Alabama Medicaid Penalty Divisor: What 560-X-25-.09 Actually Says

Updated August 27, 2026. Quick answer: Alabama publishes the division and withholds the amount. Rule 560-X-25-.09(5)(b) divides the cumulative uncompensated value by the average monthly cost to a private patient for nursing facility services in the state (at the time of application) as determined by Medicaid — and that closing phrase is the whole story: the figure is set by the agency, not printed in the rule. All 17 sections of chapter 560-X-25 were read for this page and none of them states it.

What Alabama publishes

Alabama Medicaid transfer penalty divisor, as published by the state
What the state lists	Figure
What the rule divides by	the average monthly cost to a private patient for nursing facility services in the state
Who sets that amount	Medicaid, i.e. the agency — the rule says “as determined by Medicaid” and prints no number
Which moment’s figure applies	the time of application
The section that states it	Ala. Admin. Code r. 560-X-25-.09(5)(b)
Look-back, institutional	60 months immediately prior to the first day of the month of the original, initial application
Look-back, HCBS waiver	60 months prior to the later of that date or the first day of the month in which the assets were disposed of
What the remainder does	the fractional remainder is converted to a dollar figure and added to the individual’s liability — it is not discarded
Services the penalty reaches	nursing facility services, an equivalent institutional level of care, and home and community-based waiver services
Rule’s most recent amendment	filed September 11, 2018, effective October 26, 2018
Current 2026 monthly figure	not published in the rule — see below

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How the penalty period is calculated

560-X-25-.09(5)(b) states the arithmetic in one sentence: the total, cumulative uncompensated value of the assets transferred on or after the look-back date “will be divided by the average monthly cost to a private patient for nursing facility services in the state (at the time of application) as determined by Medicaid.”
Alabama does not throw away the remainder. The quotient minus the fractional remainder is the number of months; the fractional remainder is then “converted to a dollar figure and added to the individual’s liability.” A reader who is used to states that round down should notice that the leftover here becomes money owed, not free months.
The penalty starts at the later of two dates: the month of transfer, or the first month in which the person is eligible for medical assistance and would otherwise be receiving institutional level care but for the penalty — and it cannot fall inside another penalty period under the same rule.
The look-back date is defined in paragraph (9)(j) and it is not one date for everybody. For an institutionalized individual it runs 60 months back from the first day of the month of the original, initial application. For someone receiving home and community-based waiver services it runs 60 months back from the LATER of that day or the first day of the month in which the assets were disposed of.
Where only one member of an institutionalized married couple applies, paragraph (1)(a) says transfers by the applicant AND/OR the non-applying spouse affect the applicant, and the applying spouse “will incur the entire penalty period.” If the other spouse later applies, (1)(b) apportions the REMAINING penalty between them, and any fractional remainder is served by either spouse.
A transferred stream of income is handled by projection, not by its monthly amount. Paragraph (2) tells Medicaid to determine the total income expected to be transferred over the owner’s life using federal life-expectancy tables, and to calculate the penalty on that projected total.
Alabama treats a personal service agreement as a transfer by default. Paragraph (9)(k) defines it as a legally enforceable written agreement for personal care in exchange for anything of value, and presumes the transfer occurred at the time of the exchange, with a penalty imposed unless the presumption is overcome. Family care arrangements are inside this rule.
The exemptions in paragraph (6) are the familiar federal set — the home to a spouse, a minor or disabled child, a resident sibling with an equity interest, or a caregiver child of at least two years’ residence; transfers for the sole benefit of a spouse or a blind/disabled child; a satisfactory showing of intent; undue hardship; an exempt trust; and the full return of the assets, which the rule warns may itself create excess resources.
Non-disclosure is not treated as a paperwork slip. Paragraph (4) exposes an individual who fails to disclose or report a transfer to recoupment and suspension of benefits under Code of Ala. 1975 § 22-6-8, and states that the individual and/or their representative may also be subject to criminal prosecution.

Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the Alabama rate record; the calculator is the class parent.

What this page does not settle

This page does not tell you Alabama’s 2026 divisor, because Alabama’s rule does not contain one and this page will not import a number from somewhere the state did not publish it. The rule ends the sentence with “as determined by Medicaid”, which is a delegation, not an omission.
The negative claim here was made across the whole chapter, not just the transfer section. All 17 sections of chapter 560-X-25 that exist were retrieved and scanned. They contain 50 dollar amounts between them and every one of them is something else: the $2,000/$3,000 resource limits, the $1,500 burial and life-insurance exclusions, the $6,000 income-producing-property threshold, the institutional-programme increases, and the Medicare Savings Programme subsidy table. Section .09 itself, the transfer rule, contains no dollar amount at all.
Because the figure is agency-determined rather than published in the rule, the place to get the current amount is the Alabama Medicaid Agency itself — a District or Long Term Care office, or the worker handling the application. A figure quoted by a third-party planning site is not the agency’s determination and should not be relied on for a transfer decision.
The rule ties the figure to “the time of application”, so a divisor that was correct for a neighbour who applied last year is not necessarily the one that will be applied to a file opened this month.
Nothing here decides whether a particular transfer is penalised at all. Paragraph (3) presumes it was made to establish or maintain eligibility, and paragraph (7) puts the burden on the individual to rebut that with convincing evidence — explicitly saying that a subjective statement of intent, or ignorance of the rule, is not enough.

Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.

Sources

Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.

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