In Henderson v. Dept. of Health and Human Services (May 18, 2023), a Medicaid applicant transferred significant resources, including the full value of her retirement account, to an irrevocable trust. When she applied for Medicaid during the 60 month look back period, the Medicaid agency found the resources were not countable, but imposed a transfer […]
The following Georgia Medicaid cases were litigated outside the context of an administrative hearing, or were appealed beyond that point. Of course, we are not representing there are no other published decisions on point. United Cerebral Palsy of Georgia v. Ga. Dep’t of Behavioral Health and Dev. Disabilities, 331 Ga. App. 616 (2015). A provider […]
July 18, 2011 Paul A. Kryglik, Director Office of Regulations Social Security Administration 6401 Security Blvd Baltimore, MD 21235 Re: Program Operations Manual System SI 1120.220, cash loans Dear Director Kryglik: I am requesting a ruling from your office on an issue involving Program Operations Manual System (POMS) SI 1120.220, cash loans, with respect to […]
On May 4, 2023, the Department of Community Health announced the new state-wide average nursing facility private pay rate increased from $9,034.00 to $9,584.00. This rate is the divisor when calculating the length of a transfer penalty when resources or income are transferred for less than fair market value.
When applying for Medicaid, the nursing home spouse (called the Institutionalized Spouse) is often a joint owner (or sole owner) on checking, savings and other acounts. Should those resource be taken out of the name of the Institutionalized Spouse? The answer is generally “yes,” but it requires some context and some qualifications. The context and […]
In the Matter of the Medical Assistance Pooled Special Needs Trust of Scott Hewitt (Iowa 2023), the State Medicaid agency had a contigent interest in the trust remainder due to the payback requirement in 42 U.S.C. § 1396p(d)(4)(C). However, after the beneficiary died, the master trust informed the Department that it would retain the remainder, […]
One of the most fundamental, but often overlooked issues when planning for – or evaluating – Medicaid eligibility is this: Medicaid does not alter property rights, contract rights or other legal rights with value. Medicaid simply measures those rights to determine whether they cause an applicant to be eligible or ineligible. In other words, if […]
Each year, most Medicaid eligibility limits are adjusted for inflation. The 2023 Georgia Medicaid income and resource limits are: SSI Medicaid: Income: $914 per month, Countable Resources: $2,000 QMB Medicaid: Income: $1,235 (100% FPL + $20), Countable Resources: $9,090 SLMB Medicaid: Income: $1,478 (120% FPL +$20), Countable Resources: $9,090 CCSP/EDWP/Nursing Home Income Cap: $2,742; Applicant […]
As of this writing, the following pooled trusts are authorized by the Department of Community Health to provide trust services in Georgia: Georgia Community/Trust/Bobby Dodd Institute Anita Gardner Decatur, GA 404.809.2914 Anchor For Special Needs, Inc. Annie Warner Cincinnati, OH 844.526.2467 Advocates and Guardians for the Elderly & Disabled (AGED) Thad A. Joseph Longwood, FL 888-277-1826 The Center […]
The Achieving a Better Life Experience (ABLE) Act of 2013 (S. 313/H.R.647) was introduced in the 113th Congress by a bipartisan group of Congressional Champions that included Sens. Robert Casey, Jr. (D-PA) and Richard Burr (R-NC), and Reps. Ander Crenshaw (R-FL), Chris Van Hollen (D-MD), Cathy McMorris Rodgers (R-WA) and Pete Sessions (R-TX). The ABLE […]
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