Medicaid Improvement Act signed by Governor Murphy
On July 12th we reported that a bill to improve and streamline the Medicaid application process was on the Governor’s desk. The bill was signed recently. Here’s the NJ Bar Association’s press release. Lauren Marinaro worked along with other colleagues in NJ NAELA to help get this bill passed.
This new law (S-499/A4569) is a good start towards evaluating and implementing...
New Social Security policy creates confusion over Special Needs Trusts
The Social Security Administration has published a new policy requirement concerning Special Needs Trusts in the form of a provision in its POMS . The new POMS states that attorney fees charged for preparation of certain trusts for individuals who are now receiving, or may in the future receive SSI, must be approved by the Social Security Administration (SSA).
POMS Link:...
Marinaro secures Court reversal of Medicaid denial where the proof required by DMAHS just didn’t exist
The burden to prove eligibility for Medicaid rests with the applicant, but sometimes, the agency just refuses to accept the evidence they are given. This is demonstrated in a recent New Jersey case in which a denial of benefits was reversed by the Appellate court. The decision is “not approved for publication ,” which means it doesn’t establish a precedent that’s...
Estate Recovery Bill Limits Medicaid Services That Can Be Recovered
New Jersey expanded Medicaid under the Affordable Care Act, (ACA, also called Obamacare) causing terrific health coverage gains for its residents. One unfortunate byproduct of Medicaid expansion is Estate Recovery, which can be assessed against any Medicaid recipient over the age of 55. The purpose of estate recovery is to reimburse the State for Medicaid benefits provided, and typically the...
Spousal Impoverishment Protections in Medicaid Home Care Program Help All Ages
NAELA has been at the forefront of keeping the Spousal Impoverishment Protections in the Medicaid Home Care Program (HCBS) that were included in the Affordable Care Act. So far, with great effort, it’s working.
It’s important for disabled people who are under 65 and who meet the nursing facility level of care to recognize that these protections are out there. The “level of...
Warning!! Watch out for Medicaid Traps when setting up an Irrevocable Prepaid Funeral Contract
When “spending down” excess resources in connection with an application for Medicaid benefits under the MLTSS program, the individual frequently purchases an irrevocable, prepaid funeral contract, because such a contract is treated as an “excluded resource” under the rules of the program. These contracts are set up by the funeral home, and the individual looks through a...
The Governor has a Medicaid system improvement bill on his desk
If you or any of your colleagues, friends, or family members are in support of improving the system for Medicaid eligibility determinations, you should call the Governor’s Office of new jersey’s Governor Murphy at 609.292.6000 and request that the Governor sign A4569/S499 into law. pass on this information to people you know who are interested in this issue.
According to BillTrack50, in...
New Jersey issues Guidance on ABLE accounts and Medicaid
Hot off the presses, the State of New Jersey has just released its Med-Com concerning the treatment of ABLE accounts by the New Jersey Medicaid programs. Here it is – Med-Com 19-09 ABLE Act
Up to $305,000 that is held in an ABLE account will be excluded from consideration as a “resource” for purposes of NJ Medicaid programs (the limits is $100,000 for SSI). The accounts can...
Trusts can undermine Medicaid eligibility even if they accomplish other goals
A “Trust” is an estate-planning structure that has many different uses and purposes. Fundamentally, to be valid, there needs to be (a) a Trustee — the manager, who is not the owner of the assets; (b) a Beneficiary – the party that the trustee can spend assets on, who is not the owner of the assets, (c) terms and conditions – usually contained in a legal document...
Watch out for the Rules of Evidence in Medicaid appeal hearings
The first level of appeal when the State Medicaid Agency issues an adverse decision is called a “Fair Hearing” and takes place at the NJ Office of Administrative law (OAL). The Judge is referred to as an Administrative Law Judge or “ALJ.” That Judge issues an initial decision that is subject to review and final decision by the NJ Division of Medical Assistance and...