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Lookback for Community-Based Medicaid Further Delayed – There’s still time to plan!

Governor Cuomo’s 2020-21 State Budget included $2.5 billion in cuts to New York State’s Medicaid rules which resulted in big changes to the program.  One of the most significant changes was the implementation of a lookback period for community-based Medicaid.

For many years, there has been a five year look back for applicants seeking nursing home Medicaid. This means that transfers of assets made by an applicant and/or spouse for nursing home Medicaid within five years of the date of application can result in a penalty of extended Medicaid ineligibility.  Prior to 2021, with respect to community-based Medicaid (home care), there was no look back.  An applicant could transfer all of their assets and then qualify for Medicaid the very next month.   This made it very easy for applicants to protect their assets and secure home based care when needed.

Under the new law, applicants for community-based Medicaid face a 30-month lookback period.  This new lookback period was to have taken effect as of October 1, 2020.  However, since early 2020, the COVID-19 Public Health Emergency (“PHE”) has resulted in the postponement of the 30-month lookback for community-based Medicaid applications.  Most recently the PHE was extended through September 2022.  Therefore, unless the PHE is extended once again, the 30-month lookback will be imposed on all community-based Medicaid applications filed on or after October 1, 2022.

It is uncertain whether the PHE will be extended once again.  For anyone considering applying for community Medicaid, the time to act is now while the implementation of the lookback period continues to be delayed.  Once the new law is put into effect, securing necessary care and protecting assets will become much more challenging.   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.

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