In 2013, a settlement was reached in Jimmo v. Sebelius, Docket No. 11-cv-17 (D.Vt., January 18, 2011), a nationwide federal class-action lawsuit. Under the settlement, Medicare coverage rules changed significantly. Prior to the settlement, a decades-old practice, called the “improvement standard,” required beneficiaries to show medical or functional improvement before Medicare would pay for covered.. read more →

New Jersey’s ABLE law (the acronym is short for “Achieving a Better Life Experience”) went into effect a few months ago, in October 2016.  Under the new law, New Jersey’s Department of Human Services and the Department of the Treasury are required to establish the ABLE Program pursuant to federal law. Persons who became disabled.. read more →

New Jersey’s Division of Consumer Affairs (DCA) released a Consumer Brief on Medicaid Advisors/Application Assistors. Medicaid Advisors/Application Assistors are non-lawyers who provide limited services without payment or compensation in connection with Medicaid applications. According to the DCA Consumer Brief, the limited services which Medicaid Advisors/Application Assistors may perform include the following: providing information on insurance.. read more →

The Social Security Administration (SSA) published two final regulations that will have significant impacts on the disability determination process for those applying for Social Security Disability Insurance benefits and those applying for Supplemental Security Income (SSI) benefits on the basis of disability. The first set of regulations, Revisions to Rules Regarding the Evaluation of Medical.. read more →

With thanks to the Brookdale Center for Healthy Aging at Hunter College / CUNY, attached below is the 2017 BENEFITS CHECKLIST for Older Adults in New York, showing Health and Income Programs for Residents of New York State. For additional information concerning Medicaid and public benefits planning, visit: http://vanarellilaw.com/medicaid-public-benefits-planning/ read more →

Many attorneys create trusts, and some even create special needs trusts, often using pre-written templates.  So why, you may ask, do you really need an attorney whose practice focuses on special needs planning? It is important that special needs trusts not be unnecessarily inflexible and generic, which is what can happen with a “one size.. read more →

In Simonsen v Bremby(2d Cir., No. 16-204-cv, Feb. 15, 2017), the daughter/Medicaid applicant filed suit in federal court and sought a preliminary injunction barring Medicaid from imposing a penalty period as a result of trusts established for her benefit by her mother. The two third-party trusts were considered as available resources by Medicaid, and when.. read more →

As 2007 began, Arthur Brown, who was then seventy-eight years old, and his wife, Mary, lived together in a jointly-owned condominium. Several months later, Arthur began living in an assisted living facility. The following year, Arthur was admitted into a nursing home after he was diagnosed with Alzheimer’s disease. Soon thereafter, Arthur applied for nursing.. read more →

The Division of Developmental Disabilities (DDD) is a division of New Jersey’s Department of Human Services. The DDD provides public funding for certain services designed to assist eligible New Jersey adults with intellectual and developmental disabilities, age 21 and older, to live as independently as possible. The DDD has developed a new resource for families.. read more →

To ensure that all beneficiaries can receive their payments and make proper use of funds, Congress has granted the Social Security Administration (SSA) the authority to appoint third parties, known as representative payees, to receive and manage payments when the beneficiary is unable to do so. A representative payee is an individual or organization appointed.. read more →

Kaiser Health News has released a Medicaid Pocket Primer. The Primer explains what the Medicaid program is, the structure of the program, identifies those covered by Medicaid and the services provided through Medicaid, and discusses the impact of the Affordable Care Act on Medicaid, how beneficiaries access care, the Medicaid program’s impact on beneficiaries’ ability.. read more →

The Centers for Medicare and Medicaid Services, the Department of Veterans Affairs (VA), the Social Security Administration and other state and federal agencies have released the following important numbers for 2017. MEDICARE Medicare Part A deductible: $1316 for each benefit period. Medicare Part A co-payments for hospital stays: Day 1-60: $0 co-payment for each benefit.. read more →

A New York appeals court ruled that a Medicaid applicant successfully rebutted the presumption that transfers to her daughter made one and two years before entering a nursing home were for purposes other than to qualify for Medicaid, based on evidence that the money was used to help her grandson purchase a house. Matter of.. read more →

