Healthcare Professionals

Health care professionals love working with us. Social workers, nurses, hospital discharge planners, home care agencies, assisted living facilities, nursing home admission coordinators, and nursing home financial and Medicaid coordinators all feel comfortable knowing that they can confidently refer a patient and their family to our team of professionals. They know that we will work in partnership with them to ensure that the best and most appropriate care is obtained for the patient. In addition, healthcare professionals have come to trust and respect our ability to obtain Medicaid eligibility for patients, streamlining the admission process for both the healthcare facility and our clients.

Our legal team also stays up-to-date on the constantly changing and developing Medicaid rules and regulations, so that healthcare professionals can spend less time digging through the details and more time identifying the most viable options for their patients, both medically and financially.

Important Topics of Interest

2016 New York State Medicaid Updates

2016 Medicare Updates

Asset Protection Planning – Promissory Note

Pooled Income Trust

 

Important Links

Medicaid Eligibility Requirements

Dept. of Health: General Information regarding NYS Adult Care Facilities

Dept. of Health – Managed Long-Term Care

Long Island Alzheimer’s Foundation

Additional resources can be accessed here.

 

Fair Hearing Decisions

Fair Hearing Case #7166967M

In this case, the Department of Social Services (DSS) denied the applicant’s Medicaid application on the grounds that the applicant had excess resources.  DSS determined that the applicant’s home was a countable resource and, as such, stated that the applicant had excess resources and therefore, was ineligible for Medicaid.

Ms. McCarthy argued that because the applicant’s representative signed an “Intent to Return Home” the applicant’s home should be considered an exempt resource.  Further, Ms. McCarthy argued that so long as the applicant maintained the home as her primary residence, then home should remain as an exempt resource.

Result: The Department of Social Services’ decision to deny the Medicaid application due to excess resources was determined incorrect and the decision reversed.

 

Fair Hearing Case #2091305Y

In this case, the Department of Social Services denied the applicant’s Medicaid application for several months, citing that the applicant made transfers for less than fair market value in order to qualify for Medicaid within the look-back period.

The applicant did transfer assets to her children and grandchildren within the look back period, however, Mr. Atlas argued that these transfers were made for purposes other than to qualify for Medicaid and provided evidence to substantiate that claim.

Result: The Department of Social Services’ decision to deny assistance on the grounds of transferring assets for less than fair market value was determined incorrect and reversed.

 

Fair Hearing Case #2434519R

In this case, the Department of Social Services denied the applicant’s Medicaid application due to the family’s failure to provide the requested documentation.

Evidence was presented that the family was unaware of the missing documents and was not advised in a timely manner of the missing documentation, nor of the application’s denial by the Department of Social Services.

Result: The Department of Social Services’ decision was reversed and the Department of Social Services was directed to continue processing the applicant’s application.

 

Fair Hearing Case #4100975R

In this case, the Department of Social Services denied the applicant’s Medicaid application on the grounds that the applicant’s irrevocable trust was an available resource and therefore, her assets exceeded the resource limitations.

Mr. Atlas utilized persuasive case law to point out that the irrevocable trust was not an available resource to the applicant.

Result: The Department of Social Services’ decision was reversed and they were ordered to continue processing the applicant’s case and to not consider the irrevocable trust as an available resource.

 

Fair Hearing Case #5934164M

In this case, the Department of Social Services denied the applicant’s Medicaid application for several months, citing that the applicant made transfers for less than fair market value in order to qualify for Medicaid within the look-back period.

The applicant lived with her daughter and in lieu of rent, paid for her grandchildren’s college.  She suffered a stroke which resulted in her need to reside in a nursing home.

By presenting evidence and utilizing past fair hearing decisions, Mr. Atlas pointed out that while the applicant made transfers, she was in good health, met her living expenses and reasonably expected to reside in her daughter’s home until her death.

Result: The Department of Social Services was directed to eliminate the penalty period based on the circumstances of the case—that the transfers were not made in order to qualify for Medicaid.

 

For more information, please browse through our resources, visit our blog, or give us a call at 631.420.1212, or send us an email.


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