Social Security COLA and QITs for Medicaid recipients
On January 1, 2023 the Social Security Administration will be giving its recipients an 8.7% Cost of Living Increase (COLA). You probably know that if a person on New Jersey MLTSS-Medicaid receives gross fixed monthly income in excess of $2,523 (that’s the 2022 threshold), they must establish a Qualified Income Trust (QIT) to receive the excess income, in order to preserve their Medicaid...
Estate Recovery and Medicaid Liens
“If I go into a nursing home, will the State take my house?” This is a commonly-asked question. The answer is “No, but …” If a person applies for long-term care Medicaid benefits, his available assets have to be below a certain level. The house he owns generally has to be listed for sale (called a “Plan of Liquidation”), but this requirement is waived...
Homemade Powers of Attorney can create expensive legal problems
I ran into a situation recently that I thought I’d share with my readers since it’s the type of thing that happens over and over again. The Elder person is living in New Jersey but owns real estate in another state that needs to be listed or sold because he is applying for Medicaid to pay for his nursing home. The person has Alzheimers Disease and no longer has capacity to sign...
Reduction of Home Care Hours Under Medicaid Can’t be Arbitrary
New Jersey Family Care is the Medicaid a program that provides MLTSS — Medicaid Long-Term Services and Supports. The home care program is called HCBS — Home and Community-Based Services. Once the applicant has been found eligible for Medicaid and is assigned a Medicaid case number, s/he must select a Managed Care Organization (MCO). S/he will then receive a visit from a Case...
Payback provisions are required for a qualified special needs trust
Self-settled special needs trusts must have a payback provision to be considered an exempt trust under the federal and state Medicaid program. A Medicaid applicant under 65 can transfer his or her excess resources (assets) into a “special needs trust” and avoid the usual transfer penalties, but only if the trust meets all of the requirements of the federal and state law. Also, if...
Medicaid Eligibility – What if the Services aren’t delivered?
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...
Disability Integration Act would mandate that states provide home care services
Senator Chuck Schumer introduced S-2427, the Disability Integration Act, on December 5, 2015, to counteract discrimination in Medicaid funding which is disproportionately allocated towards nursing home services. One effect of the bill could be to force States to allocate funds within their Medicaid budgets for Home and Community-Based Services (MLTSS-HCBS) for Medicaid applicants who can...
More on Medicaid Liens
As explained yesterday, the NJ State Medicaid Program cannot assert a lien against the Medicaid recipient’s property during his lifetime, unless the individual had wrongfully received benefits and the State sued and obtained a judgment. In all other cases, a lien can only be asserted after the death of a Medicaid beneficiary, and certain conditions must apply: the Medicaid recipient had...