Elder Law Update for 2015

 

Inflation-adjusted numbers for 2015

  • Medicaid Spousal Impoverishment Figures (effective Jan. 1, 2015)
    • Minimum Community Spouse Resource Allowance (CSRA): $23,844
    • Maximum CSRA: $119,220
    • Minimum Monthly Maintenance Needs Allowance (MMNA): $1,991.25 (effective July 1, 2015). [Max is $2,931/month] [NOTE: In Alaska, the amount will be $2,490.00 as of July 1, 2015. It will be $2,291.25 in Hawaii.]
    • Income cap:  In "income cap" states the limit is $2,199.00 a month
    • Medicaid home equity limit: $552,000 (minimum); $828,000 (maximum)
    • Medicare Premiums, Deductibles and Copayments:
      • Basic Part B premium: $104.90/month
      • Part A premium: $407/month
      • Part A deductible: $1,260
      • Part B deductible: $147
      • Co-payment for hospital stay days 61-90: $304/day
      • Co-payment for hospital stay days 91 and beyond: $608/day
      • Skilled nursing facility co-payment, days 21-100: $152/day
    • Medicare Premiums for higher-income beneficiaries (based on 2015 income):
      • If income $85,000 or less (double for married person filing jointly): $104.90
      • If income between $85,000 and $107,000 (double those amounts for married persons): $146.90
      • If income between $107,0000 and $160,000 (double those amounts for married persons): $209.80
      • If income between $160,000 and $214,000 (double those amounts for married persons): $272.70
      • If income in excess of $214,000 ($428,000 for married couples): $335.70
  • Social Security Benefit Changes for 2015
    • Monthly federal Supplemental Security Income (SSI) payment standard will be $733 for an individual and $1,100 for a couple.
    • Average monthly Social Security retirement payment: $1,306 a month for individuals and $2,140 for couples
    • Maximum amount of earnings subject to Social Security taxation: $116,500.

    Note: The MMNA is set at 150 percent of the monthly poverty guideline for a couple, which is $1,327.50 (lower 48 states).
     

Long-Term Care Premium Deductibility Limits

Long-Term Care Premium
Deductibility Limits

Maximum
Deduction
for 2010
Maximum
Deduction
for 2011
Maximum
Deduction
for 2012
Maximum
Deduction
for 2013
Maximum
Deduction
for 2014
Maximum
Deduction
for 2015

 

40 or less
$330
$340
$350
$360
$370 $380
More than 40 but not more than 50
$620
$640
$660
$680
$700 $710
More than 50 but not more than 60
$1,230
$1,270
$1,310
$1,360
$1,400 $1,430
More than 60 but not more than 70
$3,290
$3,390
$3,500
$3,640
$3,720 $3,800
More than 70
$4,110
$4,240
$4,370
$4,550
$4,660 $4,750

 

Social Security Numbers

  • Maximum amount of earnings subject to Social Security taxation was $113,700 for 2013 and rises to $117,000 for 2014.
  • For 2013, the monthly federal Supplemental Security Income payment standard will be $721 for an individual and $1,082 for a couple.
  • Average monthly Social Security retirement payment:  $1,294 (individuals) and $2,111 (couples)

 

Tax Update

The "Tax Relief, Unemployment Insurance Reauthorization and Job Creation Act of 2010" (Act) was passed by the Congress late on December 16, 2010 and signed into law on December 17. Section 728 of the Act specifies that certain tax refunds are to be ignored for purposes of administering certain federal programs. That has implications for several types of programs applicable to elderly clients. The provisions applies for amounts received in 2010 through 2012, and specifies that tax refunds are not to be treated as available income for SSI or Medicaid purposes, and will not be a countable resource for 12 months after the funds are received. The same rule applies, for 2010-2012, to tax refunds that an individual receives before making an application for SSI or Medicaid. Essentially, the new law treats tax refunds similar to certain tax credits (Making Work Pay Credit, Earned Income Credit , Child Tax Credit), and also applies to the First Time Homebuyer and Long Term Homeowner Tax Credits. But, the new 12-month rule (rather than the old nine-month rule) applies to these credits also. Because the law applies retroactively to amounts received after 2009, practitioners are advised to determine if any clients were denied eligibility for SSI or Medicaid due to a tax refund or credit.

