 168 C. 336. Since disclaimer is invalid state may reassess eligibility for assistance. 179 C. 463. Cited. 199 C.
524. Cited. 204 C. 17; Id., 672. Cited. 216 C. 85.
Welfare commissioner is obligated to provide medical assistance for any otherwise eligible person whose income is
not more than minimum income permissible under federal law for such eligibility. 34 CS 525. State regulation on Medicaid
abortion funding is contrary to statutory provision. 40 CS 394.
Annotation to present section:
Cited as "17b-260 et seq. (providing for supplemental medical assistance)". 233 C. 557.