Medicaid

Medicaid Managed Long-Term Care Update

Medicaid Managed Long-Term Care Update

UPDATE:  MLTC Enrollment Lock-In

Starting on December 1, 2018, individuals who enroll with a Medicaid Managed Long-Term Care (“MLTC”) plan for the first time or transfer to a new MLTC plan will be subject to a “lock-in” period.  This is a change from current rules, which do not limit an individual’s ability to switch MLTC plans.

How does the lock-in work?  For the first ninety (90) days after enrollment, an MLTC plan member can disenroll or change plans for any reason.  After 90 days, the individual will be “locked-in” for nine months, during which time he or she will barred from changing plans without good cause.  After the nine-month lock-in period has expired, the MLTC plan member can switch to a different MLTC plan at any time, and for any reason, subject to a new grace period/lock-in for each subsequent transfer.

I am already enrolled in an MLTC plan.  How does this new policy affect me?  Individuals who are already enrolled with an MLTC plan as of December 1, 2018 will not be locked-in to their current plan, but will be subject to a grace period/lock-in if they choose to switch MLTC plans after December 1st.

For updates and information in Elder Law and Estate Planning, Medicaid and Special Needs Planning, please visit our website: www.gylawny.com 

GRIMALDI & YEUNG LLP
Phone: 718-238-6960
Brooklyn and Manhattan Offices:

9201 4th Ave, 6th Floor
Brooklyn, NY 11209

546 Fifth Avenue, 6th Floor
New York, NY 10036

This post is made available by the lawyer for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this site you understand that there is no attorney client relationship between you and the lawyer. The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. ATTORNEY ADVERTISING.

July 19: Grimaldi & Yeung LLP Invites You to a Complimentary Breakfast Seminar!

July 19: Grimaldi & Yeung LLP Invites You to a Complimentary Breakfast Seminar!

Joanne Seminara, Partner of Grimaldi & Yeung LLP, will be presenting: Medicaid Planning & Asset Protection Trusts

WHEN:
Thursday, July 19, 2018
9:00 AM to 11:00 AM

WHERE:
Colonnade Diner

2001 Hylan Boulevard
Staten Island, NY 10306

Please join us to learn about long term care planning and how YOU can plan ahead!  

Complimentary Breakfast & Seminar – Please Bring a Friend! 

Seating is limited
MUST RSVP by July 16, 2018mcoppola@gylawny.com or (718) 238-6960

 

For updates and information in Elder Law and Estate Planning, Medicaid and Special Needs Planning, please visit our website: www.gylawny.com 

GRIMALDI & YEUNG LLP
Phone: 718-238-6960
Brooklyn and Manhattan Offices:

9201 4th Ave, 6th Floor
Brooklyn, NY 11209

546 Fifth Avenue, 6th Floor
New York, NY 10036

This post is made available by the lawyer for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this site you understand that there is no attorney client relationship between you and the lawyer. The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. ATTORNEY ADVERTISING.

New Medicaid Home Care Appeals Rules: Could They Affect You?

New Medicaid Home Care Appeals Rules: Could They Affect You?

New Rules on Medicaid Home Care Appeals – 2018

New York’s Medicaid Program is experiencing growing pains as the demand for care at home has increased and the hourly wage of the home care worker is also rising. As a result, many recipients of Medicaid’s home care benefit may have the amount or duration of personal care reduced.

The appeal process for challenging a denial, reduction or termination of services has changed. Beginning March 1, 2018, all home care recipients must seek an appeal with the home care agency before requesting a hearing before the New York State Fair Hearing panel. This pre-hearing appeal is an “internal appeal”.

State and federal regulations require plans to mail a written notice of any decision to reduce or terminate services.  This notice must be mailed at least ten (10) calendar days before the effective date of the decision.  Plan members who want services to continue while they appeal a reduction or termination must request an internal appeal with “aid continuing.”  To receive “aid continuing,” the plan member must submit a written appeal request within ten (10) calendar days of the date of the notice or by the effective date of the decision, whichever is later.

The deadline to request an Internal Appeal without aid continuing is sixty (60) calendar days from the date of the notice.

If one disagrees with the outcome of an Internal Appeal, one may request a State Fair Hearing after the plan issues a Final Adverse Determination.  The deadline to request a Fair Hearing is one hundred and twenty (120) days from the date of the Final Adverse Determination.  MLTC members may request a Fair Hearing sooner if the plan fails to provide a written notice of its initial decision, provides inadequate notices, does not decide the Internal Appeal within the required time frame, or fails to comply with other requirements.

Please note that the Internal Appeal process applies to decisions about what services MLTC and Managed Care Plans will provide.  Medicaid beneficiaries who disagree with a decision about their eligibility for Medicaid may request a State Fair Hearing immediately.  The deadline to request a Fair Hearing on a decision by the local Medicaid Agency is sixty (60) days from the date of the notice.  If the Medicaid beneficiary wants “aid continuing,” then the Fair Hearing must be requested before the effective date of the decision, or within ten (10) days of the date of the notice, whichever is later.

Action:  If you wish to appeal a determination of your Medicaid care plan, contact our firm for help in resolving this or any other Medicaid issue.

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Download PDF of this post here.

