Problems Increase for Medicaid Applicants
About four years ago, February 8, 2006, President Bush signed the Deficit Reduction Act of 2005. The Act made a major change in Medicaid law; it increased the amount of time to be considered for gifts. For applications now, gifts made on or after the enactment date, the “look-back” period, are considered at the time a person applies for Medicaid. Starting February 8, 2011, that period will be five years prior to the application.
Upon application, Medicaid adds up gifts made during the look-back period. Then, Medicaid divides the amount of the gifts by that year’s divisor, $6,267 for 2010, to calculate a penalty period. For instance, gifts of $62,670 result in a delay in Medicaid benefits of ten months after the application: the penalty period.
We are having to dig through more records than ever if our client has made gifts. Sometimes, the client does not know that they made a gift. For example, paying a child for care services without a written caretaker contract results in a gift, or transfer without fair consideration, triggering an ineligibility period.
Naturally, the Medicaid workers at the County Departments of Human Services are also having an increased workload. Because of reductions in staff, this results in longer times before the Department rules on applications. By regulation, they must make a decision within 45 days. However, in the case of Denver, some cases have been waiting for a decision for nine months!
