53-6-190. Receipt of transferred assets for less than fair market value — fine. (1) A person who receives an asset for less than fair market value from an applicant for or recipient of medical assistance for certain services under this part is subject to a civil fine payable to the department if the department initiates a judicial proceeding and shows by a preponderance of the evidence that:

Terms Used In Montana Code 53-6-190

  • Applicant: means a person:

    (a)who has submitted an application for determination of medicaid eligibility to a medicaid agency on the person's own behalf or on behalf of another person; or

    (b)on whose behalf an application has been submitted. See Montana Code 53-6-155

  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-6-155
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
  • Recipient: means a person:

    (a)who has been determined by a medicaid agency to be eligible for medicaid benefits, whether or not the person actually has received any benefits; or

    (b)who actually receives medicaid benefits, whether or not determined eligible. See Montana Code 53-6-155

  • State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201
  • United States: includes the District of Columbia and the territories. See Montana Code 1-1-201

(a)the asset was transferred to qualify the applicant or recipient for medical assistance for long-term care or home and community-based services;

(b)the transfer resulted in the imposition of a period of ineligibility for medical assistance under 53-6-166;

(c)the department advised the person who received the asset that the transfer would result in a period of ineligibility and the person refused to return the asset to the applicant or recipient; and

(d)the department provided medical assistance to the applicant or recipient during the period of ineligibility because the applicant or recipient received an undue hardship exception under 53-6-166.

(2)A court may impose a civil fine of 100% to 150% of the amount that the department paid for medical assistance for the applicant or recipient during the period of ineligibility that is attributable to the amount transferred to the person receiving the asset, plus the department’s court costs and attorney fees.

(3)The department may petition a court to set aside a transfer that meets the requirements in subsection (1) and to require the return of the transferred asset to the applicant or recipient. Action under this subsection must be undertaken using available resources.

(4)All money collected under this section must be distributed to the state general fund and to the United States as required by applicable state and federal laws and regulations.