A New Jersey appeals court held that payments made by a Medicaid applicant to her daughter pursuant to a written care agreement under which the daughter provided various services were actually gifts and subject to a transfer penalty. P.W. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-4756-11T3, April 29,.. read more →

As a result of the advocacy efforts by several New Jersey elder law attorneys following a class action lawsuit filed against the State of New Jersey, New Jersey Medicaid’s penalty divisor will be increased to $9,535.62 per month, or $313.50 per day, effective April 1, 2014. The newly increased divisor shall be used for all new or pending.. read more →

The Centers for Medicare and Medicaid Services (CMS) has released a letter (CMS Letter SMD-14-001) to States with guidance on how to apply Medicaid’s estate recovery and transfer of asset rules to individuals newly eligible for Medicaid under the Affordable Care Act (ACA). In general, most of the long-term care rules that apply to traditional.. read more →

The annual roundup of the top 10 11 elder law decisions from across the country for 2013 as prepared by staff at the ElderLawAnswers website is reproduced below. Almost all the cases hinged on the interpretation of state or federal Medicaid law.  Those purchasing annuities or transferring property in exchange for a promissory note did.. read more →

For the first time, the Division of Medical Assistance and Health Services (DMAHS), New Jersey’s  Medicaid agency, held that an applicant for nursing home Medicaid was eligible for benefits despite the fact that she made a substantial gift within the look-back period and owned an $80,000 annuity. M.W. v. Division of Medical Assistance and Health.. read more →

In this case, the Superior Court of New Jersey, Appellate Division, held that the state Medicaid agency was not bound by an order for separate support and maintenance entered by a Family Part judge in a case filed by one spouse against the other spouse who later applied for Medicaid benefits when the Family Part.. read more →

A federal district court in Western Pennsylvania held that the purchases of single premium immediate annuities with short payment terms by applicants for Medicaid constitute improper transfers of assets even if the annuities otherwise comply with the federal Medicaid laws in all respects. Zahner v. Mackereth, Civil No. 11-306 (W.D. PA, January 16, 2014). This.. read more →

On March 13, 2013, the highest court of our state granted my Petition for Certification, in which I asked the Supreme Court to consider the case of a retired fireman and his continuing battle to conduct estate planning for the benefit of his severely disabled son. This is the second time the Supreme Court has.. read more →

As the U.S. Court of Appeals, 2nd Circuit, held in Lopes v. Dep’t of Social Services, 696 F.3d 180 (2d Cir. 2012) and the U.S. Court of Appeals, 3rd Circuit, held in James v. Richman, 547 F.3d 214 (3d Cir. 2008) when resolving the same issue, the U.S. Court of Appeals, 8th Circuit, has now.. read more →

In an Initial Decision of the New Jersey Office of Administrative Law, Administrative Law Judge Laura Sanders held that transfers by a Medicaid applicant to her adult disabled children were exempt transfers that did not subject the Medicaid applicant to a penalty period. M.K. v. Division of Medical Assistance and Health Services and Somerset County Board.. read more →

In an opinion that breaks sharply with established practice, the New Jersey Supreme Court ruled that an application by a divorced spouse to pay child support for a disabled child into a special needs trust should be granted where the proponent shows that it is in child’s best interest to do so.  This is a.. read more →

A federal district court judge in New Jersey granted a Medicaid applicant’s motion for a preliminary injunction, thereby enjoining the State from counting an annuity owned by her husband as an available resource in determining her eligibility for Medicaid. Flamini v. Velez, Civil No. 1:12-cv-07304 (D.N.J. July 19, 2013) Elizabeth Flamini entered a skilled nursing.. read more →

John Landy and Margaret Sauchelli are elderly persons who purchased promissory notes and subsequently applied fur Medicaid benefits. New Jersey’s Department of Human Services (DHS) declared Landy arid Sauchelli to be ineligible and denied their applications. In doing so, the agency ruled that the promissory notes were countable resources that made both Landy and Sauchelli.. read more →

