Md. Code Regs. 10.09.24.10-1
A. Basis.
(1) Except as this regulation specifically provides, the provisions of this regulation may not affect:
B. Definitions.
C. Treatment of Income.
(2) Attribution of Income. In determining the income of an institutionalized spouse or community spouse, after the institutionalized spouse has been determined to be eligible for Medical Assistance, the following apply:
(a) Non-Trust Property. Except as provided under §C(2)(c) and (d) of this regulation, unless the instrument providing the income otherwise specifically provides, if payment of income is made:
(b) Trust Property. In the case of a trust, income shall be considered available to each spouse as provided in the trust or, in the absence of a specific provision in the trust, if payment of income is made:
(3) Protecting Income for the Community Spouse. After an institutionalized spouse is determined to be eligible for Medical Assistance, in determining the amount of the spouse's income that is to be applied monthly to payment for the cost of care in the institution, there shall be deducted from the spouse's monthly income the following amounts in the following order:
(a) A personal needs allowance of:
(d) Incurred expenses for medical care or remedial service for the institutionalized spouse that are not subject to payment by a third party, including:
(5) Establishment of Minimum Monthly Maintenance Needs Allowance. The minimum monthly maintenance needs allowance for a community spouse is the sum of:
(6) Applicable Percent. For purposes of §C(5)(a) of this regulation, the applicable percent, effective as of the following dates, is:
D. Treatment of Resources.
(1) Computation of Spousal Share at the Time of Institutionalization.
(a) Total Joint Resources. There shall be computed, as of the beginning of the first continuous period of institutionalization of the institutionalized spouse:
(b) Assessment. At the request of an institutionalized spouse or community spouse, as of the beginning of the first continuous period of institutionalization of the institutionalized spouse and upon receipt of the relevant documentation of resources, the Department shall:
(3) Assignment of Support Rights. The institutionalized spouse may not be ineligible by reason of resources determined under §D(2) of this regulation when:
(4) Resources may not be considered to be unavailable to the institutionalized spouse under §D3(a) of this regulation if the institutionalized spouse, or:
(b) The institutionalized spouse's guardian or attorney in fact, has assisted in making those resources unavailable unless it can be demonstrated, to the Department's satisfaction, that the:
E. Permitting Transfer of Resources to the Community Spouse.
(2) Community Spouse Resource Allowance Defined. The community spouse resource allowance is the amount by which the greatest of the following amounts exceeds the amount of resources otherwise available to the community spouse:
F. Fair Hearing.
(1) The spouse is entitled to a fair hearing as provided for under Regulation .14 of this chapter if either the institutionalized spouse or the community spouse is dissatisfied with the determination of any of the following:
Authority: Estates and Trusts Article, §14.5-1002; Health-General Article, §§2-104(b), 2-105(b), 15-103, 15-105, 15-121, and 15-401—15-407;
Annotated Code of Maryland; Annotated Code of Maryland
Effective date: May 1, 1983 (10:6 Md. R. 558)
Regulations .01, .02, and .06 amended as an emergency provision effective December 1, 1992 (19:25 Md. R. 2198); amended permanently effective June 1, 1993 (20:10 Md. R. 852)
Regulation .02B amended effective May 1, 1986 (13:8 Md. R. 898); August 8, 1988 (15:16 Md. R. 1914); May 1, 1989 (16:8 Md. R. 910); December 1, 1992 (19:23 Md. R. 2041); March 24, 1997 (24:6 Md. R. 485); June 2, 1997 (24:11 Md. R. 793)
