The leading nonprofit advocacy group, New York Legal Assistance Group (NYLAG) has released an update on the NYS Department of Health’s ‘guidance’ for applicants of home care/community Medicaid/MLTC.
In April, the Governor signed into law a change to the program which provides home health aides (often called personal care aides here, on Long Island) for seniors and persons with disabilities. That change, effective October 1, 2020, implements a 30-month look-back requirement for Medicaid applications. Similar to nursing home applications for Medicaid, applicants (and their spouses) will be required to provide 30 months of documentation for all finances, including transfers.
NYLAG has confirmed that the look back will be phased in between October 1, 2020 and April 2023. For applications filed as of January 2021, the look back will be 3 months (October 1 to January 1); for applications filed February 2021, the look back will be 4 months, increasing each month until the full 30 month look back is reached in April 2023.
Uncompensated transfers (gifts) will be ‘captured’ within each look back period and examined as to whether permissible. For example, transfers to a spouse within a look back period are lawful. Transfers by that same spouse to a trust or child may disqualify the applicant from home care if made during the applicable look back period.
Advocates are awaiting confirmation that the transfer of a home from the senior to a caregiver child – a child who has resided with the senior for at least two years and provided care and assistance, or oversight and management of that care – will continue to be a permitted transfer.
Advocates are encouraged that the pooled community income trust is likely to continue to be authorized by Medicaid to legally shelter an applicant/recipient’s excess income ($875 in 2020) so that seniors and persons with disabilities can afford to remain at home.
We are awaiting further written confirmation from the Department of Health (Medicaid) and my office will provide you with those important updates as received by me.
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