Articles Posted in Medicaid Applications

Advocates Call for Tighter New York Medicaid Rule Enforcement

Published on: September 27, 2011 | by Ettinger Law Firm

Last week state legislators proposed New York Medicaid changes which would eliminate the financial involvement of local county governments–a state take-over of the program. However, this change would do nothing to curb the overall costs of the program. Lawmakers explain that reigning in Medicaid costs remains a top priority, and so additional alterations to the program are likely. Many observers are calling for tighter enforcement rules to root out fraud. Stricter enforcement of the program will likely target medical care providers who seek to collect money, but these changes may also affect individual residents who are working through the New York Medicaid application process.

An editorial in last Friday’s Albany Times Union called upon the legislature not to go “soft” on Medicaid users. Recent problems of fraud in institutions serving those with developmental disabilities were used to highlight the current problem with the program. Some observers believe that homes for those who are unable to live independently because of age or disability are the site of the clearest patterns of excessive Medicaid utilization. Several years ago the New York Commission on Quality of Care and Advocacy for the Mentally Disabled noted that Medicaid billing for these services were “costly, fragmented, sometimes unnecessary, and often appeared to be revenue-driven, rather than based on medical necessity.”

Senior care advocates believe that many disabled seniors find themselves in need of dental care, hearing aids, and similar basic services only to be shuffled to alternative medical appointments not of their choosing or tailored to their need. These advocates claim that Medicaid changes are necessary to correct the disconnect between needed services and the ones actually provided. On top of the programmatic problems, the state’s Long Term Care Coalition noted that the Health Department lacks the resources to oversee these adult homes properly. The state body struggles to ensure that nursing homes and senior living facilities are abiding by state rules and regulations. The quality of elder care suffers as a result.

New York Lawmakers Discuss Possible Medicaid Changes

Published on: September 21, 2011 | by Ettinger Law Firm

The New York Medicaid application process can be a confusing and time-consuming experience. A large number of local residents can expect to go through it at some point in their lives. The latest figures suggest that one in four New Yorkers get some form of Medicaid, and nearly one million residents have been added to the program in the last ten years alone. Professional assistance with the application process is always advisable to ensure mistakes are avoided, the procedure is expedited, and asset-saving strategies are employed. Our New York elder law attorneys have worked with residents on these matters for decades.

Applying for Medicaid and planning for potential long-term care is made even more complicated by the fact that lawmakers threaten to make changes to the program on a seemingly endless basis. Yesterday the Albany Times Union reported that even though the state legislature is not in session until January, many officials floated the idea this week of a state take-over of the Medicaid program from local counties. As it currently stands, the federal government pays for fifty percent of Medicaid costs, the state pays for twenty five percent, and local counties pay for the remaining twenty five percent. New York is unique in its current structure in requiring county governments to pay for part of the costs. Only a handful of states across the country require local governmental bodies to contribute.

However, a new two percent property tax cap will make it considerably harder for counties to pay their share of Medicaid expenses without cutting other services like police patrols, veterans’ program, and road maintenance. As one state lawmaker explained, the property tax cap combined with rising Medicaid costs places localities in an untenable position with an unsustainable program. Governor Andrew Cuomo has also made a push for statewide Medicaid savings. The Governor created a Medicaid Redesign Team which is working on strategies to streamline state and local Medicaid responsibilities. However, some advocates worry that shifting the burden entirely onto the state does nothing to solve the underlying problem of rising costs. They worry that cuts to the program will still need to be made, including changes to qualification requirements.

New York Medicaid Planning Attorney Shares Information on Medicaid Application Process

Published on: August 23, 2011 | by Ettinger Law Firm

This weekend the Times Herald-Record published a story written by one of our New York elder law estate planning attorneys, Bonnie Kraham, Esq. The article sheds light on the process of applying for Medicaid–the joint federal and state program that can pay for long-term care costs. It explains how there are actually two forms of Medicaid: Community Medicaid and Chronic Care Medicaid. Community Medicaid is targeted at those who require care at home. To apply for this form of care various documents must be provided such as three months of financial material, proof of income, past tax returns, and various other “common documents.” A successful applicant can then keep a set monthly income with the remainder going to contribute to the care. Also, a single applicant can usually only keep about $14,000 in assets while a couple may keep $20,000. Local residents can consider visiting a New York elder law attorney to look at the possibility of using a “pooled” trust or Supplemental Needs Trust to keep more monthly income.

The second form of Medicaid is commonly known as Nursing Home Medicaid. It requires a more extensive application process. For one thing, financial statements for the past five years must be provided–this is known as the “five year look back period.” Department of Social Services (DSS) investigators will examine financial transactions from that period to determine if any gifts were made which could have been used to pay for this care. If they are found then a penalty period may be imposed during which time the applicant will not be eligible for Medicaid. In addition, DSS investigators will examine IRS reports from the past five years, DMV reports, and financial institution documentation. This is all in an effort to ensure that the applicant is not attempting to hide any assets. Fraud charges may be brought if the DSS investigators believe that an applicant has engaged in deceptive practices.

Unlike with Community Medicaid, a single individual on Medicaid in a nursing home is essentially required to pay all of their income to the facility. If the individual has a spouse living at home then the spouse is allowed to keep about $3,000 a month in income. There are also limits on the amount of assets that the applicant is allowed to keep. However, legal strategies can be used to substantially increase the amount of assets that a family can save while still qualifying. The Medicaid Asset Protection Trust is one of the most useful ways to protect assets from Medicaid costs.