Medicaid, as opposed to Medicare, is a health insurance program, jointly funded by the state and federal governments that pays for health care for America’s poor. See Medicaid Act (Title XIX of the Social Security Act), 42 U.S.C. § 1396 et seq. Not everyone is eligible for medical assistance; only those persons who fall within […]
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In State of Idaho v. Beason, 546 P.3d 684 (2024), the Medicaid agency filed an estate recovery claim in Juanita Gilbert’s estate. she received Medicaid benefits from 1996 until her death in 2015, totaling $137,023.29 and, after she died, the State wanted its money back. Juanita and her husband, Robert, owned real property in Butts […]
The Centers for Medicare and Medicaid Services launched the Guiding an Improved Dementia Experience (GUIDE) Model on July 1, 2024. It is a voluntary nationwide model test that aims to support people with dementia and their unpaid caregivers. The GUIDE Model is an attempt to provide Medicare funded comprehensive, coordinated dementia care to improve quality […]
Medicaid Post Eligibility Treatment of Income and Incurred Medical Expenses After Medicaid eligibility is established, 42 C.F.R. § 435.725 addresses how income is treated. For clarity, if the Medicaid recipient is married,income of the non-recipient spouse does not count toward eligibility and is not part of the patient cost share. Specifically, 42 U.S.C. § 1396r-5(b)(1) […]
Medicaid’s Refusal to Provide 24/7 Care in the Community Might be Discrimination In Harrison v. Young (5th Cir. June 6, 2024), the Fifth Circuit considered Ms. Barbara Harrison’s claim challenging Medicaid‘s denial of funding for medical services that she claimed are necessary for her survival. Harrison has severe physical and intellectual disabilities. She cannot walk […]
From time to time federal regulations covering nursing home quality of care are updated. Thus far, the following updates have been published in May and June of 2024. Updates posted May 10, 2024 42 CFR Part 483 — Requirements for States and Long Term Care Facilities view changes § 483.5 Definitions. view changes § 483.10 […]
Nursing homes that accept Medicare or Medicaid are required to comply with quality of care regulations. Although we have blogged elsewhere on specific nursing home resident rights, the current federal regulations are linked below. 42 CFR Part 483 — Requirements for States and Long Term Care Facilities § 483.5 Definitions. § 483.10 Resident rights. § […]
On June 11, 2024, the Gerontologist published an article on Medicaid enrollment and Intergenerational transfers of wealth among older adults. The article was based on a review of data from 2008 through 2018 analyzing estate planning and family wealth transfers of older adults aged 65 and older who became Medicaid recipients. There were 8,347 respondents […]
Dementia affects more than 50 million people worldwide. The Virtual Dementia Tour is designed to allow participants to experience what dementia patients see, hear and feel so they better understand and empathize with individuals who have dementia. One website with the UNC Greensboro reports: “The simulation temporarily alters your physical and sensory abilities to replicate […]
In 2021, we blogged about a valuation case, Connelly v. U.S., 20 F. 4th 412 (8th Cir. 2023). We noted at the time that a Petition for a writ of certiorari was filed. On June 6, 2024, the U.S. Supreme Court decided the case, ruling for the United States. Justice Thomas, writing for a unanimous […]
