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Significant Changes To New York State Medicaid

By Brian L. Miller, Esq., Littman Krooks LLP

In the shadows of the COVID-19 pandemic, Governor Cuomo and the New York State Legislature quietly made significant changes to New York’s Medicaid rules, making it harder for New Yorkers to obtain Medicaid benefits for long-term care.

The changes to New York State’s Medicaid program include the following:

  • 30 month Look-back for Community Medicaid. Community Medicaid, the program which provides care for clients at home, represents the biggest change under the proposed law. Applicants seeking Community Medicaid benefits will have to provide financial statements for the past 30 months (2 ½ years) when applying for such benefits.  Any funds transferred from the applicant and/or their spouse without fair consideration during the look-back period will create a period during which Medicaid will not pay for your care at home.  This law takes effect October 1, 2020.
  • Changes to CDPAP and PCS. Medicaid’s Consumer Directed Personal Assistance Program (CDPAP) allows Medicaid recipients to hire family members, friends or other familiar parties as caregivers with their salaries paid by the program.  The Personal Care Services Program allows Medicaid recipients to receive personal care services via home-care agencies who contract with the local department of social service.  Effective October 1, 2020 the following changes are to take place to the CDPAP and PCS services:

    To be eligible for CDPAP or PCS you will need to require assistance with three (3) Activities of Daily Living (ADLs).  ADLs include, but are not limited to: personal hygiene, dressing, eating, maintaining continence, and transferring/mobility.  Fortunately, there is an exception for individuals who have been diagnosed with dementia or Alzheimer’s, in which case they only need to require assistance with one (1) ADL.

    Additionally, the plan of treatment will need to be prescribed by a qualified independent physician selected or approved by the Department of Health, and not the Medicaid recipient’s treating physician.

The above Medicaid changes take effect on October 1, 2020, and represent some of the most significant changes to the Medicaid program in many years. If you need help or assistance and you want to remain home it is imperative that you apply for Community Medicaid as soon as possible.  Assuredly, many applications will be filed close to the October 1, 2020 deadline. To avoid delays in processing and availability of caregivers applications for Community Medicaid benefits should be submitted as quickly as practical.

If you have not created your estate and asset protection plans, now is the time to do so.  Proactive planning has always been a recommended course of action when it comes to estate and asset protection planning.  Often clients are able to preserve significantly more of their assets when planning ahead of time, rather than waiting until the need for Medicaid benefits arises.

If you have already created your estate and asset protection plans with the focus on receiving Community Medicaid, now is the time to revisit, review and possibly revise your plans to ensure that they still achieve your wishes and desires.

We understand that dealing with the stress and impact of the COVID-19 pandemic you likely have other concerns on the front of you mind.  However, seeing how quickly a ‘flu-like’ illness became a world-wide pandemic should be enough evidence that it pays to be proactive and prepared.

While our physical offices are closed during the current state of emergency, we are fully operational working remotely to provide you with the same quality service and care that Littman Krooks is known for.  If you or a loved one needs to apply for Community Medicaid, needs to prepare estate and asset protection plans, or think it may be time to update your current plans, please do not hesitate to contact us to schedule a telephone or video conference with one of our esteemed attorneys.  We are also available for evening and weekend appointments.