Regulations .02B; .03C; .04; .07B, I, J, L; .08G, H; .09B; .10C, E, F; .11D, E; .12B; .14A; and .15D amended as an emergency provision effective May 1, 1983 (10:11 Md. R. 962); adopted permanently effective September 1, 1983 (10:17 Md. R. 1521)
Regulations .02B and .05A amended as an emergency provision effective October 3, 1997 (24:22 Md. R. 1550); amended permanently effective January 12, 1998 (25:1 Md. R. 16)
Regulation .02B amended effective November 24, 2005 (32:23 Md. R. 1826); December 31, 2007 (34:26 Md. R. 2262); October 14, 2013 (40:20 Md. R. 1652)
Regulation .03 amended as an emergency provision effective May 4, 1990 (17:11 Md. R. 1339); amended permanently effective August 13, 1990 (17:15 Md. R. 1858)
Regulation .03-1 adopted effective April 1, 2002 (29:6 Md. R. 567)
Regulation .03-1B amended effective June 9, 2003 (30:11 Md. R. 735)
Regulation .03-2 adopted effective April 1, 2002 (29:6 Md. R. 567)
Regulation .03-2F amended effective January 6, 2003 (29:26 Md. R. 2027)
Regulation .03-3 adopted effective June 7, 2004 (31:11 Md. R. 856)
Regulation .03-3 amended effective December 27, 2010 (37:26 Md. R. 1787)
Regulation .03-4 adopted effective June 7, 2004 (31:11 Md. R. 856)
Regulation .03-4A amended effective December 27, 2010 (37:26 Md. R. 1787)
Regulation .04 amended effective May 1, 1986 (13:8 Md. R. 898); May 1, 1989 (16:8 Md. R. 910); June 30, 2008 (35:13 Md. R. 1179); April 19, 2010 (37:8 Md. R. 615)
Regulation .04J amended as an emergency provision effective October 1, 2001 (28:24 Md. R. 2125); emergency status expired March 29, 2002
Regulations .04J, .07B, G—N, and .08B, G—L amended as an emergency provision effective March 1, 1984 (11:5 Md. R. 449); emergency status extended at 11:14 Md. R. 1247 (July 6, 1984)
Regulations .04J, .07B, G—N, and .08B, G—L amended effective October 15, 1984 (11:20 Md. R. 1742)
Regulation .04J amended effective September 20, 2010 (37:19 Md. R. 1284)
Regulation .05 repealed and new Regulation .05 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulation .05A amended effective April 14, 2003 (30:7 Md. R. 487)
Regulation .05C amended effective April 19, 2010 (37:8 Md. R. 614)
Regulation .05D amended effective March 11, 1985 (12:5 Md. R. 482); April 19, 2010 (37:8 Md. R. 614)
Regulation .05E amended effective March 11, 1985 (12:5 Md. R. 482); March 24, 1997 (24:6 Md. R. 485)
Regulation .05H amended effective June 2, 1997 (24:11 Md. R. 793)
Regulation .05-1 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulation .05-1B amended effective April 19, 2010 (37:8 Md. R. 614)
Regulation .05-2 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulation .05-2 amended effective April 19, 2010 (37:8 Md. R. 614)
Regulation .05-3 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulation .05-3K amended effective October 14, 2013 (40:20 Md. R. 1652)
Regulation .05-4 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulation .05-5 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulations .06, .07M, .08, .10, .11, .12C, and .15 amended effective May 1, 1986 (13:8 Md. R. 898)
Regulation .07 amended effective April 19, 2010 (37:8 Md. R. 615)
Regulation .07D, M amended effective June 30, 2008 (35:13 Md. R. 1179)
Regulation .07J amended effective October 8, 1991 (18:18 Md. R. 2005)
Regulation .07M amended as an emergency provision effective September 30, 1989 (16:21 Md. R. 2258); adopted permanently effective February 1, 1990 (17:1 Md. R. 69)
Regulation .07N amended as an emergency provision effective July 1, 1984 (11:13 Md. R. 1173); amended permanently effective September 10, 1984 (11:18 Md. R. 1584)
Regulation .07N amended as an emergency provision effective July 1, 1986 (13:14 Md. R. 1628); adopted permanently effective September 8, 1986 (13:18 Md. R. 2020)
