Medicaid Stakeholders Attend the Big MAAC

New Jersey FamilyCare’s Medicaid program has many components that serve different population groups of people who are aged, disabled or poor. Did you know that there is a Medical Assistance Advisory Committee (MACC) which meets regularly and is required to hold quarterly public forums? On February 5th, along with other members of New Jersey NAELA, I attended the first MAAC (Medical Assistance Advisory Committee) meeting of the year.  MAAC meets quarterly outside of Trenton to discuss issues related to Medicaid and to take stakeholder input. It was quite a lively meeting.

In the audience there were attorneys, non-profit advocates, members of County Boards of Social Services, representatives of the Medicaid Managed Care Organizations and several Medicaid enrollees.  Here are some of the issues discussed  at the meeting:

— implementation of S499 and how that relates to denials of Medicaid applications for failure to provide certain information;

— Transitioning Medicaid/ MLTSS  recipients from a nursing home to a home in the community and how to assure continuity of care when the person switches from one program to the other;

— reductions in Private Duty Nursing and Personal Care Assistant (home health aide) hours for certain enrollees;

— how enrollees transition from one way of having Medicaid eligibility to another.

— an update on the Coronavirus, and many other topics.

I asked questions and expressed concern about how the State was implementing S499’s provision about giving extensions to applicants to obtain documentation.  I also commented on the importance of planning ahead for Medicare eligibility when a Medicaid recipient is eligible under the ACA.

Stakeholders at the meeting have a chance to ask questions of the state officials who are responsible for the Medicaid program, and they also have a chance to make recommendations for future MAAC meeting presentations.  If you have a concern about the Medicaid program in New Jersey, consider attending these meetings, or bringing them to the attention of your elder law attorney or another organization who can bring the concern to the MAAC.

Call us for advice on medicaid eligibility planning, applications and appeals ……… 732-382-6070

Update on Irrevocable Funeral Trusts and Medicaid Eligibility

Earlier this year I wrote about problems that are cropping up for Medicaid applicants who purchased irrevocable funeral trusts. The problem is that certain County Boards of Social Services were/are counting some of the dollars in the irrevocable funeral trust as if they are available resources (assets). The theory was that the items are ‘for the living,” and not “for the funeral of the deceased.” The result is that a Medicaid applicant thinks he is eligible for MLTSS to pay for his nursing home care, but his application is rejected for “excess resources.”  This can cause catastrophic consequences, considering as the cost of a nursing home in New Jersey is at least $12,000 a month and the decision is received months after the expected date of eligibility, leaving the individual (and his spouse) exposed to enormous bills. Such a decision by a county welfare board creates a legal problem that requires adept legal representation to address.

Recently, one county advised us that the following items are “disallowed:”

  • Acknowledgement cards- $10
  • Crucifix- $25
  • Flower Car- $350
  • Gratuity- $30
  •  Limo- $425
  •  Register Book- $25
  • Specially:  Prayer Cards- $50

When you are setting up an irrevocable prepaid funeral trust, discuss these details with the funeral director and try to obtain current guidance from the funeral director or an elder law attorney regarding what will or won’t cause a “Medicaid eligibility problem.” The State issued a policy memorandum, but it does NOT inform the public of what the consequence is of making a mistake of this sort. This is an example of the numerous legal traps that are embedded within the MLTSS program and aren’t always obvious on the surface to people who are filing applications. Although appeals are possible (Medicaid Fair Hearings), it would be preferable if people could know in advance exactly what the rules are so they can plan accordingly.

Call for advice on NJ Medicaid eligibility, applications & appeals …..732-382-6070