Nov
12
Changes to Medicaid and Managed Long-Term Care (MLTC)
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This summer, there was a General Information System (GIS) message that adversely affects married individuals enrolled in a managed long-term care plan (MLTC), including married persons receiving Medicaid home care attendants through an MLTC, and married individuals who receive home and community-based services (HCBS) pursuant to a waiver under Section 1915(c) of the Social Security Act, including the Traumatic Brain Injury program, the Long Term Home Health Care program, and the Nursing Home Transition and Diversion waiver program. On August 5, 2014, the Department of Health issued GIS 14 MA/15. This GIS advises local departments of social services to require spousal impoverishment budgeting with post-eligibility rules for married individuals enrolled in a MLTC under the State's 1115 waiver and for married individuals who receive HCBS. This GIS is effective January 1, 2014. Although the GIS is silent on this issue, it appears that the requirement to impose post-eligibility rules will prevent married individuals enrolled in an MLTC and married individuals who receive HCBS from contributing their excess income to a pooled community trust. This will harm those individuals who depend upon the contribution to a pooled community trust in order to remain in the community. Mandating the application of post-eligibility rules for married individuals enrolled in an MLTC and for married individuals who receive HCBS appears to violate federal law as well as the federal and State post-eligibility regulations. Moreover, since not all counties have mandated MLTC enrollment, the GIS would result in disparate treatment of married individuals based upon geographic location. This blog will keep you updated on any developments in this area as they occur.

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