TEXAS DUAL (MEDICARE AND MEDICAID) ELIGIBLE INTEGRATED CARE PROJECT IMPLEMENTED IN DALLAS AND TARRANT COUNTIES Dallas and Tarrant Counties are two of the six counties in Texas that are part of a demonstration project whereby individuals can receive managed care services if they are eligible for both...
It is anticipated that the Texas Medicaid transfer penalty divisor will be increased to the rate of $162.41 for those who apply for long-term care Medicaid on or after September 1, 2015. Under the long-term care Medicaid Rules, it is presumed that if an applicant...
On November 26, 2014, the Oregon Court of Appeals decided that the state agency’s attempt to expand estate recovery (where the state goes after the resources of a Medicaid recipient after such person’s death) was improper. Oregon had amended its rules so that the state...
On December 16, 2014, Congress passed the Achieving a Better Life Experience Act (ABLE) which allows adults and children with disabilities whose disability occurred before age 26 to shelter up to the annual gift tax exclusion amount (presently $14,000) per year into an account which...
Since the passage of the Deficit Reduction Act of 2005 signed on February 8, 2006 (“DRA”), many Texas elder law attorneys have used a transfer planning option (often referred to as “reverse half-a-loaf”) to save at least 50% of the countable resources of a Medicaid...
As many of you know, Texas is an income cap state in connection with long-term care Medicaid eligibility. Presently, if an applicant for nursing home Medicaid has "countable" income (certain income is exempt or excluded) over $2163 per month, then such applicant is ineligible for...
Medicare’s rating system for nursing homes is often misleading. Medicare set up a rating system in 2009 with the hopes that nursing homes would make efforts to increase the star rating (maximum of 5 stars) by improving the quality of care. However, some nursing homes have...
Although Congress has approved precise rules regarding Medicaid eligibility (including what is needed in an annuity to make it compliant with the Medicaid rules), the state of Pennsylvania has recently attacked the use of annuities in obtaining Medicaid benefits (which often help pay for care...
On June 3, 2014, The U.S. District Court for the District of New Jersey has enjoined the state from counting any Veterans Administration (VA) improved pension income in determining Medicaid eligibility of an applicant for Medicaid. In this case, the Medicaid applicant was about to...
The Government Accountability Office (GAO) is in the final stages of researching and writing a report on financial eligibility for long-term care Medicaid. Senators Richard Burr (R-N.C.) and Tom Coburn (R-OK) and Representatives Trey Gowdy (R-S.C.) and Darrell Issa (R-CA) requested the study. The GAO...