Please visit our website for information on Elder Law and Estate Planning: www.gylawny.com 

GRIMALDI & YEUNG LLP
Phone: 718-238-6960
Brooklyn and Manhattan Offices:

9201 4th Ave, 6th Floor
Brooklyn, NY 11209

546 Fifth Avenue, 6th Floor
New York, NY 10036

This post is made available by the lawyer for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this site you understand that there is no attorney client relationship between you and the lawyer. The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. ATTORNEY ADVERTISING.

Download the New 2018 Medicaid Financial Levels

Download the New 2018 Medicaid Financial Levels

Download PDF:  Medicaid Levels – 2018

Please visit our website for information on Elder Law and Estate Planning: www.gylawny.com 

GRIMALDI & YEUNG LLP
Phone: 718-238-6960
Brooklyn and Manhattan Offices:

9201 4th Ave, 6th Floor
Brooklyn, NY 11209

546 Fifth Avenue, 6th Floor
New York, NY 10036

This post is made available by the lawyer for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this site you understand that there is no attorney client relationship between you and the lawyer. The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. ATTORNEY ADVERTISING.

Tax bill could end to the Medical Expense Deduction! Let’s save it…

Tax bill could end to the Medical Expense Deduction! Let’s save it…

Federal Tax Change Update: Proposed Elimination of Medical Expense Deduction

Ending the Medical Expense Deduction Would Harm Many Individuals Paying the High Cost of Long-term Services and Support. On Thursday, October 3rd, House Republicans released a tax bill that proposes to end the Medicaid Expense Deduction.

WHAT WOULD HAPPEN?

How Does the Medical Expense Deduction Help Individuals with Long-term Services and Support (LTSS)?

Currently, the federal tax code allows deduction of “qualified long-term care expenses” for people who are “chronically ill,” those unable to perform two or more “Activities of Daily Living” without assistance, or who have a “severe cognitive impairment” such as Alzheimer’s disease. These expenses are usually catastrophic, requiring many Americans to spend large portions of their income and to liquidate resources.

The Medical Expense Deduction For Individuals with LTSS

This applies only to those expenses above 10% of Adjusted Gross Income and when a taxpayer itemizes their deduction. “Chronically ill individuals” can use this provision.  If Congress ends the Medical Expense Deduction, many Americans paying for Long-Term Services and Supports (LTSS) will face the double cost of both chronic long term care and federal income tax.

Impact of Ending the Medical Expense Deduction may include:

  • Eviction From a Care Facility: Without the deduction, individuals paying privately for LTSS may not have the funds to pay their tax liability and the nursing facility, leading to eviction from the facility.
  • Uncollectible Tax From Some Medicaid LTSS Populations: Individuals on Medicaid must contribute a substantial portion of their income to Medicaid as part of the “spend down program”.  They will not have any funds to pay this new tax liability.
  • Hurts Family Caregivers: Children can also use this deduction if they pay for more than half of a  parent’s care. Eliminating this deduction will negatively impact a child paying for a chronically-ill parents needs.
  • Increased Reliance of Government Programs: Many middle- and working-class individuals “spend-down” their resources to qualify for Medicaid. Without a tax subsidy, the eligibility process will be faster and will place a larger burden on an already stressed federal/state Medicaid system.

WHAT CAN YOU DO?

  1. Write to us and tell us how this tax proposal will impact your family’s/client’s long term care plans; how it will affect your family’s financial well being, and any other concerns that you may have. Grimaldi and Yeung will be sending a packet to the congressional leaders drafting this legislation and we would like to include your comments and concerns.
  2. Write directly to your congressional representatives. For information on who your representative is, please click here.

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GRIMALDI & YEUNG LLP
Phone: 718-238-6960
Brooklyn and Manhattan Offices:

9201 4th Ave, 6th Floor
Brooklyn, NY 11209

546 Fifth Avenue, 6th Floor
New York, NY 10036

This post is made available by the lawyer for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this site you understand that there is no attorney client relationship between you and the lawyer. The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. ATTORNEY ADVERTISING.

Complimentary Breakfast Seminar: “Medicaid Planning & Asset Protection Trusts”

Complimentary Breakfast Seminar: “Medicaid Planning & Asset Protection Trusts”

Grimaldi & Yeung LLP is hosting an upcoming Complimentary Breakfast Seminar:

Judith D. Grimaldi & Naomi Levin will be presenting:

“Medicaid Planning & Asset Protection Trusts”

When:
Thursday, October 12, 2017
8:30 AM to 10:30 AM

Where:
Fifth Avenue Diner Restaurant
432 5th Avenue (Btwn. 8th& 9th Sts.)
Brooklyn, NY 11209

MUST RSVP by October 9th: mcoppola@gylawny.com or (718) 238-6960

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GRIMALDI & YEUNG LLP
Phone: 718-238-6960
Brooklyn and Manhattan Offices:

9201 4th Ave, 6th Floor
Brooklyn, NY 11209

546 Fifth Avenue, 6th Floor
New York, NY 10036

This post is made available by the lawyer for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this site you understand that there is no attorney client relationship between you and the lawyer. The post should not be used as a substitute for competent legal advice from a licensed professional attorney in your state. ATTORNEY ADVERTISING.