Update: Medicaid Home Care Changes

As we reported in our blog post on September 25, 2020, New York State is implementing significant changes to the community-based (home care) Medicaid program in the coming year.  Initially, it was reported that the changes would be effective as of October 1, 2020; however, due to the pandemic, the effective date was pushed back to January 1, 2021.  This date has again been pushed back again to April 1, 2021. 

While the changes remain the same, among them being the thorough review of a home care Medicaid applicant’s (and their spouse’s) finances going back 30 months to determine whether uncompensated transfers (gifts) occurred, the implementation date has changed for this look-back requirement.  The Department of Health recently provided verbal clarification that any gifts made on or after October 1, 2020 would result in a penalty for any home care applications submitted after April 1, 2021.  However, if an applicant who has made any gifts on or after October 1st qualifies and applies for home care Medicaid prior to April 1, 2021 , no penalty will be imposed. 

As a reminder, the assessment of a penalty means that there will be a period of time during which the applicant will not be eligible to receive home care through Medicaid.  This may result in a more complicated application process, delays in receiving care or total denials of services for individuals in need.

While it is believed that this change in implementation date is final as we near 2021 and the distribution of a vaccine, it is important to note that many elements of these new rules are still in flux and should not be relied upon until written confirmation has been provided by the Department of Health, which is expected to occur in early 2021. 

We want to remind you that because these new processes are expected to take longer and you and your loved ones could be waiting for a longer period of time to receive long-term health care services in your home, it is important to start planning early.

To read about the other Medicaid changes taking effect on April 1, 2021, and how we can help, view our prior blog post here. Please do not hesitate to contact us if you are wondering how these changes might effect you. Schedule a consultation today with one of our experienced attorneys and our paralegal, Casey Baxter, who has extensive experience in Medicaid application preparations.