Regulation .07N amended effective August 10, 1987 (14:16 Md. R. 1774); July 1, 1988 (15:13 Md. R. 1554)
Regulations .07N and .10E amended as an emergency provision effective July 1, 1985 (12:13 Md. R. 1274); adopted permanently effective November 4, 1985 (12:22 Md. R. 2104)
Regulation .07N amended as an emergency provision effective July 1, 1989 (16:14 Md. R. 1565); amended permanently effective October 30, 1989 (16:21 Md. R. 2261)
Regulation .07N amended as an emergency provision effective July 1, 1990 (17:15 Md. R. 1851); adopted permanently effective November 1, 1990 (17:20 Md. R. 2427)
Regulation .07N amended as an emergency provision effective December 10, 1991 (18:26 Md. R. 2827); amended permanently effective April 1, 1992 (19:5 Md. R. 577)
Regulation .07N amended as an emergency provision effective November 25, 1992 (19:25 Md. R. 2199); amended permanently effective March 29, 1993 (20:4 Md. R. 371)
Regulation .07N amended as an emergency provision effective July 22, 1993 (20:16 Md. R. 1275); amended permanently effective November 1, 1993 (20:21 Md. R. 1654)
Regulation .07N amended as an emergency provision effective August 10, 1994 (21:18 Md. R. 1506); amended permanently effective November 7, 1994 (21:22 Md. R. 1876)
Regulation .08 amended as an emergency provision effective May 15, 1992 (19:11 Md. R. 1012); emergency status extended at 19:19 Md. R. 1702; amended permanently effective September 14, 1992 (19:18 Md. R. 1656)
Regulation .08 amended as an emergency provision effective April 8, 1994 (21:9 Md. R. 744); emergency provision rescinded retroactively to April 8, 1994 (21:14 Md. R. 1226)
Regulation .08 amended effective June 30, 2008 (35:13 Md. R. 1179)
Regulation .08B amended effective September 1, 1993 (20:17 Md. R. 1346); January 12, 1987 (14:1 Md. R. 31); August 22, 1988 (15:17 Md. R. 2049); July 3, 1995 (22:13 Md. R. 967)
Regulation .08G, H amended effective June 2, 1997 (24:11 Md. R. 793)
Regulation .08G, H, and H-1 amended effective January 12, 1987 (14:1 Md. R. 31)
Regulation .08G, H, and I amended effective August 22, 1988 (15:17 Md. R. 2049)
Regulation .08G, H, and K amended effective July 3, 1995 (22:13 Md. R. 967)
Regulation .08G, I amended as an emergency provision effective October 1, 2001 (29:4 Md. R. 413); emergency status extended at 29:8 Md. R. 696; amended permanently effective April 29, 2002 (29:8 Md. R. 700)
Regulation .08J-1 adopted effective September 1, 1993 (20:17 Md. R. 1346)
Regulation .08J-1 amended effective October 14, 2013 (40:20 Md. R. 1652)
Regulation .08L amended effective June 29, 1987 (14:13 Md. R. 1474); January 25, 1988 (15:2 Md. R. 121)
Regulation .08L amended as an emergency provision effective July 1, 1989 (16:14 Md. R. 1565); amended permanently effective October 30, 1989 (16:21 Md. R. 2261)
Regulation .08M amended effective June 29, 1987 (14:13 Md. R. 1474)
Regulations .08 and .10 amended, and new Regulation .10-1 adopted as an emergency provision effective September 30, 1989 (16:21 Md. R. 2259); adopted permanently effective February 1, 1990 (17:1 Md. R. 69) (Regulation .10-1 originally adopted as Regulation .11)
Regulations .08-1 and .08-2 adopted effective July 3, 1995 (22:13 Md. R. 967)
Regulation .08-2 amended effective April 29, 2002 (29:8 Md. R. 700)
Regulation .08-3 adopted effective November 24, 2005 (32:23 Md. R. 1826)
Regulation .09B, C amended effective September 20, 2010 (37:19 Md. R. 1284)
Regulation .10 amended effective November 10, 2003 (30:22 Md. R. 1580)
Regulation .10C and D amended as an emergency provision effective July 1, 1986 (13:14 Md. R. 1628); adopted permanently effective September 8, 1986 (13:18 Md. R. 2020)
Regulation .10C, D amended effective July 1, 1987 (14:13 Md. R. 1474)
Regulation .10C, D amended as an emergency provision effective March 13, 2009 (36:8 Md. R. 591); emergency status expired July 30, 2009
