Georgia Medicaid

Georgia Medicaid Manual Updated with Transmittal 71

On November 17, 2023, Georgia issued Manual Transmittal 71, updating its Medicaid Manual, making technical changes to the following sections.…

2 years ago

NEW VIDEO: Medicaid – 2023 Financial Eligibility

We're just getting to the point where we're producing videos for EZ Elder Law. There are, after all, only so…

3 years ago

2023 Georgia Medicaid Eligibility

Each year, most Medicaid eligibility limits are adjusted for inflation. The 2023 Georgia Medicaid income and resource limits are: SSI…

3 years ago

Coverage for institutionalized individuals and related groups under the special income rule

States may extend Medicaid to certain individuals with incomes too high to qualify for SSI, and who are eligible for…

4 years ago

Presumptive Eligibility Medical Assistance Federal Poverty Levels for 2022

The Georgia Department of Community Health recently announced the 2022 Presumptive Eligibility Medical Assistance Federal Poverty Levels. These new income…

4 years ago

Georgia Medicaid Estate Recovery Changes

As of December 21, 2021, Georgia has changed its Estate Recovery Program rules under Title 49 O.C.G.A. § 49-4-147.1. This…

4 years ago

Georgia Medicaid Renewals Extended Again

As of December 15, 2021, Georgia Medicaid renewals have been extended again due to Covid-19.

4 years ago

Medicaid Transfer Penalty Worksheet

The form below was developed by the Georgia Department of Community Health and is based on Section 2342-11 of the…

5 years ago

Georgia’s Medicaid Lien Attaches to Entire Recovery

In Richards v. Georgia Department of Community Health, 278 Ga. 757 (2004), a class of plaintiffs sued DCH contending that…

5 years ago

Medicaid: Deeming Terminates After Eligibility is Established

Deeming Terminates After Eligibility Is Established. Four years later, the Duprees were back in Court. At the annual review on…

5 years ago

Medicaid: Homeplace Exemption

Which Home is the Homeplace? Pernie Dupree entered a nursing home on September 11, 2009. Prior to her admission, she had…

5 years ago

Medicaid: No Penalty on Transfer to Disabled Child; Previously Unknown Resource Exempt

Direct Transfer to Disabled Child; Previously Unknown Resource. Applications for Medicaid were filed on November 24, 2008 and January 8,…

5 years ago

Medicaid: Annuity; Transfer Penalty for Failing to Name State as Beneficiary

Annuity; Transfer Penalty for Failing to Name State as Beneficiary. Petitioner, a 95 year old nursing home resident, applied for…

5 years ago

Medicaid: No Retroactive Application of Policy Changes Permitted; Payments for Renovations to Accommodate Petitioner Permitted; Payments Consistent with Prior Accepted Obligation Permitted

No Retroactive Application of Policy Changes Permitted; Payments for Renovations to Accommodate Petitioner Permitted; Payments Consistent with Prior Accepted Obligation…

5 years ago

Medicaid: VA Improved Pension is not income

VA Improved Pension Not Income. Petitioner applied for Medicaid on November 4, 2008. Petitioner was the surviving spouse of a…

5 years ago

Medicaid: Transfer to Disabled Child Approved Upon ALS Diagnosis

Direct Transfer to disabled child allowed from date ALS was diagnosed. Petitioner made transfers directly to a disabled child with…

5 years ago

Medicaid: Court Adjusted CSRA

Increase CSRA in Superior Court, followed by Application and Fair Hearing. After admission to a nursing home, but prior to…

5 years ago

Medicaid: No Transfer Penalty Where Transfer Was Exclusively for Purpose Other Than to Qualify for Medicaid

Transfer penalty cannot be imposed where transfer was exclusively for purpose other than to qualify for Medicaid. Petitioner was admitted…

5 years ago

Medicaid: Denial Affirmed Because Applicant was Over-Resourced

The Limit is the Limit, Part 3. Petitioner was originally admitted to Ridgewood Manor, a nursing home in Dalton, and…

5 years ago

Medicaid: Transfer Penalty Affirmed

Penalty Affirmed After Life Estate Conveyed; Hardship Waiver Unavailable Because No Legal Action was Taken to Recover Property. Petitioner, a…

5 years ago

Medicaid: Transfer Penalty Reversed Where Services Provided Under Agreement

Transfer Penalty Reversed Where Care Services Were Provided Under Agreement. Petitioner was discharged from a nursing home to home in…

5 years ago

Medicaid: Can’t Designate Cash Value of Life Insurance for Burial

Cash Value of Life Insurance Cannot Be Designated as Burial Fund. Denial of eligibility was affirmed where Petitioner had a…

5 years ago

Medicaid: Determining Equity Value

When Determining Value, Equity Value is CMV Minus mortgages and Liens. Petition created a revocable living trust in 2006. In…

5 years ago

Medicaid: Another Case without a Qualified Income Trust

No QIT, No Medicaid if Income Exceeds Cap, Part 2. Petitioner entered a nursing home in June 2008 and filed…