Medicaid/Elder Law-Related Caselaw Update:

  • Tjaden v. State of Illinois, No. 4-12-0768, 2013 Ill. App. LEXIS 904 (Dec. 24, 2013)(decedent, before death, bought  life insurance policy for $12,000 with proceeds assigned to create irrevocable trust; trustee was to pay funeral expenses if bill presented within 45 days of death; one month later, decedent gave son over $4,000 and applied for Medicaid benefits the following months; state Medicaid agency determined that funds used to purchase policy was uncompensated transfer and imposed a disqualification period penalty; court rejected argument that transfers were for funeral expenses and were, therefore, exempt because no burial contracts existed in accordance with 305 IL Comp. Stat. Ann Sec. 5/3-1.2 and because the trusts were structured such that trust funds could pass to decedent's children rather than being used to pay funeral expenses).
  • Estate of Marusich v. State of Wyoming, No. S-13-0036, 2013 Wyo. LEXIS 158 (Dec. 10, 2013)(Medicaid case focuses on definition of "estate" under state law for purposes of Medicaid lien; married couple owned home in tenants-by-entirety; husband resided in nursing home and received Medicaid benefits; upon wife's subsequent death, state placed lien on marital home to recover Medicaid benefits paid to pre-deceased husband; estate argued that definition of "estate" did not include tenancy-by-entirety property for purposes of Medicaid recovery; court noted that state had adopted definition of "estate" that included non-probate assets; court upheld validity of lien on basis that definition of "estate" contained in Wyo. Stat. Ann. 42-4-206 was expansive and reached any type of non-probate survivorship interest).
  • Hughes v. McCarthy, 734 F.3d 473 (6th Cir. Oct. 25, 2013)(Medicaid case; non-institutionalized (community) spouse purchased an annuity before institutionalized spouse determined to be eligible for Medicaid; institutionalized spouse entered nursing home in 2005 and couple used personal funds to pay nursing home bill for four years; community spouse then purchased annuity using his personal IRA funds; annuity guaranteed monthly payments of $1,728.42 to community spouse for almost 10 years - the community spouse's actuarial life expectancy; upon community spouse's death, institutionalized spouse was first contingent beneficiary and state Medicaid agency was remainder beneficiary to extent of Medicaid benefits paid to institutionalized spouse; court noted that federal Medicaid law specified that annuity is not asset of community spouse if purchased with retirement plan funds and state is named as beneficiary; annuity was actuarially sound and was for community spouse's sole benefit).
  • Gragert v. Lake, et al., No. 12-6137, 2013 U.S. App. LEXIS 20473 (10th Cir. Oct. 8, 2013)(married couple sold rental real estate to son for $28,000 in return for promissory note in wife's name; note could not be sold or assigned; husband entered nursing home and made Medicaid application; state Medicaid agency determined that note was available resource and, as a result, husband ineligible for Medicaid benefits; trial court determined that note was an available resource on basis that promissory notes are available resources; appellate court reversed on basis that not assignable and could not be sold and could not, therefore, be converted to cash).
  •  Atkinson v. Ohio Department of Job and Family Services, No. 13 CA4, 2013 Ohio App. LEXIS 4584 (Ohio Ct. App. Sept. 27, 2013)(eleven years before applying for Medicaid benefits, decedent and spouse created revocable trust and transferred marital home to trust; upon entering nursing home and applying for Medicaid, decedent removed home from trust and took title to home in her own name; the next day, decedent transferred house to her husband; defendant classified transfer as improper and assessed penalty; after decedent died, estate sued; trial court ruled for state; appellate court affirmed on basis that home was removed from available resources of institutionalized spouse and gave husband (community spouse) larger resource allowance; trust could have stayed in decedent's name after removal from trust without triggering penalty).
  • In re Estate of Shipman, No. 26512, 2013 S.D. LEXIS 67 (S.D. Sup. Ct. Jun. 5, 2013)(decedent's wife entered nursing home in 2008 and after decedent spent-down joint funds on her care totalling over $100,000 wife became eligible for Medicaid; decedent executed will in 2009 disinheriting wife; on same day will executed, couple's son, as attorney-in fact for his mother, disclaimed any inheritance that his mother may have been entitled to receive from decedent's estate; decedent died in 2010 at time when wife was receiving Medicaid benefits; wife's guardian ad litem petitioned for elective share of decedent's estate; trial court denied petition and state department of Social Services appealed; on appeal, court reversed on basis that decedent's support for wife's nursing home care did not fulfill elective share wife entitled to; court also revoked disclaimer as being in wife's best interest and disclaimer being used as estate planning tool to allow wife to receive Medicaid benefits). 
