Section 7 AAC 100.604 - Recognized Medicaid trusts(a) The following three types of recognized Medicaid trusts are exceptions to the general trust requirements in 7 AAC 100.602 for trusts: (1) a qualifying income trust authorized under 42 U.S.C. 1396 p(d)(4)(B) that meets the requirements of 7 AAC 100.610;(2) a special needs trust authorized under 42 U.S.C. 1396 p(d)(4)(A) that meets the requirements of 7 AAC 100.612;(3) a pooled trust authorized under 42 U.S.C. 1396 p(d)(4)(C) that meets the requirements of 7 AAC 100.614.(b) An applicant or recipient must submit a recognized Medicaid trust document to the department for review and approval before the department determines Medicaid eligibility. To be approved by the department, in addition to meeting the applicable requirements of 7 AAC 100.610, 7 AAC 100.612, or 7 AAC 100.614, the trust document must (1) cite the federal statute listed in (a) of this section applicable to the type of trust;(2) state that at the time the trust is funded, the applicant or recipient will be either under 65 years of age or 65 years of age or older, as applicable;(3) for a special needs or pooled trust, identify the date the beneficiary was last determined or redetermined blind under 7 AAC 40.140(a) or disabled under 7 AAC 40.170(a);(4) for a qualifying income trust, prohibit a person from depositing into the trust anything other than the applicant's or recipient's income;(5) prohibit the applicant or recipient from being a trustee or from having any ability, access, or authority to manage or control the trust account;(6) include a provision for reimbursing the state in accordance with 7 AAC 100.608;(7) identify the trustee, including a co-trustee;(8) identify procedures for resignation of the trustee and for designating a successor trustee, including a successor co-trustee; the procedure must require that, at least 30 days before the change, written notification of the change in trustee be sent to the beneficiary, the beneficiary's authorized representative if applicable, the department, and the court where the trust is registered; and(9) identify on each page of the trust document the person or organization that drafted the trust document.(c) If the department approves a recognized Medicaid trust, the trust and administration of the trust are subject to review by the department, upon notice, to determine whether the trust remains a valid trust for the purposes of meeting the requirements of a recognized Medicaid trust. Upon request, the trustee shall provide the department with the trust account number and the name of the financial institution holding the trust account. The department will consider a trust to be an invalid trust for the purposes of meeting the requirements of a recognized Medicaid trust if (1) the trust is not registered with a court;(2) the trust account receives or uses the assets of another person, except as provided under 7 AAC 100.614;(3) the applicant or recipient functions as the trustee or has any other ability, access, or authority to manage or control the trust account;(4) the trustee fails to provide the department with all requested information necessary to identify the trust account number and financial institution holding the trust account;(5) the trustee fails to cooperate or interferes with the department's ability to track and monitor the trust account, including failing to disclose or account for any payment from or deposit into the trust account;(6) the applicant or recipient has a cost-of-care liability under 7 AAC 100.550 - 7 AAC 100.579, but the trustee fails to make payments toward the cost-of-care liability;(7) the trustee fails to adhere to the terms of the trust as written; or(8) the trustee fails to comply with the requirements of (e) or (f) of this section.(d) If the department determines that a trust is invalid under (c) of this section, the department will redetermine the applicant's or recipient's Medicaid eligibility, applying the provisions of 7 AAC 100.600 and 7 AAC 100.602 to any existing trust.(e) If a trustee decides, consistent with the trustee's fiduciary duty, that use of a recognized Medicaid trust approved under this section is no longer needed to maintain the beneficiary's Medicaid eligibility, the trustee shall notify in writing the beneficiary, the beneficiary's authorized representative if one exists, the department, and the court where the trust is registered in writing no later than the first day of the month immediately preceding the month a trust or trust account will no longer be funded. The trustee shall keep the corpus of the trust intact until the trust is terminated and the state is reimbursed in accordance with 7 AAC 100.608. If the trustee fails to notify the department in accordance with this subsection, the department may find that the trust is invalid under (c) of this section.(f) If a trustee plans to resume use of an unfunded recognized Medicaid trust, the trustee shall notify the department in writing no later than the 15th day of the month immediately preceding the month that use of the trust will resume. If the trustee fails to notify the department in accordance with this subsection, the department may find the applicant or recipient ineligible for Medicaid.Eff. 7/20/2007, Register 183; am 8/1/2020, Register 235, October 2020Authority:AS 47.05.010
AS 47.07.020
AS 47.07.040