Ahlborn Medicaid Lien Update

There are three bills pending in the Florida Legislature concerning Medicaid reform. Each of them contain flaws and demonstrate that our representatives and the Governor do not understand or appreciate the necessity for an improved health care system or, why families should not be impoverished to provide basic medical care to their loved one.

1. Managed Care (SB 1972): The proposal is to shift senior citizens to managed care in the belief that it will reduce Florida's growing Medicaid budget. Unfortunately, in the counties that have pilot programs people have experienced an inability to find the right provider, obtain necessary medicine, and have had to travel considerable distance for a medical facility. There is a vulnerable population in Florida that cannot obtain or afford private health insurance and don't know how to speak out to help themselves.

2. Personal Care Agreements (SB 1356/HB 1289): Federal and state Medicaid law permits an individual to enter into a written agreement to compensate a family member who serves as a caregiver. Traditionally, children serve as the single largest group of caregivers for aging parents. Many children have had to leave the workforce or, work part-time in order to care for aging parents and prevent them from being institutionalized. Since these children have a reduced source of support, it makes sense for them to be compensated for the benefit their services provide. The value of their services is much less than that provided by a professionally trained caregiver.

These bills seek to make it more difficult for a family member to be paid by imposing the following restrictions: a)services cannot duplicate services otherwise provided by Medicaid, Medicare or private insurance; b) services cannot be those ordinarily provided out of love and affection.

Neither the family caregiver nor the elder should be penalized for preferring to be cared for by a family member.

3. Spousal Refusal (SB 1356/ HB 1289): Federal and state Medicaid law permits spouses to transfer assets between themselves with no penalty; these actions are not subject to the 5 year look back period. Moreover, in order to prevent spousal impoverishment the law allows the well spouse to refuse to make assets available for the care of the ill spouse. The marital relationship has been protected since MCCA. When filing a Medicaid application the ill spouse can assign his/her support rights to the state and be approved for Medicaid.

The bill would create a hardship and encourage divorce because it requires a married couple to be living apart for 3 years before filing an application for nursing home Medicaid. The bill also seeks to penalize the transfer of assets between spouses.

Please contact your state representative to speak out against the proposed Medicaid reform. Additionally, if your clients are in need of expert legal advice please refer them to our office. The Medicaid laws have changed drastically and are a trap for the unwary. Let us create a long term care planning strategy to help your clients achieve their goals.

Proper Planning May Create Peace of Mind