The Perils of Medicaid “Redets” – Part 2
In my blog post last week, I talked about a recent trend we are seeing - clients getting terminated from Medicaid as a result of a failed redetermination (“redet”). The purpose of a redet is for Medicaid to confirm that eligibility still exists (ie. the assets are still below the applicable limits and the QIT - if required - is being used correctly) and also to update the calculations of the Medicaid recipient’s cost share (the amount he or she is required to contribute from income towards the cost of care) due to cost of living and other adjustments. That being said, too many people are still losing benefits - sometimes in unfair ways. It starts with notice. When Medicaid is approved, the PR (the form with rows and columns of numbers used to calculate the cost share) also states at the top the month and year when the first redet is anticipated. That is just an estimate, however, since we have found the notice can arrive before or after that month. The problem is that the notice can be sent to the person who filed the original Medicaid application, a family member or the Medicaid recipient’s him or herself. Some counties insist they will only mail
The Perils of Medicaid “Redets” – Part 1
A few weeks ago in this blog, I posted about possible changes to Medicaid that may be coming from Washington. There are other changes, however, that have been happening here in New Jersey at the county and state level with respect to applications that we are now filing, but also with clients for whom we already successfully obtained Medicaid benefits several years ago. In the past 3 months we have received calls from 5 clients who told me that their loved ones’ Medicaid benefits had been terminated. The reasons were varied but it does highlight a disturbing trend. Before I get to the details of some of those cases let me first explain what happens after Medicaid is approved. As I always tell clients, Medicaid does annual redeterminations once you are approved. While these annual reviews were always part of the regulations as far back as I can remember, when I first starting filing Medicaid applications 30 years ago, “redets” as they are commonly referred to, were rare. Some counties did them others did not. Even counties that did them did so sporadically and. not annually. Within the last 10 years and especially since COVID, however, we have now seen them in all the counties we file in and
Why a POA Matters – Part 3
In this third blog post of three I explain the types of scenarios we have seen in our office in which a prospective client has a power of attorney, just not specific enough to allow the agent to take the action needed. As I explained last week, a document that contains general language, such as “the agent can do anything the principal can do” won’t be enough. Third parties presented with this type of document won’t typically honor it. The document must be much more specific. For example, the New Jersey power of attorney statute has a section which covers banking transactions. Making reference to the statute instead of listing each banking power in detail is permissible and common. The statute applies to banking institutions defined as banks, savings banks, savings and loan associations and credit unions. Brokerage firms, however, are not covered by this section. If I have a money market account, which is held in a bank rather than a brokerage firm, the POA must have other language covering these types of accounts. Otherwise, my agent will be unable to do anything with those accounts. Retirement accounts can also be problematic for agents using a POA without the right language. While these types of accounts can be held in
Why a POA Matters – Part 2
In last week’s blog post I explained that a power of attorney is an especially important document in the event of a medical crisis. It allows someone to act on your behalf to make financial and/or medical decisions if you can’t make them yourself. Simply having such a document, however, isn’t enough. What really matters is what is contained in that document. What does the document actually say? How specific is the language? What does the power of attorney allow the agent to do on behalf of the principal or not do? The agent may potentially need to present the document to a third party in many different situations and take many different actions on behalf of the principal. Does the power of attorney expressly state the agent can take the action he or she is attempting? If not, the agent may not be able to carry out the particular task because the third party presented with the power of attorney may refuse to honor it. Over the years, I have reviewed many powers of attorneys drafted by other attorneys as well as ones obtained online and completed without the assistance of an attorney. While the length of the document (ie. the number of pages) by itself doesn’t determine the strength
Why a POA Matters – Part 1
Whenever we get a call from a family in the midst of a medical crisis, one of the first questions we ask is whether there is a power of attorney. If so, we want to review that document. I have written about this very basic but often overlooked document in the past but two recent cases in our office once again highlight its importance. The power of attorney is a document by which the principal (the person executing the document) designates an agent to act on his or her behalf in certain situations. These situations can be in a medical setting (health care power of attorney also referred to as a health care directive). A power of attorney can also give the agent the power to conduct financial transaction on behalf of the principal (financial power of attorney). In our office we typically prepare 2 separate documents - one covering medical decisions and one covering financial decisions. Without a power of attorney no one has the ability to make decisions and carry out transactions on behalf of the principal. In a medical emergency doctors and hospital staff will often take direction from a spouse but eventually the lack of a health care directive will present a problem. If the
Potential Impact of Medicaid Cuts (Part 3)
In this 3rd post of 3 I discuss the potential impact of cuts to Medicaid being considered by Congress and the President. Last week I explained that specific changes, such as imposing a work requirement, are directed towards Medicaid recipients receiving Medicaid health benefits. They would not apply to those people receiving long term care benefits. Other changes, however, would reduce federal funding. Because Medicaid is a combination federal and state funded program, cutting federal funds would likely affect all of Medicaid’s various programs in indirect ways. Each state manages its own program so Medicaid changes would affect each one in different ways. If federal funds are cut, however, states would need to react by either increasing their funding to replace lost federal funds or cutting benefits. For example, the bill just passed by the House of Representatives which now awaits Senate review would cut federal funding to states that have expanded their Medicaid programs and that provide Medicaid coverage to undocumented immigrants using state funds. Federal funds could be reduced by 10% or more to states that don’t comply. Any reduction in funding is bound to have some overall effect. If states don’t replace federal funds then they could try to reduce the number of Medicaid recipients by making