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 * Update on Proposed New

Illinois Medicaid Regulations *

Written by Janna Dutton, Partner.

On April 12, 2011, the Joint Committee on Administrative Rules, the legislative body which must approve

Janna Dutton, Partner

Ja new regulations published by the Department of Healthcare and Family Services (DHFS), voted to postpone the consideration of DHFS' proposed Medicaid regulations to its May meeting.

The legislators voiced concerns over the retroactive application of certain new rules penalizing transfers of assets by a Medicaid applicant and other issues. As currently proposed, DHFS intends to apply its new rules to any transfers of assets which occurred since November 1, 2008 with the effect that persons who made gifts, even relatively small gifts, since that date may find themselves ineligible for Medicaid if they need long term care prior to 5 years from the date of the gift.

Advocates for older adults argue that this retroactive application is unfair, as at the time of the gift the person would have had no idea of the severe consequences.

For example, Ruth and Joseph, older adults, historically have given each of their children $10,000 per year. In December, 2008, they each gifted $20,000 and then no longer gifted because of dwindling funds. In June of 2011, Ruth is residing in a nursing home, exhausts her funds and applies for Medicaid. If she is otherwise eligible for Medicaid, the $20,000 gift in 2008 will not affect her eligibility because of the modest amount that was gifted. Under current rules, the penalty for Medicaid is approximately 4 months and began in December, 2008 and ended April 1, 2009. Joseph is also in a nursing home with dwindling assets. In December, 2011, Joseph applies for Medicaid under the Department's new, proposed regulations. Because the new punitive regulations will be applied to all transactions occurring since November 1, 2008, the new rules apply to Joseph, and he is ineligible for Medicaid for 4 months, beginning with the month he is residing in a nursing home and is otherwise eligible for Medicaid, which is December 2011.

The result... Joseph now is without funds and without a source of payment for his long term care for 4 months - December 2011 through March, 2012. At the time Joseph made the gift in December, 2008, he had no way of knowing that it might result in his ineligibility for Medicaid in 2012.

 ................... 

The Joint Committee on Administrative Rules will again consider the proposed new regulations in May, 2011. If you want to voice your opinion on these proposed regulations, you may call or write the members of the committee. You can locate their names and contact information at 　

 http://www.ilga.gov/commission/jcar/

 * Erin's Corner *

 The Illinois Senior Medicare Patrol Program...

a Program YOU Need to Know About!

.................. 

Erin Vogt, Client Care Coordinator

Did you know that between 3% and 10% of healthcare spending is lost to fraud. In 2008, that is at least $68 billion!

This fraud affects everyone - taxpayers, beneficiaries, and health care providers. Medicare and Medicaid are funded by taxpayer dollars, so the billions lost to fraud are our tax dollars... down the drain.  Medicare and Medicaid beneficiaries not only lose money to fraud, they also lose their hard-earned health care benefits. Legitimate health care providers lose patients and payments when scam artists bill inappropriately for services that were never provided.

Fraud can occur by home health agencies, skilled nursing facilities, durable medical equiptment companies, insurance plan marketing, hospitals, surgerical centers, provider offices, and many other locations.

For more information on what you can do to protect yourself, those you care about, and society at large, go to www.illinoissmp.org or call 1-800-699-9043. 

  * AARP Sues Government Over Reverse Mortgage Foreclosures *  

Charging that reverse mortgage borrowers were caught in what amounts to a regulatory bait and switch, the AARP's legal arm is suing the Department of Housing and Urban Development on behalf of three now-deceased borrowers' surviving spouses who are facing imminent foreclosure and eviction from their homes.  

For the entire article, click here.

* What is Asset Protection Planning? *

Asset protection planning is about protecting your assets from creditors -- and it is not just for the super wealthy.

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  *  You Can't Opt Out of Medicare Without Losing Social Security, Judge Rules.  *

  *  Book Review  *

They're Your Parents, Too!