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Medicaid Advocacy

by Ira M. Leff, Esq.

March 17, 2010

Those who think that Elder Law simply involves planning and transactional support are missing a key element of the practice. Over the last few weeks, I have represented several clients who needed an advocate on their side in order to receive what they were entitled to from Medicaid.

In Case A, I represented the Estate of deceased Medicaid recipient. The Estate Recovery Department (ER) filed a claim for $116,000 against the Estate. I was able to persuade ER to accept a new valuation of the real property and to use the IRS life estate tables rather than the Medicaid tables. In so doing, we agreed to a recovery of less than $33,000.

In Case B, DFCS denied an application for Community Care Medicaid (CCSP) because the applicant's son, who had received a gift from the applicant (A/R) was depositing gifts back to A/R directly into the Qualified Income Trust. DFCS relied on a rule which prohibits direct deposits into a QIT. See MEDICAID MANUAL§ 2407-2. I was able to convince the agency that direct deposit means assigning income to the QIT, not depositing a check in the QIT without first putting it in A/R's checking account.

In Case C, DFCS denied an application because A/R received a lump sum V.A. check for back benefits. DFCS allocated a portion of the check to each of the months which it covered and argued that A/R was over the income limit. I cited MEDICAID MANUAL § 2418-2, which says that a V.A. lump sum check is counted as income for the month of receipt in both the eligibility and patient liability budgets.

Case D is a follow-up to last week's ELM. As you may recall, we questioned whether transfers to a disabled child had to go into a trust for the child's sole benefit. I learned from Patrick Smith of Martinez, that Federal law permits outright gifts to disabled children while Georgia does not. I contacted Ginger Henry of DHR about the discrepancy. She responded that this problem will be corrected in the May 1, amendment to the Manual.

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