The following are the Covid 19 Medicaid Waivers we’re aware of. If you have information on others, please let us know at websupport@ezelderlaw.com. Policy Round Up: COVID-19 updates, opioid use disorders and the ADA, hospital and nursing home ownership, input opportunities CMS: Coronavirus waivers & flexibilities CMS: Internal Medicaid and Chip Covid 19 Summary CMS […]
In 2020, the DC Circuit Court of Appeals decided Gresham v. Azar, 950 F.3d 93 (2020). There, the Court of Appeals affirmed a District Court decision halting Arkansas Works, a program that imposed work requirements on impoverished adults seeking Medicaid under the ACA expansion. Arkansas Works included new requirements in addition to the much-discussed work […]
In Weeks v. DHS, Division of Family and Children Services, Office of State Administrative Hearings, Docket 2117014 (April 28, 2021), Brian Center Health and Rehabilitation – Canton, purportedly filed a direct appeal on behalf of Marilu Weeks after her Medicaid application was denied. Judge Teate, in Docket No. 2115533, directed Brian Center to provide evidence […]
In American National Life Insurance Company v. Breslouf (Mass. Super. 6/3/2021), a Community Spouse named Julius Breslouf purchased a Medicaid annuity as part of the plan to secure Medicaid eligibility for his wife. The annuity named the Commonwealth of Massachusetts as the remainder beneficiary, followed by his daughter, Jennifer Brouslouf. Mr. Breslouf died before the […]
The Georgia Department of Community Health recently announced the 2022 Presumptive Eligibility Medical Assistance Federal Poverty Levels. These new income limits should be used for all PE determinations completed by Qualified Hospitals effective March 1, 2022. Both memos are below:
Resource limit firm; debt not a factor. Petitioner’s application for benefits was denied twice because the Petitioner’s agent was unable to secure information requested by the caseworker. Petitioner’s agent was not able to gain control over the resources until a conservatorship was approved in February, 2008. As of March 1, 2008, Petitioner had $23,453.89 in […]
In M.K. v. Division of Medical Assistance, Superior Court of New Jersey, Appellate Division (2016), the Division imposed a period of ineligibility for benefits because she transferred ownership of her home to her daughter, J.K., for less than fair-market value within sixty months of entering a nursing home facility (the look-back period). The applicant argued […]
An applicant filed three Medicaid applications from February 7 through November 26, and all of them were denied for failure to submit necessary financial verification. A fair hearing was conducted on November 26, 2018 where the ALJ gave the applicant additional time to supply verification. Once that verification was supplied, on May 14, 2019, the […]
In a Memorandum decision, the Supreme Court of New York, Appellate Division, Fourth Department, held that a nursing home may bring a plenary action in its own right against the agency designated to declare Medicaid eligibility. A transfer of resources penalty of 11.74 months had been imposed and the nursing home sought a declaratory judgment […]
The undisputed record shows that in April 2004, Gladowski qualified for Medicaid assistance to pay for nursing home care, but the Department of Community Health delayed her benefits until September 2006 on the ground that Gladowski improperly transferred assets to qualify for Medicaid coverage. Gladowski appealed the decision to an administrative law judge (ALJ), who […]
White, a British citizen and a legal permanent resident of the United States entered the United States in 1991.She was issued a green card and resided in the U.S. continuously. When she applied for Medicaid, she was denied eligibility because she had not resided in the U.S. cotinuously for five years as provided for in […]
The Georgia Supreme Court granted certiorari to consider whether the Court of Appeals properly interpreted 42 USC § 1396p with respect to whether a Medicaid applicant’s purchase of an annuity was subject to an asset transfer penalty. In this case, the Georgia Department of Human Services, Family and Children Services (“DFCS”) granted appellee Jerry L. […]
In November 2002, Mrs. Medder’s husband died. Her husband left her real estate and personal property in his Will. In May, 2003, Mrs. Medders filed a renunciation and disclaimer “renouncing” the gift in her husband’s Will. Less than three years after the renunciation, Mrs. Medders applied for Medicaid. When Mrs. Medders applied for Medicaid, the […]
In this Medicaid case, the State appealed from a trial court decision. The trial court’s finding that the applicant was eligible for Medicaid was affirmed Reed entered Blanchette Place Care Center in July of 2003. In September, she and her daughter entered into a “personal care contract.” The contract required Reed’s daughter to perform duties […]
A community spouse purchased an actuarially sound single-premium irrevocable annuity for $250,000 for the purpose of spending down excess assets so her husband, a nursing home resident, would qualify for Medicaid. Pennsylvania denied eligibility, contending that the annuity was an available asset and that Medicaid eligibility could not be established until that asset was spent […]
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