Medicaid – Taps Sutton & Roshon, LLC

March 7, 2019

“Improvement Standard” not appropriate for Medicare coverage

Many patients, and more importantly, many medical providers, still don’t know that the “improvement standard” is no longer an appropriate measure for Medicare’s coverage of skilled nursing and rehabilitative services for patients. Frequently, Medicare providers deny or stop treatment of patients who are no longer improving from therapy or skilled nursing services. This “improvement standard” […]

August 13, 2018

Planning for Alzheimer’s Disease

Early diagnosis, treatment, and planning are important parts of managing Alzheimer’s Disease – not just for the patient and family members, but for medical professionals, as well. This article discusses a recent law passed in Massachusetts. The new law makes Alzheimer’s diagnosis, treatment, and study a high priority throughout the state. The law creates a […]

July 27, 2018

Family Caregivers and Medicaid

Many families intend to keep elderly loved ones out of a long-term care facility for as long as possible. To do so, children and other relatives often provide care to the elderly person at home. A question we frequently get from our clients and their families is: “Can my loved one pay me to provide […]

April 19, 2018

Medicaid 101: Part 12 – Medicaid Estate Recovery

The posts in this blog series have focused on Medicaid eligibility criteria, important concepts, and planning options. The final post for this series addresses Medicaid estate recovery. Beginning January 1, 1995, Ohio implemented the Medicaid estate recovery program, which is mandated by federal law. The Medicaid estate recovery program seeks repayment from the individual’s assets […]

April 12, 2018

Medicaid 101: Part 11 – Crisis Planning

Part 10 of this blog series discussed long-term planning – that is, planning to protect assets more than five years before a Medicaid application is filed. Many times, however, unexpected events occur and a long-term plan cannot be accomplished. Instead, a more immediate plan, called a crisis plan, could be implemented to still protect assets […]

April 10, 2018

New Medicare cards to be issued – beware of scams

Beginning in April 2018, Centers for Medicare & Medicaid Services (CMS) is issuing new Medicare cards to remove Social Security Numbers from the cards. New Medicare enrollees will receive one of these new cards containing an account number instead of their Social Security Number. Those already enrolled in Medicare will start receiving new cards over […]

April 5, 2018

Medicaid 101: Part 10 – Long-term Planning for Medicaid

Part 5 of this blog discussed the five-year lookback period for Medicaid eligibility. If any gifts or transfers of assets are made in the five years preceding the filing of a Medicaid application, the applicant may be penalized for those gifts or transfers. Any transfers made more than five years before a Medicaid application is […]

March 29, 2018

Medicaid 101: Part 9 – Expansion Medicaid

Part 1 of this Medicaid blog series generally discussed the Medicaid program and its eligibility requirements. For most Medicaid applicants seeking long-term care coverage, there is both an income and an asset test for eligibility. Refer to Part 1 and the corresponding sections regarding those eligibility requirements. The Affordable Care Act implemented the Medicaid expansion […]

March 23, 2018

Medicaid 101: Part 8 – Spousal Refusal or “Just Say No”

Part 6 of this Medicaid blog series discussed the traditional method for a married individual to qualify for long-term care Medicaid. In some circumstances, a non-traditional method, called Spousal Refusal, can be implemented. Typically, the healthy spouse (known as the “community spouse”) can protect more assets with the Spousal Refusal method than with the traditional […]

March 15, 2018

Medicaid 101: Part 7 – Spousal Monthly Income Allowance

Part 1 of this Medicaid blog series generally discussed the Medicaid program and its eligibility requirements. Part 2 discussed the Assisted Living Waiver program, and Part 3 addressed the PASSPORT program. This post will refer to all three programs collectively as “long-term care” Medicaid. While each of these programs has a specific set of eligibility […]

March 8, 2018

Medicaid 101: Part 6 – Snapshot Date and Community Spouse Resource Allowance

Part 1 of this Medicaid blog series generally discussed the Medicaid program and its eligibility requirements. Part 2 discussed the Assisted Living Waiver program, and Part 3 addressed the PASSPORT program. This post will refer to all three programs collectively as “long-term care” Medicaid. While each of these programs has a specific set of eligibility criteria, some criteria apply to all three programs, including the […]

March 1, 2018

Medicaid 101: Part 5 – Five-Year Lookback Period and Penalties

Part 1 of this Medicaid blog series generally discussed the Medicaid program and its eligibility requirements. Part 2 discussed the Assisted Living Waiver program, and Part 3 addressed the PASSPORT program. This post will refer to all three programs collectively as “long-term care” Medicaid. While each of these programs has a specific set of eligibility […]