Medicaid Planning Category Archives

Advocates Call for Tighter New York Medicaid Rule Enforcement

Published on: September 27, 2011 | by Ettinger Law Firm

Last week state legislators proposed New York Medicaid changes which would eliminate the financial involvement of local county governments–a state take-over of the program. However, this change would do nothing to curb the overall costs of the program. Lawmakers explain that reigning in Medicaid costs remains a top priority, and so additional alterations to the program are likely. Many observers are calling for tighter enforcement rules to root out fraud. Stricter enforcement of the program will likely target medical care providers who seek to collect money, but these changes may also affect individual residents who are working through the New York Medicaid application process.

An editorial in last Friday’s Albany Times Union called upon the legislature not to go “soft” on Medicaid users. Recent problems of fraud in institutions serving those with developmental disabilities were used to highlight the current problem with the program. Some observers believe that homes for those who are unable to live independently because of age or disability are the site of the clearest patterns of excessive Medicaid utilization. Several years ago the New York Commission on Quality of Care and Advocacy for the Mentally Disabled noted that Medicaid billing for these services were “costly, fragmented, sometimes unnecessary, and often appeared to be revenue-driven, rather than based on medical necessity.”

Senior care advocates believe that many disabled seniors find themselves in need of dental care, hearing aids, and similar basic services only to be shuffled to alternative medical appointments not of their choosing or tailored to their need. These advocates claim that Medicaid changes are necessary to correct the disconnect between needed services and the ones actually provided. On top of the programmatic problems, the state’s Long Term Care Coalition noted that the Health Department lacks the resources to oversee these adult homes properly. The state body struggles to ensure that nursing homes and senior living facilities are abiding by state rules and regulations. The quality of elder care suffers as a result.

Grandparents Day is Reminder of Importance of Long-term Care Planning

Published on: September 15, 2011 | by Ettinger Law Firm

While it slipped under the radar this year for many families, the first Sunday after Labor Day is Grandparents Day. As explained this week in the Daily Local, the holiday has been the topic of a presidential proclamation every year since 1978. More recently it has been used as a time to raise awareness of the continuing needs of many grandparents in nursing homes and the importance of helping our elders conduct long-term care planning. Considering that the majority of area seniors remain concerned about their future quality of life, our New York elder care attorneys know that all occasions are good ones to discuss these long-term care issues.

The non-profit association which champions Grandparents Day each year explained how the group has been working to help families take steps that will keep their elders in their own homes, instead of nursing homes. Efforts to transition away from nursing home care are growing in popularity nationwide. Our New York elder law estate planning lawyers have long recognized that most area seniors would prefer to “age in place,” receiving the additional care that they need without being forced to move into a nursing home or other long-term care facility.

However, the financial realities of these situations often mean that it is only those who have taken steps to prepare for this time in their lives that ultimately have the freedom to stay at home. For example, residents who visit a professional early enough to discuss these matters often decide to invest in long-term care insurance (LTCI). This insurance can ensure that the resources will be available when necessary to pay for at-home care when a senior is in need of extra assistance with day-to-day tasks. It is difficult to put a price tag on the peace of mind that comes with knowing one has done everything in their power to ensure that their quality of life will remain as high as possible no matter what the future holds.

Tips for Choosing the Best Elder Care for Loved Ones

Published on: August 17, 2011 | by Ettinger Law Firm

It is often emotionally wrenching to come to the realization that your aging loved one is in need of extra day-to-day care. For local residents, if a proper New York elder care plan is in place there should be options available to provide the necessary assistance. In many cases aid can be provided to the senior while they remain in their own home with care workers traveling to them to assist with basic living chores and some medical needs.

However, there may come a time when moving the relative into a long-term care facility is unavoidable. When that time comes there are often two major questions to answer: how will we pay for nursing home care and how do we know what facility is best? Local community members can receive guidance on the first question by visiting a New York elder care attorney. Even if no prior planning has been conducted to save assets from these costs–such as the creation of a Medicaid Asset Protection Trust–there may be options to protect part of one’s assets while on the nursing home doorstep. This is known as the “gift and loan” strategy; it is an advanced elder law technique that can save some of your relative’s nest egg from being spent down to pay for an extended nursing home stay.

This week Penn Live shared some tips to help families decide on the appropriate facility for their loved one once the financial issues have been resolved. Some assisted-living facilities are geared toward seniors who can do some things on their own (like bathing and dressing), while many other nursing homes provide assistance in virtually all tasks. In our area, the New York State Office for the Aging provides helpful information on various housing options for seniors and the specific services that they usually provide.

The Medicaid Asset Protection Trust (MAPT) – Do’s and Don’ts

Published on: April 13, 2010 | by Ettinger Law Firm

by Michael Ettinger, Attorney at Law The Medicaid Asset Protection Trust (MAPT) is a technique commonly used by elder law attorneys. It consists of an irrevocable trust, usually set up by a parent of parents sixty-five and older. One or more of the adult children are named as “trustees” to manage the trust for the benefit of the “beneficiaries” who remain the parents during their lifetimes. For example, the parents retain the right to the exclusive use and enjoyment of the home and the income from all of the trust assets. The establishment and “funding” of the trust, i.e. retitling the home and the investments in the name of the trust, starts the five year look-back period running. After five years, those assets become exempt and are protected from the costs of long-term care.

Once the MAPT is established, there are certain things the parties can and cannot do. Below are a list of the “Do’s and Don’ts” concerning the MAPT.

Do’s