A Medicaid applicant who made payments to her daughter for more than four years and claimed those payments were made to cover the cost of monthly payments for her mentally ill daughter’s rent could not prove the payments were made for a purpose other than to qualify for Medicaid because she did not prove that.. read more →

A federal district court in New Jersey holds that an annuity purchased by the spouse of a Medicaid applicant with the couple’s countable resources which exceeded the resource limit under Medicaid is not a transfer for less than fair market value for purposes of Medicaid eligibility. Carlini v. Velez (U.S. Dist. Ct., D.N.J., No. 12-7290 (JEI/KMW),.. read more →

Fully Developed VA Claims The Department of Veterans Affairs (VA) has implemented a new process designed to expedite claims for VA benefits having all information required by the agency and all required supporting  evidence. The new process, officially titled in 38 CFR §20.1509(a) as the “Expedited Claims Adjudication Initiative-Pilot Program,”  is unofficially called the Fully.. read more →

New Jersey appeals court ruled that a Chancery court’s order holding that certain trust expenditures “shall not” act to deprive the beneficiary of any Medicaid benefits should a Medicaid application be made, exceeded the court’s subject-matter jurisdiction because New Jersey’s Medicaid agency, the Division of Medical Assistance and Health Services (DMAHS), was the single state.. read more →

In recent years, applicants for Medicaid benefits in New Jersey have been incorrectly denied eligibility as a result of including as “countable income” the applicants’ Veterans Administration Improved Pension (“VAIP”) benefits awarded pursuant to 38 U.S.C. § 1541(d)(1) for unreimbursed medical expenses (“UMEs”). New Jersey’s Medicaid agency, the Department of Medical and Health Services (“DMAHS”),.. read more →

On Saturday, April 27, 2013, I presented a session on the impact of elder law issues on divorce mediation at the 2013 Annual Divorce Mediation Seminar by the New Jersey Association of Professional Mediators. The topics covered in my session included Social Security, including retirement, disability and survivors benefits, Supplemental Security Income benefits, Medicare, Medicaid,.. read more →

The Department of Veterans Affairs (VA) is causing Medicaid applicants to be incorrectly denied benefits due to the way the federal agency is reporting the VA pension benefit to state agencies for the purpose of determining Medicaid eligibility. In that regard, the VA is issuing letters to state Medicaid agencies which breakdown the VA benefit.. read more →

In the event of a Medicaid denial as a result of an unauthorized transfer or gift to a third party, one avenue of redress that may be available to a Medicaid applicant is to seek a waiver of the penalty based upon the “undue hardship” exception in the Medicaid regulations. The standards under which a.. read more →

Below, courtesy of the ElderLawAnswers website, is the annual roundup of the top 12 elder law decisions decided by federal and state courts in 2012. The cases were selected based upon readership as measured by the number of readers who “clicked through” to the full story in the website’s Weekly and Monthly e-letters. Links in.. read more →

For years, clients have asked about pension benefits available from the Department of Veterans Affairs (VA). Because of this consistent client interest, I’ve written about VA pension benefits with Housebound or Aid and Attendance Supplement in many blog posts over the years. However, one issue I haven’t blogged about yet involves calculating the amount of.. read more →

New Jersey’s Medicaid rules are complicated, and seem like they’re always changing. One such change in the rules that occurs on a regular basis is the State Medicaid agency’s amendment to the Medicaid program’s “penalty divisor.”  On December 10, 2012, a Medicaid Communication, or notice, was released by the Division of Medical Assistance and Health.. read more →

In the usual case, a transfer of assets, or gift, by a Medicaid applicant made within five (5) years of the date of the Medicaid application will result in the imposition of a penalty, or period of ineligibility for Medicaid. N.J.A.C. 10:71-4.10(a) The length of the penalty period depends upon the value of the gifted.. read more →