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Home Based Medicaid Serivices

By Uncategorized

LTSS in Home and Community-Based Settings

Many older adults and people with disabilities who want to stay in their own homes cannot do so without help. The programs that can help you or someone you care for live comfortably and safely at home are called Home and Community Based Services.

Some programs can help you fill prescriptions or get meals or rides. Other programs will help you out at home with activities like personal grooming or getting in and out of bed. The programs you use will be based on your needs.

Medicaid LTSS provides medical care and covers most of the services and supports people need to stay in their homes or a community-setting. People who have the highest or high level of need may get Medicaid LTSS in the home or community setting.

Need to apply for LTSS Medicaid home waiver for a loved one? Contact us.

Medicaid Eligibility Update

By Uncategorized

Rhode Island has updated its rules to become Medicaid eligible.

If you are a Rhode Island resident and you are seeking Medicaid benefits, you should be aware of some recent changes approved by the Rhode Island Department of Human Services as to your eligibility under the program. Final rules are expected to be published and release shortly but here is a recap of the expected changes:

  1. Income cap of $9,581 meaning that if the applicant has more than $9,581 in income, then they can never become eligible for Medicaid, nor can they start the penalty period.  If they have income under $9,581 but greater than $6,700 and they want to start a penalty period, they can do so but cannot get community Medicaid benefits, like Rx copays and doctor bills.   If their income is under $6,700, then nothing changes.    This went into effect in September and is effective for applications for eligibility delivered after 10/1/18.   50-00-2.4

    Changes Are Coming

  2. Long term care insurance is not considered countable income for purposes of the above income cap.   However, once on Medicaid, it would need to be spent as part of the patient share.    50-00-6.5.2(B)
  3. Burial Funds & Irrevocable Funeral Contracts have new limits which are helpful and could affect clients.  The new cap on Irrevocable funeral contracts is $15,000 and anything over that would be considered a countable asset.   40-00-3.5.5 A(1)(f)
  4. Life insurance is now exempt up to $4,000 of cash surrender value, with anything over being countable.  40-00-3.5.5 A(1)(h)
  5. Retirement Funds now have a new definition, but as long as they are income producing and the client gets at least the RMD, then they should still be fine. 40-00-3.5.5 A(2)(g)
  6. Penalty Divisor is $9,581 since mid September.

Like any social program, the figures and rules for eligibility are constantly revisited and updated based on changes in federal law, budgets, and program changes and advances. Staying current on the latest rules is the challenge.

If you or a loved one is facing serous medical issues requiring skilled nursing care, the Medicaid program will help pay for those costs for applicants who have assets and income within program limits. Contact us to discuss your estate plan and if your estate plan should be revised so as to become eligible for these valuable benefits.

Auditor’s report depicts disarray in R.I. social service programs

By News

The report issued on the roll-out of the computer system shows continued problems

The Rhode Island Department of Human Services (“DHS”) which administers the Medicaid program has been attempting to roll out a new computer system for several years. The system was designed to speed up application review and automate the application process to an on-line system. Unfortunately per the auditors report, the system is still experiencing issues. 

For those attorneys who assist elder clients with Medicaid applications this has been a challenging time. Medicaid will pay for the nursing home care needed by these elderly clients who have less than $4,000 in countable assets. It is stressful to family members who have submitted applications for coverage, who have a loved one being cared for at a nursing home, and not knowing if their application has been approved. They fear the consequence of an unexpected denial and how that may impact a spouse or the recipient.

Applicants can wait months or years prior to receiving an approval of their application.

Rhode Island law requires DHS to pay nursing homes for any care given patients who have applications pending for greater than 90 days. This law has allowed payments to go out, facilities to get paid, and patients to receive the care they need, until the application is approved.

Fortunately, the reports also states that things are improving and applications are being reviewed quicker and more accurately. The employees at DHS have done an admirable job overcoming a challenging roll-out but still have much work to do.

Source: Auditor’s report depicts disarray in R.I. social service programs

If you or a loved one wants to learn more about qualifying and applying for Medicaid benefits, please contact our office for a free consultation.

Many Rhode Island Nursing Homes Awaiting Payment from State

By Uncategorized

Troubled launch of the State’s new UHIP computer system at center of issue

Since the launch of the Rhode Island’s trouble social services system, UHIP, many nursing homes have gone without payment for Medicaid patients. Owed for months of care, many administrators are concerned they won’t be able to go without payment for much longer.

Debra Griffin is the administrator at Hattie Ide Chaffee Nursing Home and Rehabilitation in East Providence. She also chairs the state nursing home association. Griffin says the system for getting paid for these patients was inefficient before but it’s worse now.

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RI DHS Executives

“We haven’t received an approval since September. And that was for someone back to last April,” says Griffin.

