Big Changes made to the NYS Medicaid Program
New Yorkers are not only dealing with the crippling effects of COVID-19 but are now also faced with the most significant changes made to the Medicaid program in years. Governor Cuomo’s 2020-21 State Budget proposed a $2.5 billion cut to New York State’s Medicaid program and there was much speculation as to where the savings to the program would come from. Now the Governor’s budget has passed and here are the big changes you should know:
- Look-back period for Community based Medicaid. Previously, someone seeking home care or other community-based Medicaid services could apply almost immediately after transferring assets out of his or her name. Starting on October 1, 2020, applicants for home care will face a 30-month look back period (2.5 years). This means that transfers of assets made by a Medicaid applicant and/or spouse within 30 months prior to the date of application can result in a penalty period, that is a period in which Medicaid will not pay for the applicants home care services.
- Raised requirements for eligibility for Personal Care Services (“PCS”) and the Consumer Directed Personal Assistance Program (“CDPAP”). PCS and CDPAP programs both provide home health care services, such as home health care aides, in the community. The CDPAP program allows consumers to recruit, hire, and direct their own chosen home care workers. PCS provides caregivers through licensed agencies. The new criteria raise the bar for who can qualify for these services.
a) Under the new guidelines, a Medicaid recipient must require assistance with at least three (3) activities of daily living (ADLs). ADLs include activities such as, dressing, bathing, eating, personal hygiene, transferring, toileting and continence. Adding these requirements will reduce the ability of many to qualify for PCS and CDPAP services. Fortunately, those with a diagnosis of Dementia or Alzheimer’s can qualify for services needing assistance with only one (1) ADL.
b) Medicaid is also eliminating Level 1 personal care, which provides assistance to disabled individuals with such chores as shopping, laundry and meal preparation. These services are frequently required by elderly and disabled individuals in order to live safely in the community.
These changes take effect on October 1, 2020. It is clear to us that the intent of these changes is to limit the availability of these crucial programs. However, as in the past, we will continue to assist our disabled and elderly clients protect their resources and secure available care.
With these changes in mind, it is more important than ever to be proactive about your estate and asset preservation planning. Planning ahead can eliminate the stress and financial burden imposed by these new changes. We at CBMS urge those who have not yet completed or started their estate and asset preservation planning to do so without delay. We are here to answer any questions or concerns you may have. Give us a call at (516) 931-8100.
Disclaimer: The information in this article is continuously changing and being updated. This article is for informational purposes only and does not constitute legal or business advice. In no way is Capell Barnett Matalon & Schoenfeld LLP advising that it is appropriate for all entities to undertake these measures. If you require assistance, please contact Stuart Schoenfeld, Esq. at firstname.lastname@example.org or Monica Ruela, Esq. at email@example.com.