  • Wos v. E.M.A., 133 S. Ct. 1391 (2013)(federal Medicaid statute (42 U.S.C. Sec. 1396a(A)(25) requires participating states to implement third-party liability provision that requires states to seek reimbursement from third parties to extent third parties are legally liable to pay for Medicaid-funded services; under such provision, state considered to have acquired rights of Medicaid recipient to payment by any third party for health care items or services; in addition, to be Medicaid eligible, person must assign to state any rights person has to payment for medical care from third party (42 U.S.C. Sec. 1396k(a)(1)(A); no federal statutory right allowing subrogation or liens to recover directly from recipient of Medicaid; while most states all Medicaid recipient to recover from third parties and then seek reimbursement, federal anti-lien statute bars reimbursement until after recipient’s death; plaintiff suffered injuries at birth and medical malpractice suit resulting in a settlement of $2.8 million; Medicaid paid $1.9 million for plaintiff’s care and state asserted lien against settlement proceeds of $1.9 million; state statute mandated one-third of settlement payment to satisfy lien; plaintiff filed declaratory judgment action claiming that U.S. Supreme Court decision in Arkansas Department of Health & Human Services v. Ahlborn, 547 U.S. 268 (U.S. 2006), limited state’s recovery to portion of settlement representing compensation for medical expenses and that state statute mandating one-third payment violated federal law; while action pending, state Supreme Court ruled that state statute complied with U.S. Supreme Court’s Ahlborn decision; trial court ruled against plaintiff and U.S. Circuit Court of Appeals for the Fourth Circuit reversed (E.M.A. v. Cansler, 674 F.3d 290 (4th Cir. 2012)); U.S. Supreme Court affirmed – state is assigned rights of Medicaid recipient to payment by third party, but anti-lien statute bars encumbrance of balance of settlement not designated as compensating plaintiff for payments made by Medicaid; state’s conclusive presumption that one-third of settlement represents medical care violated anti-lien statute and is pre-empted as arbitrary). 
  • Harms v. Nebraska Department of Health and Human Services, 20 Neb. App. 451, 824 N.W.2d 772 (Neb. 2013)(plaintiff, along with spouse before his death, conveyed farm to daughter with reservation of life estate that allowed plaintiff and spouse to live in farm house; plaintiff remained responsible for payment of taxes, insurance, upkeep and repairs; nine years later, plaintiff and spouse leased farmland along with grain bin to farm teneant while remaining in farmhouse; eight years later, after spouse died, plaintiff moved to nursing home leaving farm house unoccupied; plaintiff depleted assets paying for nursing home care and made Medicaid application; application approved, but plaintiff required to pay $665.38/month; plaintiff's net income calculated by defendant by taking cash rent income from farm and reducing it for insurance and property tax, but not other farm-related expenses as reported on tax return (e.g., machine work, depreciation of mowers, gasoline for mowers, paid labor, repairs and maintenance of farm property, supplies and truck expense; electrical expense for outside utility light, rodent extermination, tax prep and legal fees); at administrative hearing, hearing officer upheld defendant's determination because other property with associated expenses did not produce farm income; trial court upheld hearing officer; on further review, court noted that under Neb. Adm. Code Sec. 469 Ch. 2, Sec. 010.01H, expenses as condition of life estate are deducted from gross income; court reversed trial court on basis that plaintff paid such additional expenses as costs associated with maintaining premises for benefit of lessee even though lease did not specify responsibility for such expenses; implicit agreement present that plaintiff would pay such expenses, and they are to be deducted from plaintiff's income for Medicaid eligibility purposes). 
