James v. Richman, 465 F. Supp. 2d 395 (M.D. Pa. 2006). Robert and Josephine James were married when Robert went to the nursing home. A resource assessment was done and Medicaid determined they had $278,343 in available resources. To reduce their resources, Josephine purchased a $250,000 single premium immediate irrevocable annuity from General Electric Assurance […]
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The Deficit Reduction Act of 2005, Pub. L. No. 109-171 (Effective date February 8, 2006). The Deficit Reduction Act of 2005 (DRA) changed the Medicaid eligibility rules significantly. Most of the changes are (or will be) codified at 42 U.S.C. § 1396p. DRA lengthened the look-back from 36 to 60 months; changed the start date […]
Harris v. McRae, 448 U.S. 297 (1980). The Medicaid program created by Title XIX is a cooperative endeavor in which the Federal Government provides financial assistance to participating States to aid them in furnishing health care to needy persons. Under this system of “cooperative federalism,” King v. Smith, 392 U.S. 309, 316, if a State […]
CMS: Centers for Medicare and Medicaid Services. Community Spouse The spouse of an institutionalized spouse. 42 U.S.C. § 1396r-5(h)(2). CSMIA: Community Spouse Monthly Income Allowance. This is the amount of the institutionalized spouse’s income that is diverted, if necessary, to bring the community spouse’s income up to the MMMNA. CSRA: Community Spouse Resource Allowance. DRA: […]
On April 26, 2021, in a letter to Senators Brown, Casey, Hassan, and Representative Dingell, the National Academy of Elder Law Attorneys (NAELA) commented on the Home and Community-Based Services (HCBS) Access Act. Among other comments, NAELA supported the proposal’s expansion of the criteria for being medically eligible for Medicaid HCBS. One suggestion was including […]
Video from Pixorize describing Medicare and Medicaid as two different healthcare programs with different functions and beneficiaries.
The Massachusetts Supreme Court recently limited Medicaid estate recovery claims to three years as discussed in the following video:
The Kaiser Family Foundation published a fact sheet indicating that Medicaid spending is concentrated on the elderly and individuals with special needs. “Seniors and people with disabilities make up 1 in 4 beneficiaries but account for almost two-thirds of Medicaid spending, reflecting high per enrollee costs for both acute and long-term care.” “Medicaid is low-cost […]
In April, 2021, Justice in Aging, the Western Center on Law & Poverty, the National Academy of Elder law Attorneys (NAELA), the National Health Law Program, and the California Association for Nursing Home Reform submitted an issue brief to Congress calling for an end to Medicaid Estate Recovery. A NAELA Press Release dated April 16, […]
