By notice contained in Medicaid Communication 14 – 15 issued on December 19, 2014, the State of New Jersey formally announced the official end of the Medicaid Medically-Needy program. Medically-Needy Medicaid no longer accepted applications after November 30, 2014. Beginning on December 1, 2014, individuals seeking Medicaid to pay nursing home costs as well as home.. read more →

 Supplemental Security Income (SSI): Effective 1-1-15  SSI Federal Benefit Rate           SSI Resource Maximum For an Individual – $733.00                   2,000.00 For a Couple – $1,100.00                      3,000.00 New Jersey State Supplement: New Jersey supplements the federal benefit rate with additional money. The payment received by SSI recipients each month includes.. read more →

New Jersey Medicaid may not count IRAs, 401(k) and pension plans owned by the spouse of an applicant in determining eligibility if funds may be withdrawn only by borrowing against the retirement assets. Avery v. Union County Division of Social Services Rose Avery admitted her husband, Friend Avery, to a nursing home in July 1997. After.. read more →

As discussed in a prior blog post, a major overhaul of Medicaid will be introduced in New Jersey in the coming months. The new Medicaid program is called Managed Long Term Services and Supports (MLTSS). The MLTSS implementation date has been repeatedly adjourned, and the next date scheduled to put the new program into effect.. read more →

New Jersey’s Qualified Income Trust Template For many years, Medicaid programs available to elderly and disabled New Jersey residents to help pay for long-term care costs have been quite limited. The Medicaid-Only Medicaid program pays the care costs of nursing home residents. A companion program, Global Options for Long-Term Care, pays care costs for residents.. read more →

In In re Tomei Trust, in connection with a family dispute regarding ownership of a business, plaintiff sought to terminate a trust he established, in which his father was the trustee. Plaintiff claimed that his father misappropriated trust funds, and asserted that the trust termination date was August 18, 2003. Plaintiff claimed that, despite the.. 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 →

The Medicaid programs in New Jersey which help residents pay long-term care costs are about to get a major overhaul. Currently, there are three (3) Medicaid programs in New Jersey that pay for long-term care costs. The Medicaid-Only Medicaid program pays the costs of caring for nursing home residents. A companion program, Global Options for.. read more →

(In Zahner v. Mackereth (U.S. Dist. Ct., W.D. PA, Jan. 16, 2014), a federal district court ruled that long-term annuities, that is, annuities with payment terms of 5-years or more, purchased by Medicaid applicants were not transfers for less than fair market value and, therefore, were not subject to a penalty period, but that shorter-term annuities.. read more →

In a very unusual ruling, a New York appeals court ruled that, despite transferring significant assets to family members, an applicant still qualified for Medicaid because the transfers were made exclusively for a purpose other than to qualify for benefits. Matter of Safran v. Shah, Docket No. D42144 (App. Div., 2nd Dept., July 2, 2014).. read more →

In Brill v. Velez (U.S. Dist. Ct., D. N.J., No. 1:13-cv-05643 (NLH/AMD), June 27, 2014), a federal district judge ruled that an applicant’s claim against the State of New Jersey for denying Medicaid benefits based upon the purchase of an annuity survived a motion to dismiss even though the State reversed the denial because the applicant.. read more →

On June 23, 2014, the Government Accountability Office (GAO) released its report, Financial Characteristics of Approved Applicants and Methods Used to Reduce Assets to Qualify for Medicaid, which Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) and Reps. Darrell Issa (R-CA) and Trey Gowdy (R-SC) requested. The GAO report confirmed that about 95% of approved.. read more →

In the May 19, 2014 J.P. v. Division of Medical Assistance and Health Services decision, New Jersey’s Appellate Division affirmed the final agency decision of the Director of the Division of Medical Assistance and Health Services (“DMAHS”), resulting in the imposition of a transfer penalty on the petitioner’s Medicaid application. After the ALJ had accepted the.. read more →

71st Semi-Annual Tax and Estate Planning Forum Our country is experiencing a growing number of households in which a parent and an adult child reside together. Census data reveals that the number of Americans living in multi-generational family households is the highest it has been since the 1950s, with a significant increase in recent years… read more →

A federal district court in New Jersey ruled that a Medicaid applicant was not entitled to a preliminary injunction to prevent the State from counting her annuity as an available resource. Matrangolo v. Velez (U.S. Dist. Ct., D. N.J., No. 13-6289 (MAS) (LHG), May 30, 2014). Plaintiff Marie Matrangolo, an 88-year-old woman who has been a.. read more →

Hon. Robert B. Kugler, United States District Judge for the District of New Jersey, reversed a denial of an application for Medicaid benefits by ruling that a pension benefit from the Department of Veterans Affairs (“DVA”) may not be counted as income for the purposes of any Medicaid program to the extent that the DVA.. read more →

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 →