The Centers for Medicare and Medicaid Services has released its SSI and Spousal Impoverishment Standards for 2017. SUPPLEMENTAL SECURITY INCOME (SSI) SSI Federal Benefit Rate for an Individual: $735.00 SSI Federal Benefit Rate for a Couple: $1,103.00 Substantial Gainful Activity (SGA) Limit: $1,170.00 (Blind SGA: $1,950.00) MEDICAID  Minimum Community Spouse Resource Allowance: $24,180 Maximum Community Spouse.. read more →

(On December 1, 2016, I moderated the first Advanced Special Needs Trust Symposium, an all-day event held at the New Jersey Law Center. In addition to moderating the panel of speakers, I also presented on the topic of the “Uses of Special Needs Trusts in Cases Involving Divorce.” Due to the length of my paper,.. read more →

(On December 1, 2016, I moderated the first Advanced Special Needs Trust Symposium, an all-day event held at the New Jersey Law Center. In addition to moderating the panel of speakers, I also presented on the topic of the “Uses of Special Needs Trusts in Divorce.” Due to the length of my paper, I divided.. read more →

On November 15, 2016, I presented at the Second Annual Caring for Caregivers Conference at the East Rutherford Community Center. The first section of my presentation focused on guardianship law in New Jersey, Public Benefit Basics, and the use of special needs trusts by parents of adult disabled children. The powerpoint slides from the first part.. read more →

Medicare’s annual open enrollment period runs from October 15 to December 7–the period when enrollees can shop for new coverage. Now is the time to review your options to determine if you should switch plans. During Medicare’s annual open enrollment period, you may (1) enroll in a Medicare Part D (prescription drug) plan; (2) change your Part.. read more →

A U.S. district court denied a preliminary injunction to a Medicaid applicant who sued New Jersey to prevent the state from denying benefits based on her dead husband’s assets. Flade v. Connolly (U.S. Dist. Ct, D. N.J., No. 16-4407, Sept. 23, 2016). Plaintiff, Eileen Flade, was a nursing home resident. On April 12, 2016, plaintiff applied for.. read more →

Westfield, NJ – October 6, 2016 — Donald D. Vanarelli, Esq. (http://VanarelliLaw.com/) will participate in the New Jersey State Bar Association’s Elder & Disability Law Section Roundtable Discussion on Medicaid Appeals to be held on October 13, 2016 at the New Jersey Law Center in New Brunswick, NJ. Mr. Vanarelli will present on “Appealing a.. read more →

Question: Does a Section 529 educational savings plan account impact the eligibility of a minor receiving Supplemental Security Income (SSI) benefits?  Are there any regulations governing such plans? Answer: Qualified Tuition Programs (QTPs), also referred to as Section 529 educational savings plans, allow individuals to contribute to an account established to pay a designated beneficiary’s.. read more →

“Use of Special Needs Trusts in Cases Involving Divorce”  to be presented by leading NJ Elder Law and Estate Planning Attorney, Donald D. Vanarelli, Esq., who will also act as Moderator of the Symposium Donald D. Vanarelli, Esq. (http://VanarelliLaw.com/) will moderate and present at the Advanced Special Needs Trust Symposium given by the New Jersey Institute.. read more →

In this case, the Court considered whether a Medicaid applicant received full and fair notice of the reasons for the agency’s decision to deny benefits prior to holding a hearing on the applicant’s appeal. E.W. v. Cape May County Board of Social Service, OAL Docket. No. HMA 14667-15 (OAL December 24, 2015) In 2012, E.W.,.. read more →

A New York trial court entered judgment against a woman who refused to contribute to her spouse’s nursing home expenses, finding that because she had adequate resources to do so, an implied contract was created between her and the State of New York entitling the state to repayment of Medicaid benefits it paid on the.. read more →

In a recent opinion, an appellate court in Minnesota held that county officials were not liable for incorrectly telling a Medicaid applicant that his estate would not be subject to a Medicaid lien because the applicant could have hired a lawyer to learn the correct information. Benigni v. St. Louis County (Minn. Ct. App., No. A15-1154, June.. read more →