Griffin says firing Department of Human Services workers who understood long- term care Medicaid applications before the launch of the new system was a mistake.

“Long- term applications are not run of the mill,” said Griffin. “You have to have a level of knowledge and expertise in the approval process.”

Governor Gina Raimondo acknowledges letting workers go before the launch of the system that was a mistake. The Governor has just accepted the resignations of two top officials involved in the launch. But Griffin says that the governor’s latest actions to fix the problem may not be enough to solve nursing homes’ financial woes.

Griffin says the state owes her home more than $200,000, and most nursing homes in the state are still awaiting payment.

The original Article was written by Kristen Gourlay for RINPR and can be found HERE.

Matt Leonard

NJ: Medicaid Planning Must Be Done By Lawyers

By News, Uncategorized

Joining the states of Florida, Ohio, and Tennessee, the New Jersey Supreme Court has found that non-lawyers who apply the law to a Medicaid applicant’s specific circumstances are engaging in the unauthorized practice of law.

The state Supreme Court had received complaints that non-lawyers retained by families or nursing homes to assist with the Medicaid application process were providing erroneous or incomplete law-related advice, and a state attorney ethics hotline had received reports that non-lawyers have charged “clients” large sums of money for faulty Medicaid-planning legal assistance, causing the elderly victims significant financial loss.Lawyers

Asked by the state Supreme Court for an opinion specifying what activities non-lawyers may engage in and what activities are the unauthorized practice of law, the Committee on the Unauthorized Practice of Law has concluded that while non-lawyer Medicaid advisors may provide limited services, “[a]pplying the law to an individual’s specific circumstances generally is the ‘practice of law.’

A Medicaid advisor or Application Assistor may provide information on insurance programs and coverage options; help individuals complete the application or renewal; help them with gathering and providing required documentation; assist in counting income and assets; submit the application to the agency; and assist with communication between the agency and the individual. But the advisor may not provide legal advice on strategies to become eligible for Medicaid benefits, including advice on spending down resources, tax implications, guardianships, sale or transfer of assets, creation of trusts or service contracts, and the like.”

For the Committee on the Unauthorized Practice of Law’s Opinion 53, “Non-Lawyer Medicaid Advisors (Including ‘Application Assistors’) and the Unauthorized Practice of Law,” courtesy of New Jersey elder law attorney Donald D. Vanarelli, go to: Vanarellilaw.com

Rhode Island has not addressed this issue of Medicaid Planning and assisting with Medicaid applications as being activities that constitute legal advice and thus only to be dispensed by licensed attorneys. People are on notice that use of non-attorney’s for this planning is a risk that each person should weigh before embarking on planning with non-attorneys.

 

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What is Medicaid?

By Uncategorized

What is Medicaid?

The Rhode Island Medical Assistance Program, also known as “Medicaid”, is a Federal and state funded program that pays for medical and health related services for eligible Rhode Islanders. This inincludes inpatient and outpatient hospital care, preventive services, durable medical equipment, and many more services and benefits.

In order to qualify for this benefit program, you must be a resident of the state of Rhode Island, a U.S. national, citizen, permanent resident, or legall alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be either pregnant, a parent or relative caretaker of a dependent child(ren) under age 19, blind, have a disability or a family member in your household with a disability, or be 65 years of age or older.

What is Medicaid Planning?

Medicaid Planning is a form of estate planning where assets of an individual are transferred into various trusts and five (5) years after the transfer the individual would be eligible for Medicaid.

Qualifying for Medicaid is based on medical needs and assets. Applying for Medicaid is a cumbersome process, a long application that is often intimidating to many first time applicants. People often ask about qualifying for Medicaid – that process as mentioned earlier, is one that requires strict attention to the rules of eligibility and being careful with asset transfers.

Want to learn more? Contact us to schedule an appointment.

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RI Receives $112.8M In Federal Funds For Health-Benefits Computer System

By Uncategorized

Federal Grant Clears Way For Design and Implementation of Health-Benefits Computer System

On October 19, 2015 the State of Rhode Island announced it has received an additional $112.8 million in federal funds for a new computer system. The system, whose overall cost has soared to $380 million, is being built to verify eligibility for Medicaid, tax credits for HealthSource RI and other public assistance.

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The expectation with the new computer system is that it will allow all future applications for benefits to be completed on-line, allowing for better tracking and controls. Currently, if a person wishes to apply for Medicaid the application is done via a booklet with multiple pages of supporting document all needed to accompany the application. In the near future, applications will be able to be submitted electronically and all supporting documents will be scanned and attached to the application, reducing time and errors.

Still have questions as to Medicaid qualification and benefits? Contact our office for a free consultation.

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