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Medicaid › Skilled Nursing Facility › Health Insurance

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Stotler Hayes Group, LLC

Still Stuck in the (Utah) Gap: How the “Miller Trust” Punishes the Most Vulnerable

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For those seeking Medicaid coverage to pay for their care in a skilled care setting, like a nursing home, the Medicaid process can be daunting. For institutional Medicaid approval, an applicant must prove that they are...more

Stotler Hayes Group, LLC

Avoiding Transfer Penalties: How to Identify Successful Strategies to Remove Penalties on Medicaid Eligibility for the Skilled...

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Medicaid is the primary payer for 63% of nursing facility residents, propping up a large part of the industry’s funding. ...more

Mandelbaum Barrett PC

Medicaid Final Agency Decision Reaffirms Criteria Necessary to Qualify for Caregiver Child Exception

Mandelbaum Barrett PC on

Certain Medicaid programs impose a transfer penalty on applicants who have transferred resources (assets) for less than fair market value within five (5) years preceding the Medicaid application. Simply stated, the transfer...more

Stotler Hayes Group, LLC

Ongoing Delays in the Medicaid Eligibility Process

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For skilled nursing facility residents applying for long-term care Medicaid benefits, under federal regulation, all state agencies are required to issue an eligibility determination on the application within 45 days of the...more

Stotler Hayes Group, LLC

How To Secure Cooperation In The Medicaid Eligibility Process

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In our day-to-day work representing skilled nursing facilities, we are regularly asked by our clients to assist in securing Medicaid benefits for their residents.  This often entails seeking the cooperation of the resident or...more

McCarter & English, LLP

New Jersey Statutory Update Part II

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Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more

Stotler Hayes Group, LLC

CMS Announced New Changes To Medicaid Spousal Impoverishment Rules

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On May 22, 2024, the Centers for Medicare and Medicaid Services (“CMS”) announced that it would be implementing updated 2024 spousal impoverishment standards that will take effect on July 1, 2024....more

Stotler Hayes Group, LLC

The Great Unwinding And Its Effect On Skilled Nursing Facilities

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Following the termination of the Public Health Emergency (“PHE”) as a result of COVID-19, and the continuous enrollment provisions put in place to ensure that Medicaid beneficiaries were able to receive Medicaid benefits...more

Lippes Mathias LLP

New York State Medicaid Updates for 2024

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Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more

Ballard Spahr LLP

HHS OIG to Review CMS Citations

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Summary - The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more

Baker Donelson

Key Health Provisions in the American Rescue Plan Legislation

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On March 11, 2021, President Biden signed into law the American Rescue Plan Act, a $1.9 trillion package to provide relief related to the COVID-19 public health emergency. The final legislation, which passed with support from...more

Morgan Lewis

The American Rescue Plan Act and Healthcare Providers – A First Look

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The American Rescue Plan Act of 2021 (ARPA) provides $1.9 trillion in relief funding to address the COVID-19 pandemic, support the US economy, and provide relief for impacted Americans. ...more

Ruder Ware

CMS Releases Key Medicare Figures for 2021

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The Centers for Medicare and Medicaid Services (“CMS”) recently released key Medicare figures for 2021 that will affect all elderly and disabled individuals who receive program benefits. This notice summarizes the changes...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update - August 2020

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Introduction - CMS has taken extensive measures to assist providers and promote access to care in light of the Public Health Emergency (PHE) related to the COVID-19 pandemic. The efforts taken have and continue to benefit...more

Holland & Knight LLP

Comments on CMS Proposed Rule on Medicaid Fiscal Accountability Due Feb. 1, 2020

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The Centers for Medicare & Medicaid Services (CMS) on Nov. 18, 2019, published a proposed Medicaid Fiscal Accountability rule that would amend existing regulations related to 1) base and supplemental payments, 2)...more

McGuireWoods LLP

Washington Healthcare Update

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This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

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