5 years ago

Medicaid: Life Insurance Snafu

Life Insurance Snafu. Petitioner and Respondent stipulated facts in this case. Petitioner applied for nursing home Medicaid in March 2008.…

5 years ago

Medicaid: No Penalty for Transfer to Disabled Child

No Penalty For Transfer to Disabled Child. DFCS imposed a transfer of resources penalty where Petitioner transferred cash assets to…

5 years ago

Medicaid: No QIT, No Medicaid

No QIT means No Medicaid If Income Exceeds Cap. Petitioner entered the nursing home in July 2007 and applied for…

5 years ago

Medicaid: Determining Which Property is Exempt Home

Determining Which Property is the Exempt Homeplace; Whether Jointly Owned Second Property was Exempt. Petitioner lived at her residence in…

5 years ago

Medicaid: Penalty Reversed Where Home Given to Caregiver Child

Penalty Reversed Where Home was Given to Caregiver Child. In 2002, Petitioner’s daughter moved into Petitioner’s home to provide care.…

5 years ago

Medicaid: No transfer penalty where transfer reimbursed third party for advancing expenses

No Penalty Where Transfer Reimbursed Third Party for Paying Applicant’s Expenses. Petitioner was admitted to a nursing home on May…

5 years ago

Medicaid: The Limit is Still the Limit

The Limit is the Limit, Part 2. Petitioner entered the nursing home on April 17, 2007 and applied for Medicaid…

5 years ago

Medicaid: Cost-Share Calculation

Calculation of Cost-Share. As of November 1, 2008, Petitioner’s gross monthly income was $2,385.54. DGCS calculated the cost-share as $2,189…

5 years ago

Medicaid: Corpus of Irrevocable Trust Countable

Corpus of Irrevocable Trust was Countable Resource. Two trusts Petitioner created in 2000 held a cumulative balance of approximately $64,000.…

5 years ago

Medicaid: Cost-share deduction for health insurance premium

Cost-share deduction for health insurance premiums. The ALJ stated the issue as whether a nursing home resident is entitled to…

5 years ago

Medicaid: The Limit is the Limit

The Limit is the Limit. An 84 year old applicant was denied Medicaid for the months of December 2007 through…

5 years ago

Medicaid: Lost application; eligibility retroactiev to three months from original appliction

Where application was lost, eligibility retroactive eligibility related back three months from date of original application. After receiving a personal…

5 years ago

Medicaid: DFCS directed to determine eligibility where application pending over one year

DFCS directed to determine eligibility where application was pending for over one year. Petitioner filed an application for Medicaid on…

5 years ago

Medicaid: Sole Benefit Trust rejected and transfer penalty imposed

Sole Benefit Trust rejected and transfer penalty imposed. An 86 year old applicant established an irrevocable trust for the benefit…

5 years ago

Medicaid: Transfer Penalty Reversed Where Cured

Transfer Penalty Reversed Where Home Was Returned. Three months prior to a nursing home admission, a 98 year old Petitioner…

5 years ago

Medicaid: Court Reaches Wrong Conclusion Regarding Community Spouse

Incorrect Decision Reached Regarding Status of Community Spouse. A nursing home resident’s spouse was denied a Community Spouse Monthly Income…

5 years ago

Medicaid: Federal Law Trumps State Law When They Conflict

Georgia’s Medicaid Manual cannot be enforced when it conflicts with federal law. Applicant resided in an assisted living facility until…

5 years ago

Medicaid: Ignorance of QIT Requirement No Excuse

Ignorance of QIT Requirement Does Not Excuse Failure to Comply. Nursing home resident’s son assisted with her October 25, 2007…

5 years ago

Assessment of transfer penalty on sale of life estate affirmed

Assessment of transfer penalty on sale of life estate affirmed. Conservators sold life estate for $1,500, then sold the applicant’s…

5 years ago

No Penalty Where Resources were Transferred to Disabled Child

No penalty may be assessed where resources are transferred directly to a disabled child. A nursing home resident transferred approximately…

5 years ago

Medicaid: Hire a Lawyer

Hire a Lawyer. An unrepresented nursing home resident applied for Medicaid on December 21, 2007. A 981 was issued after…

5 years ago

Medicaid: Community Spouse Resource Allowance administratively raised

Community Spouse Resource Allowance administratively raised. Evidence was stipulated that the combined marital income of the couple did not result…

5 years ago

Medicaid: Valuation; value of transferable promissory note

Valuation; value of transferable promissory note. Petitioner filed a motion for summary determination and respondent failed to answer. The issue…

5 years ago

Medicaid Transfer of Resources Penalty Affirmed (2008)

Transfer of resources penalty affirmed. Nursing home resident applied for Medicaid in January 2008. During review, caseworkers discovered a home…

5 years ago

Medicaid Treatment of Retirement Accounts

Treatment of retirement accounts. Section Section 2332 indicates that an applicant must apply for periodic benefits, but does not indicate whether the…

5 years ago

Medicaid Resource Limit Firm; Debt not a factor (2008)

Resource limit firm; debt not a factor. Petitioner’s application for benefits was denied twice because the Petitioner’s agent was unable…

5 years ago