This is being provided to the General Practice list serve as a courtesy.
The Elder Law Section is committed to informing our members, on a timely basis, about issues that affect our practice. Below is a brief description, prepared by David Goldfarb, of the some of the changes proposed by the
Medicaid Redesign Team.
The Proposals of the Medicaid Redesign Team
Governor
Andrew M. Cuomo's submitted a proposed appropriation bill on February 1, 2011. It included language that for the next fiscal year (April 1, 2011 through March 31, 2012) the Commissioner of Health could implement the recommendations of the newly created Medicaid Redesign Team (MRT), including modifying or discontinuing Medicaid program benefits. The proposed savings from the overall proposal was set at $2,850,000,000.
On February 24th, 2011, the MRT passed a number of recommendations, all of which the Governor has endorsed. The ones that primarily impact on our clients' eligibility for Medicaid and the provision of Medicaid services are outlined below.
The recommendations of the MRT raise many questions. Some of the recommendations are still vague and ambiguous or misconstrue the present law. The MRT did not consider all of the implications of some of the proposed changes, which could drastically limit or nullify some of the proposed cost savings. Changing eligibility may also violate federal Maintenance of Effort (MOE) requirements in both the federal Stimulus Act and the Health Care Reform Bill. Some of the changes would require federal waivers.
This is still early in the process. The Governor has 30 days (until March 2nd) to amend his budget, the appropriation bills, or his proposed legislation as of right. After that he may submit amendments only with the approval of the legislature. And of course, legislative approval of the budget is required in order for it to be effective.
The Elder Law Section believes it is important for you to know what is in the pipeline even though it is early in the process and much could still happen. We are committed to keeping our members posted as best we can to changes as they take place.
Some of the highlights that affect our clients and us are as follows:
The Proposed Elimination of Spousal/Parental Refusal:
This proposal would eliminate spousal and parental refusal for community based Medicaid. It would require that the income and resources of legally responsible relatives residing in the same household as the Medicaid applicant be counted in determining the applicant's eligibility for Medicaid. Under current New York law, a legally responsible relative living with a Medicaid applicant may refuse to make his/her income and resources available to the applicant. Under such circumstances, Medicaid eligibility for the applicant is determined based on only the applicant's income and resources. Local departments of social services may pursue a recovery of Medicaid paid from the non-contributing spouse/parent. This proposal would count the income and resources of a legally responsible relative who is living with an applicant for purposes of determining the applicant's eligibility for Medicaid.
The Proposed Implementation of a 60 month Look Back for Non-Institutional Long Term Care
The Proposed Expansion of Estate Recovery and Expansion of the Definition of Estate
The Section's Budget Task Force and lobbyists are busy working to try to change the proposals or minimize their impact and will continue to monitor the situation and keep the members of the Elder Law Section informed.
Sharon Kovacs Gruer, chair of the Elder Law Section
Sharon Kovacs Gruer, Esq., CELA, LL.M. Sharon Kovacs Gruer, P.C. 1010 Northern Boulevard Suite 302 Great Neck, New York 11021 (516)487-5400 Web: nytrustlaw.com Email: skglaw@optonline.net
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