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MEDICAID AND MEDICARE 2017 COLA NUMBERS

Posted by: Begley Law Group

by Thomas D. Begley, Jr., Esquire, CELA CMS has released the Medicare and Medicaid numbers for 2017. They are as follows: Medicaid Income Cap[1] $2,205 Maximum Community Spouse Resource Allowance (CSRA)[2] $120,900 Minimum CSRA[3] $24,180 Maximum Minimum Monthly Maintenance Needs Allowance (MMMNA)[4] $3,022.50 MMMNA (July 1, 2016 until June 30, 2017)[5] $2,002.50 MMMNA (July 1, 2017 until June 30, 2018)[6] $2,030.00 Excess Shelter Allowance (July 1, 2016 until June 30, 2017)[7] $600.75 Excess Shelter Allowance (July 1, 2017 until June 30, 2018)[8] $609.00 Maximum Resource Limit (Individual)[9] $2,000 Minimum and Maximum Cap on Equity in the Home[10] $560,000 –$840,000 Medicare […]

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Filed under Blog, Estate Planning, Life Care Planning, Medicaid Applications, Medicaid Planning, Medicaid Planning, Special Needs Planning, Special Needs Trusts.
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ADVANTAGES AND DISADVANTAGES OF ABLE ACCOUNTS

Posted by: Begley Law Group

by Thomas D. Begley, Jr., Esquire, CELA Congress enacted and the President has signed legislation known as the Achieving a Better Life Experience (ABLE) Act of 2014.387 The Act is modeled on 529 Plans and will provide tax-favored accounts for individuals with disabilities to pay for qualified expenses. Before these accounts can be implemented, two things must happen: (1) the federal government must adopt regulations governing the accounts, and (2) state must either create their own ABLE accounts or contract with other states to do so. It is likely that these accounts will operate in a manner similar to existing […]

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Filed under Blog, Blog Special Needs Planning, Estate Planning, Estate Planning, Long Term Care, Medicaid Applications, Medicaid Planning, Special Needs Planning.
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MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS

Posted by: Begley Law Group

by Melanie S. Kaplan, Esquire As of July 1, 2014, what was formerly known as Global Options for Long Term Care (GO) is now known as Managed Long Term Services and Supports. (MLTSS). Individuals previously receiving benefits under AIDS Community Care Alternatives Program (ACCAP), Community Resources for People with Disabilities (CRPD) and Traumatic Brain Injury (TBI) were automatically enrolled in the MLTSS program. The MLTSS program was designed to permit individuals to live in the community for as long as possible with services and support. The change from GO to the MLTSS program has reduced the number of programs and […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning, Uncategorized.
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OVERVIEW OF MEDICAID TRUSTS

Posted by: Begley Law Group

by Thomas D. Begley, Jr., CELA Types of Trusts. Trusts established and funded after August 10, 1993, are governed by OBRA-93. The Medicaid-qualifying trust rules were repealed by OBRA-93, and new rules for revocable and irrevocable trusts created after August 10, 1993, were established. OBRA-93 also created special disability trusts, each of which has rules. These trusts include Self-Settled Special Needs Trusts and Pooled Trusts. OBRA-93 also established a Miller Trust, to be used when a potential Medicaid recipient has income in excess of the income cap. The fourth trust authorized under OBRA-93 is a sole benefit of trust. The […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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PROTECTING THE HOME FROM THE COST OF LONG-TERM CARE

Posted by: Begley Law Group

by Thomas D. Begley, Jr., CELA Seventy percent of Americans will require some form of long-term care be it nursing home, assisted living or home care. The cost of this care can range from $20 per hour or more for home care to $10,000 – $12,000 per month for nursing home care. Before becoming eligible for Medicaid in a nursing home or assisted living facility, an individual must list their home for sale and if it does not sell during the individual’s lifetime, Medicaid will place a lien on the home on death. If the individual is receiving home care […]

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Filed under Estate Planning, Life Care Planning, Long Term Care, Medicaid Applications, Medicaid Planning.

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20 THINGS YOU NEED TO KNOW ABOUT ABLE ACCOUNTS

Posted by: Begley Law Group

by Thomas D. Begley, Jr., Esquire, CELA On December 16, 2014, Congress enacted and the President has signed an Act known as Achieving a Better Life Experience (ABLE) Act of 2014.[1] This Act is to provide a tax-favored account, similar to a 529 Plan, for individuals with disabilities to pay for qualified expenses. Highlights of this Act are as follows: State Established or Contracted. Each state is authorized to establish and operate an ABLE program. This must be done by each state before these accounts can be opened in that state. States may contract with other states to operate these […]

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Filed under Life Care Planning, Medicaid Applications, Medicaid Planning, Medicaid Planning, Special Needs Planning.
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MILLER TRUSTS

Posted by: Begley Law Group

by Thomas D. Begley, Jr., Esquire, CELA For purposes of Medicaid long-term care services, New Jersey has always been an income cap state. That means that an individual’s income must not exceed 300% of the Federal Benefit Rate (FBR). Beginning January 1, 2015 that means that an individual’s monthly income cannot exceed $2,199. Historically, individuals in nursing homes were able to qualify for a “Medically Needy” program to spend their income down and qualify for Medicaid. Individuals requiring care in assisted living or at home were not eligible for the Medically Needy program and could not become eligible for Medicaid, […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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IS THE BIPARTISAN BUDGET ACT OF 2013 THE DEATH OF AHLBORN?

