A New York appeals court held that a community spouse is entitled to an increased minimum monthly maintenance needs allowance (MMMNA) because her basic monthly expenses are almost double her monthly income and therefore qualify as “exceptional circumstances” necessitating access to her husband’s income. Matter of Balzarini v. Suffolk County Dept. of Social Servs. (N.Y. [...]
Entries Tagged as 'Medicaid Planning'
A New York Appeals Court Holds That A Wife’s Usual Household Expenses Necessitate An Increased Maintenance Allowance Even Though Her Husband Is A Medicaid Recipient In A Nursing Home
September 29th, 2008 · No Comments
Tags: Governmental or Public Benefit Programs · Medicaid Applications · Medicaid Planning
CMS Never Ending Penalty Period Rule Upheld in Appeal of Denial of Application for Assisted Living Facility Medicaid in New Jersey
September 26th, 2008 · No Comments
The Center for Medicare and Medicaid Services (“CMS”) states that the Deficit Reduction Act of 2005 (Pub. L. No. 109-171, 120 Stat. 4, 151) (“DRA”) does not permit a person to receive benefits under a Medicaid waiver program (including assisted living facility Medicaid) if there has been a transfer of assets within sixty months of the [...]
Tags: Assisted Living Facilities · Governmental or Public Benefit Programs · Medicaid Planning
Proposed Rule Addresses Problems that May Arise When A Medicaid Applicant Purchases A Long-Term Care Insurance Partnership Policy in One State and Then Applies for Medicaid In Another State
September 18th, 2008 · No Comments
The U.S. Department of Health and Human Services has issued a new notice addressing the problems that occur when a Medicaid applicant purchases a long-term care insurance “partnership” policy in one state and then applies for Medicaid in another state. See, 73 Fed. Reg. 51302-51305 (2 Sept 2008), available here.
The Deficit Reduction Act of 2005 [...]
Tags: Governmental or Public Benefit Programs · Long-Term Care Insurance · Medicaid Planning
In an important case, a NJ administrative law judge decided that a bank account titled to a Medicaid applicant and another person does not automatically disqualify the applicant for Medicaid
September 16th, 2008 · No Comments
New Jersey’s Office of Administrative Law recently issued a significant ruling that may make it easier to qualify for Medicaid. In K.R. vs. Somerset County Board of Social Services, O.A.L Docket No. HMA 12343-07 (Aug. 25, 2008), New Jersey’s Office of Administrative Law ruled that an account titled to a Medicaid applicant “or” another person [...]
Tags: Governmental or Public Benefit Programs · Medicaid Planning · News Briefs · Nursing Homes
New Jersey plans to implement Long-Term Care Insurance Partnership Program on July 1, 2008
June 6th, 2008 · No Comments
The Deficit Reduction Act of 2005 (”DRA”) authorized the expansion of the Long Term Care Insurance Partnership Program into the various states. New Jersey’s Long Term Care insurance Partnership Program was approved by the Center for Medicare and Medicaid Services (”CMS”) on February 12, 2008 and will become effective on July 1, 2008. Under this [...]
Tags: Long-Term Care Insurance · Medicaid Planning · News Briefs
NJ Medicaid is now denying eligibility if the applicant engages in Medicaid estate planning with the intent of achieving eligibility for benefits, holding that the “motivation” of the applicant determines whether the applicant is or is not eligible. This ruling is plainly contrary to settled NJ law
May 22nd, 2008 · No Comments
I recently received a denial notice from the local Medicaid agency in a case in which the applicant’s Medicaid estate plan involved making a loan to a relative. The borrowing relative signed a promissory note agreeing to repay the note each month at a regular payment amount with included a reasonable interest rate. The note [...]
Tags: Medicaid Planning
The State of Pennsylvania has decided that an irrevocable annuity owned by the Community Spouse is NOT an available resource in determining the Institutional Spouse’s eligibility for Medicaid. This is still an unresolved issue in New Jersey, more than TWO YEARS after the new federal Medicaid law was passed.
May 7th, 2008 · No Comments
The federal Deficit Reduction Act of 2005 (DRA), which became effective on February 8, 2006, made major changes to the federal Medicaid law. One such major change in the federal law is in the treatment of annuities owned by the spouse of a Medicaid applicant (called the “Community Spouse” in the law) . Under the [...]
Tags: Annuities
NJ ALJ Concludes That the Penalty Period for Applicants for Assisted Living Facility Medicaid Benefits Has a Start Date
May 1st, 2008 · No Comments
An administrative law judge has concluded that an individual who is trying to avoid nursing home care by applying for home- or community-based coverage under a Medicaid waiver program, but who has made a transfer during the look-back period, must have the penalty period begin on the date on which the applicant would otherwise be [...]
Tags: Assisted Living Facilities · Medicaid Planning
Financial Exploitation of an Elder May Have Negative Consequences if the Elder Later Applies for Medicaid Benefits
April 28th, 2008 · No Comments
I recently litigated two different cases in the Superior Court, Union County, each involving the financial exploitation of the elderly. In one case, a non-relative “friend” took a frail, elderly widow into her home as a tenant. The elderly widow had no family in NJ. The friend acted as caregiver for the elder, and the [...]
Tags: Financial Exploitation of the Elderly · Medicaid Applications · Medicaid Planning
Receipt of VA Aid & Attendance benefits will NOT make a resident of an assisted living facility ineligible for Medicaid based on excess income.
April 24th, 2008 · No Comments
In recent presentations to staff at assisted living facilities, I was told that staff members hesitated to recommend to appropriate facility residents that they should apply for Veteran’s Administration (VA) Aid & Attendance benefits, even when the residents had limited income and/or resources and would financially benefit from the additional income that the VA benefit [...]
Tags: Medicaid Planning · Veterans Benefits