J-4500, Changing the Assessment Amount

Revision 09-4; Effective December 1, 2009

With an automatic SPRA, no additional verification is necessary to establish the amount of the SPRA. Send Form H1274, Medicaid Eligibility Resource Assessment Notification (PDF), indicating the minimum SPRA and the right to appeal. See Section J-4110, Automatic SPRA.

See Section J-4311, Examples of the Assessment Date, for information about an institutional SPRA or Home and Community-Based Services waiver SPRA.

With an institutional SPRA, the SPRA assessment date and amount do not change unless they are based on incomplete or inaccurate information.

With a Home and Community-Based Services waiver SPRA, if the application is certified, the SPRA assessment date and amount do not change unless they are based on incomplete or inaccurate information. If the application is not certified, the SPRA assessment date is re-established if the individual reapplies.

The SPRA amount must not be deducted from resources for an individual who is found eligible, who is certified, or who is subsequently denied and then reapplies. Only those resources in the name of the Home and Community-Based Services waiver (institutionalized) spouse are considered at reapplication.

If an institutional spouse was certified incorrectly because of unreported resources and the case is subsequently denied, the original SPRA amount is not used when the institutional spouse reapplies for Medicaid. A new SPRA amount that includes the previously unreported resources must be calculated.

The SPRA can change if it is expanded as described in Section J-6000, SPRA Expansion.