Important Update: Nursing Home Carve-Out in Managed Long-Term Care

by David Goldfarb

The recently adopted 2018-2019 New York State budget contains a number of significant amendments regarding healthcare in New York. As in prior years, the bulk of the budget focused on Medicaid funding, but many of the recent changes came in response to anticipated cuts to Medicaid at the federal level. One change is of particular note is the recent carve out provision for nursing home care. This recent change could significantly change how you plan to pay for your own long-term care or that of a loved one.

In New York state, Managed Long-Term Care (MLTC) refers to a system for providing long-term services to chronically ill or disabled people under the Medicaid programs. The program allows those who are eligible to remain in their homes and communities for as long as possible, and is designed to cover adult daycare or home care.

The 2018-2019 budget, effective April 1, 2018, provides that individuals who are placed in a nursing home for three months or more will no longer qualify for Medicaid’s Managed Long-Term Care. Instead, these individuals will receive services on a fee-for-service basis, unbundling extended nursing home care from the managed Medicaid care payment model.

Time for an Estate Planning Check-Up

While Medicaid may still provide coverage, this carve-out could obviously leave a significant impact on how you plan to pay for your care in your later years or how you plan to care for a loved one. No one wants to burden their family, and we all want to provide a comfortable level of care for our loved ones. These arent easy topics to think or talk about, but if you dont take action now, you will find yourself with fewer options when you need them.

  1. If you havent done any estate planning, we recommend that you meet with an estate planning attorney as soon as possible to discuss this issue and do some big picture planning. An attorney who concentrates in elder law will prove especially helpful.
  2. If you have done some estate planning, we recommend that you review your plan and your documents. Then meet with your lawyer or your financial planner to discuss whether your financial plans still meet your objectives. Your estate plan may require only minor modifications.
  3. If you have a loved one who is currently residing in a nursing home, get in touch with the facility and make sure you understand the options. You also want to stay abreast of this issue, as the Department of Health has stated that it will provide further guidance concerning the rights of nursing home residents and other implications of this change.

Contact a New York Elder Law Firm

The law firm of Goldfarb Abrandt, Salzman & Kutzin LLP has helped New Yorkers with their estate planning needs for more than 25 years. If you need help navigating this issue or other estate planning and related concerns, call us at (212) 387-8400 or send us an email via our online contact form.