nj medicaid Tag

The NJ Division of Medical Assistance and Health Services (DMAHS) has released Medicaid Communication #22-01 which provides the new numbers that are relevant to applications for Medicaid Long Term Services and Supports (MLTSS) benefits.    22-01_Income_and_Resource_Standards_for_Medicaid_Only (1)      MLTSS pays for nursing home care (skilled nursing facilities), Assisted Living Facilities and...

Some 2021 numbers are now published for New Jersey Medicaid’s MLTSS program. These apply to people who are applying for benefits under the MLTSS/ Medicaid program for long-term care services. These numbers relate to the resource limit for a married applicant and spouse, the income “cap” that would trigger a need to set up a...

As COVID-19 affects employment nationwide, more New Jerseyans will need to make strategic decisions about health insurance and tax filing this year.  Marketplace insurance and MAGI Medicaid are based on your 2020 Modified Adjusted Gross Income (MAGI).  There is special enrollment for a change in employment status. MAGI will include any unemployment you collect as well as any distributions from...

This has been a busy year for the elder law attorneys at our Firm in the realm of community education. We’ve been teaching at programs run by the NJ Institute for Continuing Legal Education almost every month. Among the topics of Linda and Lauren’s lectures were Representing Clients in Medicaid Fair Hearings at the Office of Administrative Law; Getting the Most out of...

When a married person applies for MLTSS Medicaid benefits, the applicant must provide 5 years of records pertaining to all financial activity of the applicant and their spouse. The applicant also must supply proof of the spouse’s current income and assets. Sometimes, the spouse just refuses to cooperate with the process, creating a dilemna for the Medicaid applicant. In some...

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...

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...

Medicaid services are now provided through managed care organizations (MCO’s), which are required by federal law to provide a grievance and appeal process for the enrollees. An enrollee may be dissatisfied with the number of hours of service, or the services being provided, or a host of other issues. Three major nonprofits have collaborated on a new guide for advocates to help them in...

After the Governor and the Assembly leader resolved their Fourth of July Weekend Budget Kerfuffle, some positivity came out of it for Medicaid long-term care providers and beneficiaries. Nursing home reimbursements would be increased by $10.5 million, shifting funds from Managed Long-Term Services and Supports (MLTSS). This would be $5.25 million of state funds with an identical federal match....

There is plenty of debate about the benefits and drawbacks of buying long-term care insurance.  The premiums are expensive for a person in their 70’s who is first considering a purchase. Potential buyers worry that they will pay premiums for years and never have to use the policy. The industry has been in flux and there aren’t too many carriers around. What I do know is that over...