  • Teague v. Kidd, No. E2011-02363-COA-R3-CV (Tenn. Ct. App. Nov. 21, 2012)(plaintiff, administrator of nursing home, claimed that defendant misappropriated funds from defendant’s mother who resided in plaintiff’s nursing home until date of death; mother received Medicaid benefits and state filed claim against estate to recover Medicaid benefits; defendant was mother’s agent under power of attorney that gave her access to mother’s bank accounts, and couldn’t account for missing funds; trial court entered judgment against defendant (and spouse) for $176,367.31; on appeal, court affirmed against the defendant, but not spouse because spouse not in confidential relationship with mother-in-law).
  • Williams v. Ohio Department of Job and Family Services, 978 N.E.2d 1260 (Ohio Ct. App. 2012)(Medicaid applicant approved for benefits, but with restricted coverage for 17.7 months due to transfer of home from applicant's revocable trust to community spouse; on administrative hearing, decision affirmed; administrative appellate panel determined that new period of restricted Medicaid coverage should be assessed; trial court affirmed; on appeal, court affirmed on basis that home properly included in CSRA as "countable resource" because deed titled in name of revocable trust at time Medicaid agency made resource assessment; home not exempt under state administrative code; because home transferred from revocable trust to community spouse, transfer of home to spouse not exempt as spousal transfer; modified period of restricted coverage affirmed). 
  • Lopes v. Department of Social Services, 696 F.3d 180 (2d Cir. Oct. 2, 2012)(plaintiff filed application for Medicaid, but application was denied because community spouse was receiving income stream from single premium annuity that defendant considered to be an available resource to plaintiff; community spouse argued that income from annuity was not available asset to plaintiff because of anti-assignment clause in annuity contract; trial court granted summary judgment to plaintiff; on appeal, court affirmed on basis that community spouse had no power or right to assign payments under the annuity, and 20 C.F.R. Sec. 416.1201(a)(1) supported plaintiff's argument and was consistent with S.S. Program Operations Manual Sys. SI 01110.15; annuity income stream was income rather than resource that had to be spent-down before plaintiff was eligible for Medicaid). 
  • Dahly v. Anderson, No. 20120013, 2012 N.D. LEXIS 188 (N.D. Sup. Ct. Aug. 30, 2012)(married couple named son as agent under power-of-attorney (POA); upon married couple beginning to suffer from dementia, daughter moved in with them to care for them via written agreement; wife entered nursing home while husband remained in marital home and was cared for by daughter; wife's interest in home transferred to husband by son via power granted to him in POA; son later used POA to transfer husband's interest in home to daughter caregiver; husband entered nursing home and daughter sold home with proceeds of sale split between daughter and brother (POA agent); husband's application for Medicaid denied on basis that sale proceeds available to husband for purposes of Medicaid eligibility; court determined that exemption available to child caregiver applicable; exception contained in 42 U.S.C. Sec. 1396p(c)(2)(A)(iv) allows children providing in-home care to disabled parents over long term can recieve family home without impacting parent's Medicaid eligibility).  
  • In re Estate of Perry, 283 P.3d 785 (Idaho 2012)(husband and wife owned home together that wife had owned individually before the marriage; after the marriage, wife quitclaim deeded home to herself and her husband; wife then entered nursing home and husband transferred home into his sole name; wife received Medicaid benefits; husband died and home was sold; state filed claim in husband's estate seeking recovery of Medicaid benefits that had been paid to wife up to that point in time in accordance with wife's ownership interest; court determined that federal law does not bar state from recovering assets from estate's of either spouse in such situations, including community property (Note:  ID is a community property state)). 
  • Indiana Legislation Barring Medicaid Estate Recovery (Enrolled Act No. 1258, effective Jul. 1, 2012)(Act adds IC 6-4.1-1-3.5 to the Code too bar estate recovery upon surviving spouse's death for recovery of Medicaid benefits that had been paid to pre-deceased spouse; Act is part of revised probate provisions). 
  • In re Estate of Stidham, No. E2011-02507-COA-R3-CV, 2012 Tenn. App. LEXIS 54 (Tenn. Ct. App. Aug. 23, 2012)(before death, decedent created revocable trust and funded it with his property; decedent later entered nursing home and received Medicaid until death; no estate administration due to insolvency of estate; state later sought to appoint administrator on basis that state entitled to reimbursement from trust assets for Medicaid benefits paid to decedent; state did not receive notice of decedent's death and, as such, one-year statute of limitations inapplicable; state law also says probate estates cannot be closed unless release filed showing that Medicaid benefits received during life have been paid; property contained in revocable trust does not shelter assets from claim of state for Medicaid recovery). 
