Medicaid 2012

It is now 2012, five years after the implementation of the burdensome new Medicaid regulations by the Federal Government. Here are a few of the results: (1) The County Boards of Social Services take longer than ever to process a Medicaid application. They are short-staffed and are basically under a hiring freeze due to limited resources in the State budget. The cases are more complex and involve a great deal more paperwork; as a result the caseworkers are overwhelmed. (2) In some Counties, you cannot even get an appointment to process Medicaid for over one month. (3) Families are totally unprepared when they try to process an application on their own, as they do not even have the vaguest idea what the system entails and there is no resource on the market that can really prepare them. The more sophisticated families engage a professional. But for those that cannot afford professional help, they are basically at the mercy of the system. (4) More and more individuals are being disqualified from Medicaid for months as a result of gifting to relatives over the last five years. Most families do not understand that although the IRS allows gifts of $ 13,000 per year per individual, Medicaid will not approve these gifts. Medicaid treats these gifts as an illegal method of disposing of resources in order to qualify for Medicaid more quickly. (5) The County Medicaid Offices are also short-staffed, so the Community Choice Counselors who visit patients in the community to evaluate their medical conditions cannot respond quickly. Weeks or months go by before a patient who desperately needs placement in a nursing home can be seen. And under Medicaid guidelines, these individuals will not be eligible �medically� until seen by the counselor and may not qualify for Medicaid coverage as a result. Often, these individuals wind up going to hospitals by default. They are then placed from the hospitals. (6) When patients are disqualified from Medicaid after paying privately in nursing homes, the nursing homes have no payment sources. In recent years, there have been several lawsuits against family members as a result of the 2006 Medicaid regulations. The Medicaid system is broken, with no solution in sight. Government regulators have the goal of reducing Medicaid payments to nursing homes and assisted living facilities in order to balance the Federal budget and State budgets. The plight of these unfortunate families and of the health care providers is not their focus. As eldercare professionals, CARENET, Inc. can only do its best to provide quality services to those individuals in need. We will continue to work diligently to assist families with Medicaid issues, to provide financial plans that prevent Medicaid problems, and to counsel families regarding the medical issues of the elderly and how best to manage them.

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