A Texas appeals court held that the state could not count the assets of a Medicaid applicant as “available resources” under the Medicaid rules because the applicant was incapacitated and not able to liquidate the assets. Texas Health and Human Services Commission v. Marroney (Tx. Ct. App., No. 03-18-00190-CV, May 24, 2019). Anna Marroney suffered a.. read more →
Earlier this month, New Jersey’s Division of Medical Assistance and Health Services (DMAHS), the State Medicaid agency, announced an increase in the penalty divisor from $343.85 to $351.84 per day, or $10,701.80 per month, effective April 1, 2019. This is an increase of only $7.99 per day, a very small increase when compared with prior.. read more →
On April 26, 2019, the U.S. Department of Housing and Urban Development (HUD) issued a Notice to state housing agencies concerning the impact of ABLE accounts on eligibility for Section 8 vouchers, public housing and a host of other federal housing programs. ABLE accounts were created in 2014 by the passage of the Achieving a.. read more →
Petitioner, a severely impaired young woman, resides at home with her father, her primary caregiver. She requires monitoring 24 hours a day. She cannot eat or speak, and is unable to sit, stand or change positions on her own. She is fed and hydrated through a gastrostomy tube. She experiences frequent seizures, which occur even.. read more →
J.G., an indigent nursing home resident, applied for Medicaid benefits. While his Medicaid application was pending, J.G. passed away. Thereafter, the Essex County Division of Family Assistance and Benefits, the county welfare agency, denied J.G.’s Medicaid application, concluding he was ineligible as he died before eligibility could be met. Future Care Consultants, J.G.’s designated authorized.. read more →
New Jersey appeals court allows an assisted living facility pursue a tortious interference with contractual relationship claim against a discharged resident’s son after the son refused to move his mother out of the nursing home or allow her to discuss her removal with the facility staff. The Orchards at Bartley Assisted Living v. Schleck (N.J… read more →
Each year the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. Last month, the Board of Trustees released its 2019 Social Security Trustees Report, which is summarized below. SOCIAL SECURITY The report provides an annual assessment of the financial health of the.. read more →
Petitioner, J.F., through his daughter and power of attorney, M.P., applied for Medicaid benefits. The county welfare agency requested five years of bank statements from his checking account and told him the application would be denied if the requested information was not provided by April 23, 2015. M.P. asked for an extension of time. In.. read more →
Question: My mother deeded her house to my sister and me more than seven years ago, meaning that the transfer is beyond Medicaid’s 5-year look-back period and should not affect my mother’s eligibility for Medicaid benefits. My family moved into her home (which is now owned by my sister and me) approximately 4 years ago.. read more →
Congressman John Garamendi, D-CA, recently introduced the Fair COLA for Seniors Act, H.R. 1553, to end inadequate retirement cost-of-living adjustments (COLAs) that don’t account for the effects of inflation on older Americans. H.R. 1553 would require a switch to the Consumer Price Index for the Elderly (CPI-E) from the Consumer Price Index for Urban Wage.. read more →
Free Seminar “Planning For The Catastrophic Costs Of Long-Term Care” Wednesday, April 3, 2019 4:00 PM Free Seminar Law Office of Vanarelli & Li, LLC 242 St. Paul Street Westfield, NJ 07090 Health care issues increase as we age, and become more complex. Please join Donald D. Vanarelli, Esq., Certified Elder Law.. read more →
The Social Security Administration (SSA) is proposing regulations which may make it more difficult for people who don’t speak English to qualify for disability benefits. Under planned regulations released February 01, 2019, the SSA would no longer consider a person’s “inability to communicate in English” when reviewing applications, both for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. The.. read more →
This blog post discusses recent changes in how the Social Security Administration (SSA) evaluates disbursements from trusts, particularly special needs trusts. SSA regulations are published by the agency and compiled in the Program Operations Manual System (POMS). The POMS is a primary source of information used by Social Security employees to process claims for Social.. read more →
Social Security Disability Insurance (SSDI) is one of the major federal programs that provides monetary assistance to people with disabilities. Supplemental Security Income (SSI) is a federal program that helps people with disabilities and very low income and assets pay for food and shelter. SSDI is often confused with SSI. Although both programs pay benefits to.. read more →
Is your medical item or service covered by Medicare Part A and/or Part B? Now there’s a quick way to check! Medicare’s free “What’s Covered” app delivers accurate cost and coverage information right on your smartphone. Now you can quickly see whether Medicare covers your service in the doctor’s office, the hospital, or anywhere else.. read more →
Nursing Home Resident’s Son Who Filed A Medicaid Application Which Was Denied Did Not Breach Admissions Agreement
A New Jersey appeals court held that a nursing home is not entitled to summary judgment in a case alleging breach of the admissions agreement against a resident’s son based solely on the fact that Medicaid denied the resident’s application due to excess resources. Meridian Nursing and Rehabilitation Inc. v. Skwara (N.J. Super. Ct., App. Div., No… read more →
M.K. resided in an assisted living facility (ALF) since 2006. She applied for Medicaid benefits and was approved as of May 1, 2015. Due to the income limitations of the Medicaid program, M.K. deposited all of her income in a Qualified Income Trust, or QIT. By doing so, income deposited in the QIT was not.. read more →
A Massachusetts trial court ruled that a Medicaid hearing examiner should have accepted evidence that a Medicaid applicant’s transfer of her house fell under the caretaker child exception and that the applicant’s other transfers were not made in order to qualify for Medicaid. Coko v. Daniel Tsai, Director of the Office of Medicaid (Essex Sup. Ct… read more →
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After L.K.’s representative filed for Medicaid benefits, Medicaid sent a checklist of documents to be provided within thirty days, including American Funds account statements. Five months later, Medicaid sent a second letter, again seeking the same documents, again within thirty days. After that deadline passed, L.K’s representative sent some of the account statements and advised.. read more →
On December 18, 2018, I presented at the 2018 Elder Law College given by the New Jersey Institute for Continuing Legal Education at the Crowne Plaza, located at 690 Route 46 East, Fairfield, New Jersey. Basically, my presentation was an overview of the laws governing Medicaid Planning by Guardians in New Jersey. (I first wrote about the.. read more →
A New Jersey appeals court held that the state was not required to assist a Medicaid applicant by obtaining debit card statements from her bank to verify her application. C.F.J. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-4385-16T4, Dec. 11, 2018). C.F.J. entered a nursing home and applied for.. read more →
Wyoming’s highest court ruled that the state should not have denied a Medicaid applicant’s request to reduce her penalty period because her sons partially returned transferred assets by paying her attorneys’ fees. Anderson v. State of Wyoming (Wyo.,No. 2018 WY 135, Dec. 4, 2018). Nursing home resident Lucile Anderson transferred cash and property to her sons… read more →
Kansas’s highest court suspended for six months an attorney who, among other things, charged a couple three times the going rate to qualify for public benefits based upon financial need from the Veterans Administration (VA) and Medicaid. In the Matter of Crandall (Kan., No. 117,910, Nov. 30, 2018). A couple hired David Crandall to update their.. read more →
Petitioner was admitted to Monmouth Medical Center. Thereafter, petitioner was discharged to Liberty Royal Rehabilitation and Health Care Center (Liberty Royal), a Medicaid certified nursing home. Less than one week later, he was transferred to Crystal Lake Nursing and Rehabilitation Center (Crystal Lake), another Medicaid certified nursing home. Petitioner remained at Crystal Lake until his.. read more →
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