  • Morris v. Oklahoma Department of Human Services, et al., 685 F.3d 925 (10th Cir. 2012)(married couple challenged denial of wife's Medicaid application; application denied after computation of couple's resources and CSRA; plaintiffs attempted to spend-down excess resources by buying an annuity payable to husband; ineligiblity determined by administrative agency on basis that wife could not spend her share of resources on annuity payable to spouse or, if she could, she would be subject to a transfer penalty; but, they could converty jointly held resources to income for community spouse by buying annuities; court determined that annuity unavailable resource even if its purchase is in addition to CSRA; no transfer penalty for purchase of annuity if made before Medicaid eligibility determination). 
  • Hughes, et al. v. Colbert, 872 F. Supp. 2d 612 (N.D. Ohio 2012)(case involves spousal impoverishment provision of 42 U.S.C. Sec. 1396r-5 which bars a community spouse from buying an annuity above the community spouse's share after an initial Medicaid eligibility determination has been made; in this case, one spouse bought an annuity after her spouse applied for Medicaid benefits, and a different spouse bought an annuity after his spouse went into a nursing home, but before she applied for Medicaid benefits; court held that, in both situations, spousal impoverishment provision barred community spouse from using spousal resources beyond the CSRA to buy annuities). 
  • Health Care & Retirement Corporation of America v. Pittas, 46 A.3d 719 (Pa. Super. Ct. 2012)(plaintiff sued defendant (son of Medicaid beneficiary) for liability on mother's outstanding debt ($93,000) associated with treatment and care of mother under state (PA) filial responsibility law; arbitration award in favor of defendant; trial court reversed on basis that plaintiff met burdent to provide enough evidence that defendant had financial ability to support mother).
  • Gsellman v. Ohio Department of Job and Family Services, et al., 2012 Ohio 1620 (Ohio Ct. App. 2012)(application for Medicaid benefits denied on basis that assets in applicant's trust counted toward $1,500 Medicaid resource limit because trust could have made payments to applicant; trust assets valued in excess of $500,000 at time of application for benefits). 
  • In re Mallery, No. 513277, 2012 WL 653303 (N.Y. Sup. Ct. Mar. 1, 2012)(before entering nursing home, petitioner added friend to bank account as joint owner and changed title to home from herself to herself and her friend as joint tenants; upon entering nursing home after falling at home, petitioner subjected to 19-month penalty for uncompensated transfers to friend within 60-month “look-back” period; petitioner claimed transfers were made in the context of estate planning rather than to qualify petitioner for Medicaid; trial court upheld penalty; on appeal, court affirmed based on petitioner’s failure to rebut presumption that transfers made to qualify for Medicaid and petitioner’s failure to substantiate claim that petitioner had not intended to enter nursing home – petitioner was elderly and suffering from dementia). 
  • Montgomery v. Ohio Department of Job and Family Services, 2012 Ohio 574 (Ohio Ct. App. 2012)(plaintiff's wife entered nursing home and made application for Medicaid benefits; application approved, but with period of restricted Medicaid coverage; community spouse bought non-assignable promissory note that provided for equal payments paid over time to the order of the community spouse; court had to determine whether purchase of note available asset to community spouse; wife's estate claimed that note part of couple's resources and fact that community spouse held note immaterial; court determined that under state administrative code, not held by applicant for medical assistance program or a recipient of medical assistance program, and not an excludible asset under state administrative code; state law excluding promissory notes from countable resources only applicable to promissory notes held by Medicaid applicants rather than the spouse of a Medicaid applicant). 
