Medicaid

Modeled after a program that encourages low readmission rates to hospitals, the Centers for Medicare and Medicaid Services (CMS) will introduce a new financial incentive program effective October 1, 2018 for skilled nursing facilities. CMS will withhold 2% of a facility’s Medicare reimbursement until they have shown that they can keep down the number of […]

Medicare Advantage Plans Expanded Coverage of Health Related Benefits – Does it Create Further Health Care Disparities? Last month, the Centers for Medicare & Medicaid Services (CMS) expanded how it defines the term “primarily health related” benefits that insurers are permitted to include in their private Medicare Advantage plans.  Insurers would include these extra health […]

By Jane M. Fearn-Zimmer, Esquire Clients frequently want to know whether they may make gifts to their children and grandchildren for birthdays, holidays or to assist the child financially.  It is not uncommon to encounter confusion between the federal gift tax regulations with the Medicaid regulations, which are two entirely distinct sets of rules. Many […]

I am not I favor of the proposed Senate healthcare bill in its current form.  However, I believe there is some good news that has come out of the debate on the healthcare bill.  The current debate has brought out the importance of Medicaid to many lower and middle class families.  It is my hope that those […]

Effective April 1, 2017, the State of New Jersey has increased the Medicaid penalty divisor to $423.95 per day.  This means that for every about $13,000.00 that is gifted within the Medicaid five year look back, New Jersey will impose a one month period of Medicaid ineligibility. The Medicaid divisor increased from $332.50 per day to $423.95 […]

If a Medicaid applicant gives away assets without receiving fair market value in return during the five year Medicaid look back period, a Medicaid penalty period for the uncompensated transfer of assets will generally result.  The Medicaid penalty period runs prospectively from the date the applicant is determined otherwise eligible for Medicaid. As a practical […]

Last week, the Center for Medicare Advocacy, Justice in Aging, the Medicare Rights Center, and 97 other national organizations sent a letter to Congressional leadership expressing grave concerns with proposals that would radically change Medicaid—a vital safety net that provides quality health care and services for millions of Americans, including 10 million older adults and people […]

The Christie Administration today released for comment the state’s draft renewal application for the Comprehensive Medicaid Waiver. The document represents the state’s next-steps and vision for the health care system that serves low-income residents eligible for Medicaid services. Over the course of the next few weeks, the Department of Human Services (DHS) will engage with stakeholders, […]

Pennsylvania’s Aging Waiver Program is a Medicaid eligible program that covers home and community care and related services.  Effective April 1, 2016, Maximus is the Enrollment Broker for all of the Waiver Programs.  The below article written by elder law attorney, Dana Breslin, with contribution form elder law attorney, Leslie Wizelman, sets for the new procedure for enrolling in the PA […]

A recent study compared the long-term care industry in California, Ontario, Canada, England, and Norway as to the extent to which ownership of nursing facilities has shifted from the public sector to private for-profit and not-for-profit companies, and how this shift affects the transparency of information and accountability for public reimbursement. The international study found that increases […]

We are hearing many things from the Presidential candidates, both good and bad.  However, whether you are a Democrat, Republican, or Independent, the one important topic that is not being debated is how an increasing elderly US population will pay for future long-term care expenses.  This is one of the most important public policy issues facing our […]