Regulation .10C, D amended effective July 27, 2009 (36:15 Md. R. 1165); September 20, 2010 (37:19 Md. R. 1284); October 14, 2013 (40:20 Md. R. 1652)
Regulation .10E amended as an emergency provision effective May 1, 1983 (10:7 Md. R. 632); adopted permanently effective May 9, 1983 (10:9 Md. R. 791)
Regulation .10-1 amended as an emergency provision effective July 1, 1992 (19:15 Md. R. 1382); amended permanently effective November 1, 1992 (19:21 Md. R. 1891)
Regulation .10-1C amended effective November 10, 2003 (30:22 Md. R. 1580)
Regulation .10-1C, E amended and G adopted effective November 12, 1990 (17:21 Md. R. 2529)
Regulation .10-1D amended effective October 8, 1991 (18:18 Md. R. 2005)
Regulation .11C amended effective September 10, 1994 (11:8 Md. R. 1584) June 2, 1997 (24:11 Md. R. 793)
Regulation .11E amended effective September 10, 1984 (11:18 Md. R. 1584)
Regulation .12B amended effective August 8, 1988 (15:16 Md. R. 1914)
Regulation .12C amended effective September 10, 1984 (11:18 Md. R. 1584)
Regulation .13 repealed and new Regulation .13 adopted effective March 19, 2012 (39:5 Md. R. 382)
Regulation .13C amended effective August 8, 1988 (15:16 Md. R. 1914)
Regulation .14 amended effective August 8, 1988 (15:16 Md. R. 1914)
Regulation .14 amended and recodified to Regulations .14 and .14-1 effective December 1, 1992 (19:23 Md. R. 2041)
Regulation .14B amended as an emergency provision effective May 1, 1984 (11:10 Md. R. 858); emergency status expired August 28, 1984
Regulation .14B amended effective August 29, 1984 (11:17 Md. R. 1492)
Regulation .15 amended effective August 8, 1988 (15:16 Md. R. 1914); July 3, 1995 (22:13 Md. R. 967)
Regulation .15 amended as an emergency provision effective October 13, 1992 (19:22 Md. R. 1979); amended permanently effective February 1, 1993 (20:2 Md. R. 113)
Regulation .15 amended as an emergency provision effective April 8, 1994 (21:9 Md. R. 744); emergency provision rescinded retroactively to April 8, 1994 (21:14 Md. R. 1226)
Regulation .15A-3 amended as an emergency provision effective November 12, 2002 (29:24 Md. R. 1915); amended permanently effective February 17, 2003 (30:3 Md. R. 179)
Regulation .17 adopted effective December 31, 2007 (34:26 Md. R. 2262)
Chapter revised effective January 6, 2014 (40:26 Md. R. 2162)
Regulation .02B amended effective September 11, 2017 (44:18 Md. R. 866); May 20, 2019 (46:10 Md. R. 486); April 4, 2022 (49:7 Md. R. 465); April 13, 2026 (53:7 Md. R. 328)
Regulation .03A amended effective August 5, 2024 (51:15 Md. R. 706)
Regulation .03A, C amended effective May 20, 2019 (46:10 Md. R. 486)
Regulation .03A, F amended effective April 4, 2022 (49:7 Md. R. 465)
Regulation .03F adopted effective May 20, 2019 (46:10 Md. R. 486)
Regulation .03-1 amended effective July 21, 2025 (52:14 Md. R. 712)
Regulation .04F amended effective March 28, 2016 (43:6 Md. R. 406)
Regulation .04-1D amended effective December 31, 2018 (45:26 Md. R. 1243)
Regulation .04-1M adopted effective May 7, 2018 (45:9 Md. R. 461)
Regulation .05-4B amended effective July 4, 2016 (43:13 Md. R. 713)
Regulation .07B, F amended effective April 13, 2026 (53:7 Md. R. 328)
Regulation .08-1B amended effective February 1, 2016 (43:2 Md. R. 127)
Regulation .08-2B, C amended effective April 10, 2017 (44:7 Md. R. 355); May 20, 2019 (46:10 Md. R. 486)
Regulation .08-2C amended effective August 29, 2016 (43:17 Md. R. 954)
Regulation .08-4 adopted effective April 13, 2015 (42:7 Md. R. 568)
Regulation .10C, D amended effective September 11, 2017 (44:18 Md. R. 866)
Regulation .10-2 adopted effective April 13, 2015 (42:7 Md. R. 568)
Regulation .12E adopted effective April 13, 2026 (53:7 Md. R. 328)
Regulation .15A-3 amended effective April 13, 2015 (42:7 Md. R. 568)