NJ Supreme Court issues Notice concerning Courts and Cases

The latest release by the NJ Supreme Court outlines the latest rules concerning trials, scheduling, closings, and so on which will affect cases, lawyers  and litigants throughout New Jersey. Cases can still be filed but numerous adjustments are being made to the deadlines and procedures. Emergencies can be addressed, and all matters are going to be handled by telephone or videoconferencing. Here is the entire Release.Supreme Court release 3-27-2020

For updated information about hearings at the Office of Administrative Law (such as appeals of Medicaid/MLTSS  denials), click HERE.  

For updated information about Medicare Hearings and Appeals, click HERE

For information about Social Security offices and hearings click HERE.

 

Stay safe, stay healthy. Call us for help with all your elder care, estate planning and special needs concerns ….. 732-382-6070

COVID-19 Testing available for Medicare beneficiaries

Medicare Part B generally covers medically necessary outpatient testing for beneficiaries. CMS has recently advised that if testing is ordered by the patient’s physician and the test is performed on or after February 4, 2020, it will be a covered service under Medicare Part B. Read more here.

The Centers for Medicare and Medicaid Services is issuing fact sheets and alerts that address corona virus-related concerns raised by Medicare beneficiaries as well as health care providers. Some of them are: guidance to home health care providers — anyone who hires a home care provider might want to study this and share it with their employee — expanded tele-health services to enable people to contact professionals for advice by phone; and specific guidance for specific health care settings such as nursing homes or dialysis centers. 

The Center for Medicare Advocacy (CMA) is an excellent source for updates about Medicare and for advocacy on legal problems with Medicare coverage that are encountered by enrollees. Another great source of help can be found at your local SHIP office — the State Health Insurance Assistance Program (SHIP).

Call us for help with your elder care law problems …… 732-382-6070

Upcoming Live Seminar: Protecting Assets While Qualifying for Medicaid

Aside

Lauren Marinaro will present at an upcoming National Business Institute live seminar: Protecting Assets While Qualifying for Medicaid

Date: Tuesday, August 15, 2017

Time: 9:00 AM – 4:30 PM

Location:
Molly Pitcher Inn
88 Riverside Ave
Red Bank, NJ 07701

For more information or to register, please visit:

http://www.nbi-sems.com/Details.aspx/R-76376ER%7C?ctname=SPKEM

Don’t count on the Medicaid representative at the County Board to remind you to Spend Down

An application for Medicaid benefits cannot be approved before the applicant (and spouse, if any) has completed the spend-down, because benefits are not payable unless the applicant is financially eligible. It is not uncommon for someone to initiate an application for Medicaid without having any idea whether they are eligible or not. The nursing home may start the process; a nonattorney representative may start the process; a hospital social worker may suggest that  they apply. They may leave the intake interview with a List of Required Documents, but not be told that they have to spend down to “X” level before the application can be processed. Sometimes, months go by and the hapless applicant is running up nursing home bills without actually being Medicaid eligible because they didn’t “spend down.”

Despite the fact that the regulations of the State Medicaid Manual  at N.J.A.C. 10:71-2.2(c) specifically obligate the County Welfare Board to assist the applicant in this process, all government agencies are reticent to provide advisory opinions on what measures will comply with a program’s rules. There may be substantial opportunities to shelter assets for the family, but the CWA cannot be counted on to provide that sort of advice. Also, given the huge volume of cases, there may be many procedural tangles that prevent the applicant from receiving necessary advice through the CWA. Unfortunately, if the applicant sits back and waits for guidance, they may discover that they and their spouse are incurring tremendous financial obligations that they have no good way to pay.

The spend-down may be a combination of expenditures, exempt transfers and replacement of existing assets. The math is precise and until the spend-down is completed, there can be no eligibility. By getting individual legal advice early in the process, an applicant can take advantage of the opportunities that the rules provide to protect his family and achieve eligibility at the soonest possible time.

Call for representation regarding Medicaid eligibility spend down planning …. 732-382-6070

Block Grants Could Throw Elder Care into Chaos

Since the election, there have been serious plans put out there to radically alter the Medicaid program .  Right now, while it can be hard to get Medicaid without guidance and assistance,  if you meet the eligibility criteria you are entitled to receive certain statutory benefits under federal law.  The benefits provided to every person on Medicaid are paid for through a combination of  state dollars and federal dollars, and each state has a formula for this.

Block grants change this.  Instead of the federal government contributing a certain amount per person, each State would receive a yearly amount (block of funds), and the State would decide how to allocate the funds.  Right now, this is how the Temporary Assistance for Needy Families (TANF) program works. While block grants may provide enough money to help people in good economic times (when enrollment is lower), when times aren’t so great the money won’t go as far, and eligible people might not get the services they would have gotten before.  This could mean waiting lists for nursing home Medicaid residents (creating financial hardship for the nursing home providers), and waiting lists for receipt of home health care services by aged or physically disabled people residing in the community, as well as waiting lists for residential services for people with intellectual disabilities, and less health care for low-income adults and children. Here is the  KAISER FAMILY FUND Block grant analysis

What can we do about this?  I can think of a couple of things.  First, speak out–let your Congressperson know that you don’t like the idea of block grants and you don’t want services for seniors cut.  Second, really think about whether a loved one has put off seeking present or future public benefits that he or she could benefit from. Seniors need to plan for their care and it’s important to seek enrollment before the rules substantively change for the foreseeable future.  If you’re not sure, we’re here to help.

We can prepare and file your Medicaid application. Call us for legal advice about your eligibility … 732-382-6070