Probate & Trust Law Section Conference Manual ... - Minnesota CLE

TABLE OF CONTENTS
I. INTRODUCTION ............................................................................................................................... 1
II. MEDICAL ASSISTANCE DEMOGRAPHICS ............................................................................... 3
III. THE 2013-2014 MEDICAL ASSISTANCE NUMBERS ............................................................... 5
A. THE MONTHLY GIFT PENALTY (SAPSNF) AMOUNT ........................................... 5
B. COST OF LIVING AND OTHER ADJUSTMENTS ..................................................... 6
1. SOME NUMBERS CHANGE; OTHERS HAVEN'T ...................................... 6
2. PERSONAL NEEDS ALLOWANCES FOR SINGLE PERSONS ................ 6
3. COMMUNITY SPOUSE ASSET ALLOWANCES ......................................... 7
4. COMMUNITY SPOUSE INCOME ALLOWANCES .................................... 9
IV. MAINTENANCE OF EFFORT (MOE) FREEZES CONTINUE ............................................. 10
A. CASCADING MOES ......................................................................................................... 10
B. RESTRICTIONS ON STATE MEDICAL ASSISTANCE
CHANGES AFTER THE ACA MOE ENDS ................................................................. 13
V. DEATH OF THE TRANSFER/APPLY/DENY STRATEGY ...................................................... 13
A. THE 2009 AMENDMENT TO ELIMINATE REDUCTION OF
PENALTY PERIODS FOR PARTIAL RETURN OF UNCOMPENSATED
TRANSFERS ........................................................................................................................ 13
B. STATE PLAN AMENDMENT .......................................................................................... 14
C. CURRENT HPCM GUIDELINES .................................................................................... 14
VI. AVOIDING PROBLEMS WITH THE NEW ASSET TRANSFER POLICIES ....................... 19
VII. THE 2009 AMENDMENTS WAITING FOR JANUARY 1, 2014,
TO BECOME EFFECTIVE ............................................................................................................ 19
A. REDUCTION OF EXCESS ASSETS IN MONTH OF APPLICATION.................... 19
B. LIMITING USE OF CURRENT INCOME TO PAY OLD MEDICAL
EXPENSES .......................................................................................................................... 20
C. INCREASING NURSING FACILITY LEVEL OF CARE CRITERIA ..................... 21
VIII. THE REFORM 2020 PATHWAYS TO INDEPENDENCE WAIVER ....................................... 25
IX. OTHER MA PROVISIONS NOT CHANGING IN THE PAST YEAR .................................... 26
A. NO CHANGE IN TREATMENT OF GIFTS TO RELIGIOUS GROUPS,
CHARITIES, AND FAMILY MEMBERS ...................................................................... 26