In this case, K.L., a Medicaid applicant, was assessed a penalty period, or period or ineligibility for Medicaid nursing home benefits, of 604 days based upon (1) the failure to obtain fair market value for a life estate owned by K.L. when real estate containing the life estate interest was sold, and (2) a number.. read more →

This matter arose from the imposition of a transfer penalty on Petitioner’s receipt of Medicaid benefits. Beginning in 2018, Petitioner resided with her son, R. R., and R. R. ‘s wife. Petitioner previously resided in her own home. On November 1, 2018, Petitioner and R. R. executed a “Room Rental Agreement, ” wherein Petitioner agreed to.. read more →

A.V. suffered from Alzheimer’s disease and dementia. In January 2021, A.V. moved into a skilled nursing facility. That April, she filed her first application for Medicaid benefits, seeking a community spouse resource allowance for her husband, J.V.  In June 2021, the Cumberland County Board of Social Services (CCBSS) denied the claim, advising A.V. and J.V… read more →

In this case, the New Jersey Superior Court, Appellate Division, reversed a final decision of the state Medicaid agency imposing a 203-day period of disqualification for Medicaid benefits based upon the applicant’s alleged transfer of assets for less than fair market value within the five-year look-back period before the applicant entered a nursing home. J.F… read more →

A New York appeals court held that transfers made by a Medicaid applicant before she was diagnosed with Parkinson’s disease were not transfers for less than market value subject to penalty because the transfers were made as part of a history of gifting to her children done exclusively for a purpose other than to qualify.. read more →

A New Jersey appeals court upheld a Medicaid penalty period imposed on a nursing home resident who, prior to admission, paid home health care aides via checks payable to “cash” without written contract, and didn’t prove that the rates paid to the aides were for fair market value. D.Z. v. Ocean County Board of Social.. 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 →

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 →

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 →

Medicaid, unlike Medicare, is a public benefit program based upon financial need. As a result, you are eligible for Medicaid only if you are over age 65, blind or disabled, and have few assets. If an applicant is married, all assets in the sole name of the husband, in the sole name of the wife, and.. read more →

Gifts made during the Medicaid look-back period result in a penalty, or period of ineligibility, unless the applicant can prove that the gifts were made exclusively for some purpose other than to qualify for Medicaid. S.L. v. Division of Medical Assistance and Health Services, Docket No. A-3520-11T4 (App. Div., September 2, 2014) In December 2009,.. 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 New Jersey appeals court upheld the imposition of a penalty period on a nursing home resident’s receipt of Medicaid benefits, holding that the resident failed to rebut the presumption that a court-ordered payment made to the resident’s adult children for previously uncompensated services provided under a power of attorney was not a valid payment.. read more →

A New Jersey appeals court ruled that a nursing home resident who transferred the majority of her assets to her son during the look-back period was ineligible for nursing home Medicaid benefits when she failed to prove the transfer was done exclusively for a purpose other than to qualify for Medicaid. A.M. v. Division of.. read more →