Posted by: Begley Law Group

Article by Thomas D. Begley Jr. As a condition of Medicaid eligibility, a Medicaid applicant is required to assign to the state any rights to payment of medical care from any third party.[1]  If the individual fails to pursue the claim, the state has the option of pursuing it.  Federal law requires that each state Medicaid program have procedures for determining the legal liability of third parties to pay for medical assistance provided by the state’s Medicaid plan, and for recovery from third parties of the cost of medical assistance provided, whenever recovery is feasible.[2]  In New Jersey, the Attorney […]

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For Medicaid Applications, Having an Attorney Can Be Crucial

Posted by: Dana E. Bookbinder

Given the convoluted and ambiguous set of provisions that are our federal and state Medicaid laws, it is a wonder how any lawmaker could expect individuals, especially seniors with compromised health, to apply for benefits on their own.  Federal regulations require Medicaid caseworkers to be helpful to those who file for benefits, but state and federal budgetary constraints have created a reality that is much more frustrating than the printed law would suggest.   Many individuals file applications unprepared for the minutiae that will delay the processing of their application for several months and cost them tens of thousands of dollars […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.

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Resolving Your Nursing Home’s Medicaid Application Challenges – Special Report

Posted by: Begley Admin

Case Study 1: Private funds exhausted – Medicaid denied Bill has been a resident at the Forget-Me-Not Nursing Home for 18 months. After 12 months, Bill’s private pay funds were exhausted and the Medicaid coordinator at the nursing home filed an application on his behalf. Bill’s wife, Linda, was not cooperative in providing the required financial information. Medicaid eventually dismissed the application because it was incomplete. By the time all the necessary information was finally obtained, and the application was re-filed, the nursing home had lost six months of revenue, totaling $60,000, and its cash flow had been interrupted for 12 months.   Case Study […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning, Special Reports.

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What other medical insurance options are available for my client after he has received a personal injury settlement?

Posted by: Begley Admin

The previous blog discussed the importance of ensuring that plaintiffs in personal injury lawsuits obtain the best possible medical coverage. This blog continues the discussion and focuses on other medical insurance that may be available. This includes: • Medicare. A person receiving SSDI for two years will receive Medicare. It is important to obtain a Medicare supplement, if at all possible. There is an open enrollment period for Medicare supplements for six months after the Medicare recipient obtains Medicare Part B. Another option is to enroll in a Medicare Advantage Plan. There is an open enrollment period for Medicare Advantage […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.

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Estate Recovery

Posted by: Thomas D. Begley, Jr.

A state is entitled to recover for Medicaid payments correctly paid on behalf of the individual by use or real or personal property liens and recovery from decedents’ estates. 42 U.S.C. § 1396p(b)(1)(B); HCFA Transmittal 63; N.J.S.A. 30:4D-7.2 et seq.; N.J.A.C. 10:49-1 et seq. The state is required to seek reimbursement from an individual’s estate for the cost of nursing facility services. 42 U.S.C. § 1396p(b)(1)(B). However, no recovery may be made until after the death of the recipient’s surviving spouse, and only when there are no surviving children who are under age 21 or blind or permanently disabled. A. […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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Global Options (GO) for Long-Term Care

Posted by: Thomas D. Begley, Jr.

Effective January 1, 2009 the Department of Health and Senior Services (DHSS) received approval from the US Centers for Medicare and Medicaid Services (CMS) to consolidate three Medicaid-supported home and community base services programs into a single program known as Global Options (GO) for Long-Term Care. Provisions of the GO Program include: Participants will have the option to hire and direct their own service providers. Care managers will have greater flexibility in modifying individual care plans. The program is designed to supplement, not replace, the assistance already being provided by family, friends and neighbors. GO participants work with a care […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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The Nursing Home Decision

Posted by: Dana E. Bookbinder

Families are understandably apprehensive when selecting a long term care facility for their loved ones.  As a firm focusing a large part of its practice on elder law, our attorneys and staff are often called upon for assistance with this important decision.  Fortunately, nursing home care has substantially improved over the past generation.  Federal regulations that set standards for nursing homes particularly in the area of patient rights have been in place over fifteen years.  As our attorneys and many staff members who regularly visit homes in our area can readily attest, nursing homes and assisted living facilities today generally […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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Selecting a Nursing Home for Your Loved Ones

Posted by: Thomas D. Begley, Jr.

The Centers for Medicare and Medicaid Services (CMS) recently completed a rating of nearly 16,000 nursing homes throughout the United States.  This was done under the CMS Nursing Home Compare System.  Based on these ratings, the Scripps Howard news service did a statistical analysis.  Many of the findings were interesting.  They included: NON-PROFITS Generally, nursing facilities run by non-profits are better than institutions run by for-profit corporations.  This validates observations made by this office over a long period of time. STAFF RATIO Nursing homes with higher nursing staff-per-patient ratios deliver better care than those with lower staff-per-patient ratios.  This should […]

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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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New Jersey and Pennsylvania Medicaid Planning, Medicaid Applications, Asset Protection, Special Needs Trust, Estate and Trust administration and Estate Planning.
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