How the Tough New Medicaid Rules for Long Term Care Affect You!!

As we have been anticipating for over a year now, the Department of Healthcare and Family Services (“the Department”) has finally adopted amendments to  “Medical Assistance Programs”, which can be found in 89 Illinois Admin. Code Part 120. These amendments will become effective on January 1, 2012, and will serve to implement the provisions of the Federal Deficit Reduction Act of 2005 (“DRA”) regarding Medicaid assistance for long-term care in Illinois.

Before being finalized, the rule changes went through many different revisions. Myself and several other elder law attorneys participated in the review of these rule revisions.

The rules that have changed are many and complex.  For example, the new rules change the lookback period for reviewing prior transfers to as far back as January 1, 2007. This means that the rules regarding transfers are being applied retroactively despite outcry from the elder law community and many other industry groups.  The new rules will be applied to persons who file an application for Medicaid long-term care assistance on or after January 1, 2012.

Also, regarding asset transfers for which a Medicaid applicant has received less than fair market value, (for example gifts to children or other persons- other that  what the Department considers “incidental”), there will be a period of Medicaid ineligibility for long-term care. This period of ineligibility will not begin,  however,  until the Medicaid Applicant is in the nursing home, spent down to poverty level and a Medicaid application is filed. Then, and only then,  will the ineligibility period begin to run!

More specificity about how the new rules are  implemented will hopefully be available once the state issues its Policy Manual about the new rules. As of this date, no revision to the Policy Manual has been published to reflect the new rules.

Read more about the devastating impact these rules will have on the senior and disabled community and why “Senior” Estate Planning is more important than ever. A more in depth discussion can be found in the “Elder Law Articles” section of our website.

Look for many future blog entries on this topic. This is a “sea change” in the way our taxpayer – clients will become eligible for Medicaid payment for their nursing home care in the days ahead.