Section 208.010 RSMo. was revised in 1989 to conform with the provisions of the Medicare Catastrophic Coverage Act of 1988 that state in part that ‘the State plan must provide for a period of ineligibility for nursing facility services and for a level of care in a medical institution equivalent to that of a nursing facility services… in the case of an institutionalized individual who at anytime during or after the 30 month period immediately before the date the individual becomes an institutionalized individual… or the date the individual applies for such assistance while an institutionalized individual, disposed of resources for less than fair market value.’
The Omnubus Budget Reconciliation Act of 1993 (OBRA ’93) mandated changes in the treatment of transfers of property occurring on or after August 11, 1993. ORBA ’93 changed Section 1917 of the Social Security Act to require a look-back period of 36 months for all transfers and 60 months for transfers involving trusts. It removed the 30-month maximum on the length of the period of ineligibility, replacing it with an unlimited penalty period. Penalties for multiple transfers were changed to run consecutively rather than concurrently.