C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 435—ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA › Subpart I—Specific Eligibility and Post-Eligibility Financial Requirements for the Medically Needy

42 C.F.R. § 435.840

Medically needy resource standard: General requirements

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(a) To determine eligibility of medically needy individuals, a Medicaid agency must use a single resource standard that meets the requirements of this section.

(b) In States that do not use more restrictive criteria than SSI for aged, blind, and disabled individuals, the resource standard must be established at an amount that is no lower than the lowest resource standard used under the cash assistance programs that relate to the State's covered medically needy eligibility group or groups of individuals under § 435.301.

(c) In States using more restrictive requirements than SSI:

(1) For all individuals except aged, blind, and disabled individuals, the resource standard must be set in accordance with paragraph (b) of this section; and

(2) For all aged, blind, and disabled individuals or any combination of these groups of individuals, the agency may establish a separate single medically needy resource standard that is more restrictive than the single resource standard set under paragraph (b) of this section. However, the amount of the more restrictive separate standard for aged, blind, or disabled individuals must be no lower than the higher of the lowest categorically needy resource standard currently applied under the State's more restrictive criteria under § 435.121 or the medically needy resource standard in effect under the State's Medicaid plan on January 1, 1972.

(d) The resource standard established under paragraph (a) of this section may not diminish by an increase in the number of persons in the assistance unit. For example, the resource standard for an assistance unit of three may not be less than that set for a unit of two.

[58 FR 4933, Jan. 19, 1993]
Notes of Decisions
Cited in 6 cases, 1985–1996 · leading case: Haley v. Commissioner of Public Welfare
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Haley v. Commissioner of Public Welfare (1985) mass “See 42 C.F.R. §§ 435.840 , 435.841 (1984) (determination of resources must be reasonable).”
Hession v. Illinois Department of Public Aid (1989) ill “The Department notes that this section sets forth the elements which a State Medicaid plan must contain and contends that, because a resource spend down is not mentioned in this section or in the corresponding HHS regulations (see 42 C.F.R. §§435.840 through 435.852 (1987)), the…”
Ross v. Giardi (1996) conn “See 42 C.F.R. § 435.840 (1995). We recognize the apparent incongruity of allowing the state to apply resources eligibility criteria in its medically needy program that are no more liberal than its categorically needy program.”
Matarazzo v. Rowe (1993) conn “Resource eligibil *333 ity is determined, therefore, solely by reference to 42 C.F.R. §§ 435.840 through 435.843. These provisions, the defendant contends, require the state agency in determining eligibility simply to compare the applicant’s resources to the asset disregard…”
Walter O. Boswell Memorial Hospital, Inc. v. Yavapai County (1986) arizctapp “See 42 C.F.R. §§ 435.840 , 435.841, 435.850, and 435.”
Gandenberg v. Barry (1988) ohsd “See 42 C.F.R. 435.840. However Ohio does not provide such assistance to the medically needy and therefore such eligibility requirements are inapplicable.”
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