On June 15, 2015, the New Jersey Assembly Health and Senior Services Committee approved a bill that will exempt up to $500 per month from being considered as part of the Medicaid five-year look back.  The purpose of the proposed law, A-3760, is to allow residents applying for long-term care not to be penalized for making small gifts for birthdays, anniversaries, graduations, or to religious organizations or charities.

On June 15, 2015, Jerry Rothkoff, on behalf of the NJ elder law bar, had the privilege of testifying in favor of the bill.  Jerry is seated at the front table in the chair on the right.  His testimony is below.  The bill now goes to the full NJ State Assembly for a vote.  A NJ State Senate version of the bill will be voted on in the Fall before the Senate Health and Human Services Committee.

Jerry Rothkoff’s testimony before the New Jersey Assembly Health and Senior Services Committee:

Good morning Chairperson Conaway, Vice-Chairperson Benson and members of the Assembly Health and Senior Services Committee. My name is Jerold Rothkoff and I am the Immediate Past President of the New Jersey Chapter of the National Academy of Elder Law Attorneys. Thank you for this opportunity to speak on A3760. I would like to thank Chairperson Conaway and Co-Chairperson Benson and members of the committee for hearing this bill.  I would also like to thank our sponsor, Assemblywoman Vaineiri-Huttle for her extraordinary leadership and to Assemblywoman Munoz as well as Assemblyman Garcia, Assemblyman Benson and Assemblywoman Tucker for sponsoring this legislation which will help ensure that all New Jersey Medicaid applicants receive equal treatment regardless of the county of application.  Finally, thank you to Chairperson Conaway for his important enhancements to this bill.

Medicaid applicants must provide records of all financial transactions for the five years (60 months) – called the look back period — immediately preceding the date of their application.  Gifts made during this period are considered transfers in contemplation of receiving Medicaid  and result in a penalty period being imposed during which time the applicant will not get his/her medical care paid by Medicaid.  Different counties throughout the state use different thresholds for whether a gift should be counted or disregarded ranging anywhere from $10.00 to $1,000.00.

The proposed statutory change is designed to recognize the fact that many people make contributions on a regular basis to religious organizations, give holiday and birthday gifts to their immediate families, make gifts in honor of important events such as graduations, wedding, and births of a child.  Similarly, people will cash checks for small amounts or withdraw small amounts from an ATM machine in order to pay cash for small purchases or for weekly contributions or small gifts.  Most people do not keep a record of what these small amounts of cash were used for.   None of these small transactions are made with any thought of depleting assets to qualify for Medicaid, yet in certain counties they could preclude an individual from qualifying.

A3760 would also provide clear guidance to help county social service staff in determining whether or not financial transactions are de minimus and, therefore, not in contemplation of Medicaid eligibility.   This would bring New Jersey into conformity with other states like Maryland and Pennsylvania that have previously addressed this issue.

Additionally, currently, there are significant delays at the County Boards of Social Services level in processing Medicaid applications.  In part, this is due to several factors, including increased need for elder care due to increased life expectancy, fiscal cutbacks at the county level, increase in applications due to Medicaid Expansion, and the relative lack of computerization at the county level to process Medicaid applications.

For example, in Camden County, the county where our law firm is located, it is not unusual for a county caseworker to take at least one year to process the Medicaid application and issue a decision regarding eligibility.  In many cases, after months of delay, the county reviews the application, and subsequently requests additional documentation from the Medicaid applicant.  The applicant typically is given between 5-10 days to provide the additional requested documentation.  The applicant may not have a reasonable ability to supply the additional documentation within the required timeframe, resulting in the application being denied.

A3760 would remedy this unreasonable situation by providing the Medicaid claimant with a reasonable timeframe to provide the county with the additional requested documents.

If passed this would be:

·     A win for consumers who would no longer have to go through the onerous process of providing every check that was written and documentation for every ATM withdrawal made over five years and then to be penalized for making a small donation;

·     A win for the County Boards of Social Services, already backlogged with applicants, which would no longer have to micromanage every transaction; and

·     A win for long term care providers who would be paid in a more timely manner.

Simply put, it is the right thing to do.

Thank you in advance for supporting this important issue which will help bring fairness and efficiency to the Medicaid application process. 

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