Proceed With Caution:
Rapidly Changing Medicaid Rules!
As I sat down to write this month’s update on senior law, I could not bring
myself to write an insightful story with clever names to keep your interest like
usual. Instead, worry about the constant government announcements about
cost-cutting Medicaid changes overwhelmed me.
Will my clients whom I’ve come to love as part of my extended family have
Medicaid coverage to pay for nursing home costs? Will the Feds "tighten up" the
budget so much that our sweet spouses at home struggle to pay the bills while
their sick spouse is in a nursing home? Will there be anything left for the
spouse at home when the nursing home spouse dies? Will my over-worked and
stressed-out parent caregivers of children with disabilities have to pick up
even more of the caregiving duties until their own health gives out? What about
my friend in Norman who is only 50 but has MS and is forced to live in a nursing
home because she can’t get enough help at home and even in the nursing home
doesn’t receive any therapy from Medicaid?
I wished I could just pinch myself and wake up from this nightmare. Yes, medical
costs are skyrocketing. Yes, some people do "take advantage" of the system. But,
who will suffer from the tightening of the rules so the government can cut
costs? Medicaid helps those people who live every day with disability, disease
and poverty.
Even Oklahoma has started changing "interpretations" to make it more difficult
to qualify for Medicaid. Some things that we could do just a few months ago, we
can no longer do in our planning. Every week it seems we learn of some new
restriction. They aren't changing any "rules," they are only changing the
"interpretations." And, so many things are not in the written rules, so it is
simple for them to flip-flop at the drop of a hat!
Last week, the new Secretary of Health and Human Services, Mike Leavitt, gave
his first speech. His emphasis was that the Medicaid program must change because
it is not financially sustainable. He specifically addressed closing the
planning opportunities families now have when a loved one goes into a nursing
home.
Medicaid is at the forefront of the President’s agendas and especially the
States' agendas because of the huge drain it is on the federal and state
budgets. Yes, I am a taxpayer too and I want our government programs to run
efficiently. However, efficiency must be balanced against the high cost of
placing unwarranted financial and emotional stress on families who are caring
for aging and ill loved ones.
My caution to you is that what worked yesterday may not work today. You cannot
rely upon past knowledge of Medicaid rules and “interpretations.” Courts have
referred to the Medicaid program as a "Serbonian bog" and more complex than the
Internal Revenue Code! My guess is that with the current changes we are
experiencing in Oklahoma as well as the announcements being made in the federal
sector, we are in for even more changes which will only add complexity to the
utmost of already complex issues.
Make sure you are not giving out Medicaid advice unless you are absolutely
positive it is right and thorough. If you are in charge of a facility, make sure
your staff is not giving out Medicaid advice. I anticipate as families start to
feel the financial crunch, they will get desperate to look for someone else to
pay the bills through lawsuits for wrong Medicaid advice. Medicaid advice is
legal advice.
Please, please be careful, especially in light of current changes and what’s to
come!
Tracy Neisent
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