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

New Jersey Takes Action to Modify Medicaid Program for COVID-19

 

New Jersey’s Medicaid program normally has a lot of rules and red tape.  Some of the rules relate to who meets the level of care for Long Term Services and Supports (LTSS) and some relate to financial eligibility.  All of these rules require travel and manpower to implement that may not be available during this pandemic emergency.
Federal Medicaid law has a type of waiver of Medicaid rules for emergencies, like COVID-19, or before that, Superstorm Sandy.  These are called 1135 waivers, and they can be obtained much more quickly than other types of Medicaid waivers.Waivers were just granted making it easier for certain individuals to get the care they need through the Medicaid program. Two provisions particularly stand out.  First, if a person is approved for the MLTSS Home and Community-Based Services Program (formerly known as Global Options) and wants to hire her own privately-selected employee as her “Care Provider,” “Provisional provider enrollment” can be granted  if certain information for the employee is given, assuming there will be regular enrollment after the emergency is over.  This may be useful for family member providers or volunteers helping families ride out quarantine.Second, the necessity to have a PAS completed before a Medicaid-eligible person is admitted to a nursing home. Pre-Admission Screenings are now waived for 30 days for new admits, and are not required for facility to facility transfers.

Our state Medicaid director, in a letter dated March 19th, asked for such waiver authority to modify or suspend certain normal Medicaid rules retroactive to March 1st, such as:

  • Suspending Prior Authorization requirements
  • Waiving Pre-Admission Screenings as a requirement for nursing home placement (these are done by state nurses physically visiting applicants at their facilities)
  • Letting a nursing home get Medicaid payment even if they are providing services in an alternate facility due to an evacuation.
  • Making it easier for family members to serve as Medicaid-paid personal care assistants
  • Relaxing rules for filing deadlines for fair hearings
  • Allowing more Telehealth and telephonic reimbursement by Medicaid

Monday, CMS replied to Director Jacobs, clarifying that the nationwide 1135 will allow for most of these requests but that some require state plan amendments:

  • Prior authorization is a function of the state plan and will require an amendment but previous prior authorizations can be extended due to the emergency
  • Pre-Admission Screenings are waived for 30 days for new admits, and are not required for facility to facility transfers
  • MCO decision fair hearing appeals will get 120 days to be filed if it happens within the emergency period
  • Expanding eligible providers to include Medicare providers who may not have been Medicaid enrolled for the duration of the emergency
  • Provisional provider enrollment if certain information for an employee (like a family member) is given, assuming there will be regular enrollment after the emergency is over
  • Medicaid will be able to pay facilities even if they have to move residents to alternative settings during the emergency.

We strive to stay as informed as possible on Medicaid Eligibility and Medicaid benefits so that we can best guide our clients who need senior care urgently.  We will continue to ask questions and monitor the day-by-day and hour-by-hour developments during this health care crisis.

Call us for advice about Medicaid eligibility, spend-down plans, applications and appeals ……………………732-382-6070

NJ DMAHS announces initiatives to protect the most vulnerable

The State of New Jersey Department of Human Services has announced some initiatives designed to help assure continuity of care, access to medicine and nutrition assistance, for individuals who are dependent on programs such as SNAP, group homes, charity medical care, MLTSS home care and services in certain DDD-funded programs. As always, the real test will be in the details for how these initiatives will be administered, but many of the ideas sound great. Some of the efforts  that were announced through a press release on the 18th are these:

“Cash, Shelter and Food Assistance

  • Automatically extending for 60 days WorkFirst New Jersey cash assistance to individuals whose case is up for renewal in March or April;
  • Extending all Emergency Assistance cases through April 30;
  • Deeming the current state of emergency as a good cause exemption for the work requirements in WorkFirst New Jersey and SNAP and suspending all adverse actions for non-compliance;

“NJ FamilyCare/Medicaid

  • Covering COVID-19 testing, visits for testing, and testing-related services at no cost;
  • Waiving costs for COVID-19 testing, visits for testing, and testing-related services in the Children’s Health Insurance Program (CHIP);
  • Covering 90-day supplies of prescriptions for maintenance medications and early refills of prescriptions in Medicaid and CHIP; and
  • Directing hospitals to waive cost sharing for uninsured individuals who are eligible for charity care for medically necessary testing and testing-related services for the COVID-19 virus.

Supporting Older Residents

  • Mobilizing nurse care managers at Medicaid health plans to call high risk populations to identify and address their critical needs including supplies such as durable medical equipment and food;
  • Allowing older residents receiving prescription drugs through Medicaid or the state prescription drug assistance program (PAAD and Senior Gold) to refill their prescriptions early and receive 90-day supplies of   maintenance medications;
  • Working with our county partners to ensure that those receiving home-delivered meals continue to have access to food;

“For those receiving DDD services, 

  • Temporarily closing congregate day programs for individuals with intellectual and developmental disabilities and supporting this transition;
  • Providing flexibility to families to quickly hire workers and working closely with program providers and direct support professionals during the closure; ……. “

Tremendous partnership efforts will be needed across all sectors of government and society to take care of our most vulnerable citizens at this difficult time. Hopefully the DHS will focus on flexibility and practicality, minimize red tape and streamline the steps it takes to accomplish these laudable goals.

 

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

Marinaro Joins NAELA Board, Continues as Co-Chair of Federal Policy Group

Lauren Marinaro has been selected for a two year term as National Board Member for the National Academy of Elder Law Attorneys (NAELA) for 2020-2022.  NAELA  is a national membership organization for attorneys that keeps its members informed and up-to-date on fast-breaking changes in the law — legislation, agency rules and court decisions — that would affect seniors and people with disabilities.  Lauren’s  excited to work with the board on the issues that affect the practice of elder law and our clients.  She will continue her work as NAELA Federal Policy co-Chair.  So much has happened and continues to happen on the policy front as the two political parties bring their contrasting ideas to the world of public benefits–block grants, 1115 waivers, changes to Social Security rules, and ABLE accounts just to name a few.  By taking what we learn from our clients back to our national organization, she will have the opportunity to help bring about meaningful and helpful changes in the programs our clients rely upon.

Federal and state programs that .particularly impact people who are aged or disabled include Social Security, SSI, Medicaid, Medicare, public housing, HUD, food stamps (SNAP). Then there are the programs that govern insurance products, reverse mortgages, predatory lending, state and local tax exemptions, and landlord-tenant issues. The list goes on and on. The NAELA public policy committee looks at all of these issues on an ongoing basis, and Lauren is playing an active role with that process.

for advice and representation on elder law issues, call us at ……….. 732-382-6070

Medicaid Improvement Act signed by Governor Murphy

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 procedures that can improve the experience that the public has when they need to apply for Medicaid benefits for long-term care. As regular readers of this blog know, applying for MLTSS is often a harrowing experience and applicants encounter many frustrating proof requirements that can be difficult if not impossible to meet.  The bill appoints a Medicaid eligibility ombudsperson to receive complaints, as well as liberalizes requests for more time to retrieve documents in the application process.

Look for more updates here on the Murphy administration’s implementation of this new law!

For advice on MLTSS Medicaid applications and appeals, call us at … 732-382-6070