DMAHS Tag

The NJ Division of Medical Assistance and Health Services (DMAHS) has just released Medicaid Communication #20-01 which provides the new numbers that are relevant to applications for Medicaid Long Term Services and Supports (MLTSS) benefits.   20-01_Medicaid_Only_Standards         MLTSS pays for nursing home care (skilled nursing facilities), Assisted Living Facilities and part-time home care...

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...

The need to place a beloved family member in a nursing home may be one of the most harrowing and heartbreaking decisions a person has to make. Not only is there a terrible sense of guilt and failure, but the sheer cost of a single month in a nursing home is staggering, and leaves the family with a bleak view of their future security. They feel vulnerable, because they are at the mercy of...

The federal  Nursing Home Residents’ Rights Act protects residents against arbitrary, involuntary discharge by specifying only 6 grounds for discharge..And above all,  even when one of those 6 bases exists, a nursing home also has the duty to make a safe discharge.   A nursing home cannot involuntarily transfer a Medicaid resident unless there is another placement available which is...

The Medicaid program pays for nursing home care for financially eligible people. The program is administered by the State Division of Medical Assistance and Health Care Services (DMAHS), which delegates the application processing to the employees of the county Boards of Social Services (sometimes called county welfare boards). All of these people are government employees. They receive and...

After a Medicaid long-term care application is approved and the Plan of Care (PoC) for  home and community-based services is approved (MLTSS-HCBS), the individual may be faced with a wait. The New Jersey Medicaid HMO’s that provide the services for the State of New Jersey are required by the State contract to have a deep enough provider pool to service the need. However, clients are...

Effective July 1, the State of New Jersey Division of Medical Assistance and health Services (DMAHS) has raised the Minimum Monthly Maintenance Allowance (MMMNA) for the spouse of a person who is on Medicaid. For residents of nursing homes, the general rule is that all of the resident’s income must be turned over to the facility as a cost-share, except for authorized deductions which...

MedCom No. 15-08 was issued on April 29th by the NJ Division of Medical Assistance and Health Services (DMAHS) to provide instructions to applicants who receive  benefits from the Veterans Administration.  When a person applies for Medicaid to pay for nursing home, assisted living or home care under the MLTSS program, they need to disclose their income from all sources. Each MLTSS program has...

  The public is allowed to attend the quarterly meetings of the Medical Assistance Advisory Council  (MAAC). The council provides input to the state Director of the Division of Medical Assistance and Human Services (DMAHS) in the design and implementation of the NJ Family Care/ Medicaid Long-Term Services and Supports programs. Federal law and State statute provides for the establishment...

You probably know by now that NJ Medicaid’s Home and Community Based Services are now being administered NJ FamilyCare and that the State’s Comprehensive Medicaid Waiver has created a whole new landscape that is centered around managed care. http://www.state.nj.us/humanservices/dmahs/home/mltss.html When applying for these services you will encounter a lot of code words. For...