Page:United States Statutes at Large Volume 120.djvu/95

 120 STAT. 64

42 USC 1396p note.

PUBLIC LAW 109–171—FEB. 8, 2006 with respect to nursing facility services or other long-term care services under this title unless— ‘‘(i) the annuity is— ‘‘(I) an annuity described in subsection (b) or (q) of section 408 of the Internal Revenue Code of 1986; or ‘‘(II) purchased with proceeds from— ‘‘(aa) an account or trust described in subsection (a), (c), or (p) of section 408 of such Code; ‘‘(bb) a simplified employee pension (within the meaning of section 408(k) of such Code); or ‘‘(cc) a Roth IRA described in section 408A of such Code; or ‘‘(ii) the annuity— ‘‘(I) is irrevocable and nonassignable; ‘‘(II) is actuarially sound (as determined in accordance with actuarial publications of the Office of the Chief Actuary of the Social Security Administration); and ‘‘(III) provides for payments in equal amounts during the term of the annuity, with no deferral and no balloon payments made.’’. (d) EFFECTIVE DATE.—The amendments made by this section shall apply to transactions (including the purchase of an annuity) occurring on or after the date of the enactment of this Act. SEC. 6013. APPLICATION OF ‘‘INCOME-FIRST’’ RULE IN APPLYING COMMUNITY SPOUSE’S INCOME BEFORE ASSETS IN PROVIDING SUPPORT OF COMMUNITY SPOUSE.

42 USC 1396r–5 note.

(a) IN GENERAL.—Section 1924(d) of the Social Security Act (42 U.S.C. 1396r–5(d)) is amended by adding at the end the following new subparagraph: ‘‘(6) APPLICATION OF ‘INCOME FIRST’ RULE TO REVISION OF COMMUNITY SPOUSE RESOURCE ALLOWANCE.—For purposes of this subsection and subsections (c) and (e), a State must consider that all income of the institutionalized spouse that could be made available to a community spouse, in accordance with the calculation of the community spouse monthly income allowance under this subsection, has been made available before the State allocates to the community spouse an amount of resources adequate to provide the difference between the minimum monthly maintenance needs allowance and all income available to the community spouse.’’. (b) EFFECTIVE DATE.—The amendment made by subsection (a) shall apply to transfers and allocations made on or after the date of the enactment of this Act by individuals who become institutionalized spouses on or after such date. SEC. 6014. DISQUALIFICATION FOR LONG-TERM CARE ASSISTANCE FOR INDIVIDUALS WITH SUBSTANTIAL HOME EQUITY.

(a) IN GENERAL.—Section 1917 of the Social Security Act, as amended by section 6012(a), is further amended by redesignating subsection (f) as subsection (g) and by inserting after subsection (e) the following new subsection: ‘‘(f)(1)(A) Notwithstanding any other provision of this title, subject to subparagraphs (B) and (C) of this paragraph and paragraph (2), in determining eligibility of an individual for medical assistance with respect to nursing facility services or other long-term care services, the individual shall not be eligible for such assistance

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