June 15

House Bill Would Make Income from Community Spouse’s Annuity Available to Medicaid Applicant

New legislation in the U.S. Congress would change the way income from a community spouse’s annuity is counted for the purposes of Medicaid eligibility. The bill would make a portion of the income available to the institutionalized spouse.

In April 2015, Rep. Markwayne Mullin (R-Okla.) introduced H.R. 1771 to amend the section of the Medicaid law dealing with the treatment of income (42 U.S.C. 1396r–5(b)(2)). The proposed amendment would provide that if the annuity pays income solely in the community spouse’s name, one-half of the income will be considered available to the institutionalized spouse. The same thing is true if the annuity pays income to both the institutionalized spouse and the community spouse. If the annuity pays income to the community spouse and another person, then one-half of the community spouse’s portion will be considered available to the institutionalized spouse.  The legislation has been referred to the House Committee on Energy and Commerce.

To read the proposed amendment, click here.

June 11

CMS Issues Guidance on Applying Protections to Spouses of HCBS Recipients

Little noticed among its more famous provisions, the Affordable Care Act expanded impoverishment protections to the spouses of home and community-based services (HCBS) beneficiaries.  However, although the rules have been in effect since 2014, states have not always been in compliance, according to Justice in Aging (formerly the National Senior Citizens Law Center)

States now have less of an excuse not to comply because the Centers for Medicare and Medicaid Services (CMS) has issued guidance to states on the implementation of section 2404 of the Affordable Care Act which amended section 1924 of the Social Security Act, “Protection for Recipients of Home and Community-Based Services Against Spousal Impoverishment.” The Act amended section 1924(h)(1) to require, for the five-year period beginning January 1, 2014, that states include in the definition of an “institutionalized spouse” married individuals who are “eligible for medical assistance for home and community-based services . . . ”

The guidance describes how states must apply the statute in making Medicaid eligibility determinations.  Justice in Aging summarized some of the highlights in a recent Health Network Alert:

  • Under the statute, an individual must be eligible for HCBS in order for the protections to apply, and CMS interprets this to mean individuals must meet the nonfinancial eligibility requirements for HCBS.
  • For those eligible through use of the spousal eligibility rules based on their need for HCBS, the statute does not require that they actually receive the HCBS for which they are eligible. This rule will apply, for example, to clients who are on a waiting list for a waiver.
  • CMS provides additional guidance on what type of HCBS an applicant must be eligible for in order for spousal impoverishment rules to apply.  
  • The guidance includes clarification on how the expanded application of spousal impoverishment rules applies in post eligibility treatment of income (PETI) cases and the rule’s applicability to individuals deemed eligible for services under the Modified Adjusted Gross Income (MAGI).  

 To read the letter providing guidance to state Medicaid Directors, click here

June 8

Former Nursing Home Resident Received Proper Notice of Hearing When Case Placed on Docket

In a nursing home’s lawsuit against a former nursing home resident for unjust enrichment, an Ohio appeals court rules that although notice of the trial court’s hearing was initially sent to the wrong address for her attorney, the resident received proper notice because the court placed the hearing on its docket. Gibsonburg Health, LLC v. Miniet (Ohio Ct. App., 6th Dist., No. S-14-023, May 15, 2015).

Elena Miniet moved to a nursing home in 2008. In August 2012, she lost her Medicaid benefits and did not pay the nursing home from October 2012 through November 2013, when she was discharged. The nursing home sued Ms. Miniet for unjust enrichment and breach of contract, among other things. Ms. Miniet filed a motion to dismiss. The trial court denied the motion, and set a hearing date on the court docket. Because the court did not have the right address for Ms. Miniet’s attorney, her attorney did not receive notice of the hearing until six days before it was scheduled.

At the hearing, the trial court found in favor of the nursing home, ruling that Ms. Miniet had been unjustly enriched and ordering her to pay $13,837 in damages. Ms. Miniet appealed, arguing she did not receive due process because her attorney did not receive proper notice of the hearing.

The Ohio Court of Appeals affirms, holding that Ms. Miniet received “adequate notice to satisfy [her] right to due process under the facts of this case” because “date of the hearing had been on the court’s docket for over a month before [Ms. Miniet’s] counsel received actual notice.”

For the full text of this decision, go to: http://www.supremecourt.ohio.gov/rod/docs/pdf/6/2015/2015-Ohio-1863.pdf

June 4

Vietnam Vets’ Nightmares Offer Key to Dementia

For decades, dementia-causing conditions like Alzheimer’s were a mystery, illnesses that couldn’t be diagnosed for sure except at post-mortem. The development of advanced PET scans, combined with new tracer dyes means that doctors can now follow subtle biological routes in the brain and spinal fluid. That could explain how and why physical and psychological wartime traumas can double the risk of such conditions. “Vietnam Veterans are getting to an age now where we should be picking up changes in those people who are going to develop Alzheimer’s,” said Christopher Rowe, Director of Molecular Imaging Research at the Austin Hospital in Melbourne, who is leading the Australian arm of the research. The findings will offer insights into what causes dementia, cases of which are projected to almost double every 20 years. They could shed light on the long-term effects of assaults on the brain — whether sustained in battle, in a car wreck or on the football field, said Michael Weiner, professor of radiology at the University of California, San Francisco School of Medicine, who’s leading the study.

For the article from Bloomberg Business, click here.

June 1

Spousal Support Is Obligation of Deceased Spouse’s Estate (Pa. Super.)

The executrix of Ronald Renninger, Sr.’s estate appealed an order requiring the estate to pay spousal support to Ronald’s common law wife. The executrix argued that the trial court erred in its order because the divorce abated due to Ronald’s death and an order for support cannot be granted following the death of a party to the divorce action. The appellate court disagreed.

The court held that the trial court entered an interim support order while Ronald was alive awarding support from the time of the wife’s filing of the support action until the date of death. This is consistent, according to the court, with a longstanding rule that a spouse can collect unpaid support as a creditor of the deceased spouse’s estate. Thus, the lower court did not err in denying the support action simply because Ronald died during the pendency of the action. The court also disagreed with the executrix’s contention that the wife was not entitled to receive support due to her violence toward Ronald. The court held that the Executrix has the burden of presenting clear and convincing evidence to establish a defense to spousal support and the Executrix’s evidence that both parties sought mutual personal protection orders against each other is merely evidence of a troubled relationship and not sufficient evidence to overcome a spousal support obligation. For these reasons, the court affirmed the spousal support award from the date Ronald’s wife filed her petition until his date of death.

Moser v. Renninger, 2015 WL 1959448 (May 1, 2015)

NEWER OLDER 1 2 30 31 32 35 36