Medicaid’s MAAC meetings are open to the public
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...
Applicants need an advocate during Clinical Assessment for NJ Medicaid Services
The State of New Jersey has not yet proposed new regulations covering the details of its NJ FamilyCare MLTSS Medicaid program. However, the details can be found by reading the Contract which must be signed by a participating Contractor to the program. The Contract is 118 pages long. It does cross-reference certain federal and state regulations. Of course, an applicant first has to become...
Applying for NJ MLTSS? Here are the acronyms you need to know
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...
State of NJ issues MedCom to Medicaid Supervisors on use of Qualified Income trusts (QITs)
On December 19th, 2014, the NJ Division of Medical Assistance and Health Services (DMAHS) issued Medicaid Communication No. 14-15 to the County Welfare (CWA) Directors, explaining the necessity for certain higher-income Medicaid applicants to divert their excess income into a Qualified Income Trust (QIT) before they can apply for MLTSS Medicaid services to pay for nursing home, assisted...
Medicaid isn’t the only program that requires a look-back
If you apply for Medicaid benefits to pay for long-term care in a nursing home, assisted living or at home, you have to be prepared for the grueling 5-year look-back, a process that can leave you in a quagmire as you search for answers to the most minute questions about the personal financial lifestyle of your household or the applicant you’re assisting. Medicaid is now being referred to...
MLTSS and You (and maybe your lawyer too)
Now that we know that expanded Medicaid is kicking off in a big way this month, with expanded eligibility and full integration of all the waiver populations and nursing home residents in the new Managed Long Term Services and Supports program, we need to start thinking about how this will affect clients’ particular interactions with Medicaid, the managed care organization (MCO) and...
It’s official: NJ Qualified Income trusts are needed for high-income Medicaid applicants as of 12/1/14
I am sure you’ve seen or heard about the changes coming to the NJ MLTSS Medicaid program with respect to applicants whose gross monthly income exceeds the “income cap,” which is presently $2,163. I’ve blogged about this over the last few months. Well it’s official now – the State has confirmed that December 1 is indeed the date in which this new procedure...
Appealing reduction of home care hours under NJ Medicaid
Has your loved one been receiving home care services under any of the New Jersey Medicaid Home and Community-based programs such as Global Options? The State’s Comprehensive Medicaid Waiver replaced that program with MLTSS – Medicaid Long Term Services and Supports — and each recipient is assigned to a Managed Care Organization (MCO) which performs a care plan assessment and...
NJ Medicaid MLTSS Feedback Forums scheduled in October
You know by now that the New Jersey Department of Human Services has been developing a new Medicaid Long Term Services and Supports (MLTSS) program under its 2013 Comprehensive Medicaid Waiver. It’s still a work-in-progress. This program affects all elderly and disabled Medicaid applicants and Medicaid recipients who need long-term care Medicaid services outside of nursing homes. Three...
Coordinating Home Care for the Frail Aged takes Persistence
It is axiomatic that aged individuals would prefer to remain in the comfort of their familiar surroundings rather than finish their lives in an institutional setting. This is the case whether the person lives in a mansion or a little apartment, in a house with their beloved front porch or a home with their comforting tiny living room or sunny little back yard. Federal initiatives exist that...