  • Hutcherson v. Arizona Health Care Cost Containment System Administration, No. 10-16426, 2012 WL 248045 (9th Cir. Jan. 27, 2012)(wife entered nursing home and husband purchased annuity that named state as primary beneficiary, and couple's daughter as secondary beneficiary; pursuant to 42 U.S.C. § 1396p(c)(1)(F)(i), an annuity that names the state as a primary remainder beneficiary “for at least a total amount of medical assistance paid on behalf of the institutionalized individual” is not a transfer of an asset for below-market value that triggers disqualification from Medicaid; upon husband's death, state had paid $23,840.51 for wife's care with $75,000 remaining in the annuity; daughter sought court declaration that state’s ability to recover from annuity limited to amount state had paid up to the point of John's death; trial court granted summary judgment for state; on appeal court affirmed - 2006 statutory amendment to statute referenced above created a right in the states to recover as a remainder beneficiary against a community spouse's annuity for costs of institutionalized spouse's care as of date of death of community spouse). 
  • In re Giaquinto, No. 51171, 2012 WL 224886 (N.Y.S.Ct. Jan. 26, 2012)(individual entered nursing home and Medicaid benefit application made; state Medicaid agency required applicant's wife to buy annuity to bring wife's income up to MMMNA allowance; trial court ruled against state; on appeal, court affirmed, but reversed trial court's award of attorney fees Medicaid case; on further review, court determined that federal law does not bar a state from requiring a community spouse to purchase an annuity; attorney fees not awarded).
  • Estate of Muscle v. Director, 2011 WL 6997429 (N.J. Tax Ct. Nov. 30, 2011)(intervivos transfer of stock to executor was subject to inheritance tax because it was in lieu of testamentary disposition; stock gift done with intent to qualify transferor for Medicaid benefits and made at time transferor suffering from bacterial infection; transferor romantically involved with executor at time of transfer; stock transfer amounted to more than one-half of transferor’s estate value).
  • In re Fimon, No. A11-561, 2011 Minn. App. Unpub. LEXIS 958 (Minn. Ct. App. Oct. 24, 2011)(appellant transferred title to his home to his two sons and himself by warranty deed in 2003 for consideration of $500 or less; in 2009, appellant executed warranty deed transferring title to home to the two sons, reserving a life estate for cosideration of $500 or less; 2009 deed referred to as "corrective deed" and referred to 2003 deed; five months after execution of "corrective deed," appellant applied for Medicaid benefits; state Medicaid agency determined that appellant made disqualified transfer of home by virtue of 2009 deed in which the appellant transferred his interest as joint tenant without receiving fair market value compensation and imposed 3.84-month ineligibility period for Medicaid benefits; agency decision upheld at hearing and hearing decision upheld by trial court; on appeal, court noted that transfers within 5-year lookback period are presumed to have been made for purpose of establishing or maintaining medical assistance eligibility; 2009 deed did not merely correct 2003 deed - 2003 deed conveyed a one-third joint tenancy to each of the sons with no reference to a life estate, while 2009 deed does more than simply correct clerical error; one son's testimony that father intended to transfer life estate in 2003 rejected and agency's determination entitled to deference).
  • Hedlund v. Wisconsin Department of Health Services, 2011 Wis. App. 153 (Wis. Ct. App. 2011)(assets that Medicaid applicant transferred to children who later on same day transferred assets to irrevocable trust for applicant’s benefit held to be available to applicant for Medicaid eligibility purposes even though transfer occurred 17 years before application; under state (WI) law, assets in trust are deemed available if applicant’s assets used to fund trust and trust formed under applicant’s direction; not necessary that applicant have legal ownership of assets used to form trust at time trust is formed; reasonable inference present that children created trust at applicant’s direction).
  • In re Clark, No. 1-428/10-1672, 2011 Iowa App. LEXIS 983 (Iowa Ct. App. Oct. 5, 2011)(administrator appealed denial of equitable defenses for Medicaid reimbursement; administrator filed a separate tort action seeking damages; case has not been resolved; Department of Human Services filed a claim against the estate for reimbursement to recover Medicaid payments made; estate sought declaratory judgment; estate's request was denied; court stated case is not ripe since adverse claims exist and are based on speculative facts; court reversed and remanded with directions; if the estate receives fund from the underlying claim, the issue would be ripe and can be resolved at that time).
  • Pfeffer v. Arizona Health Care Cost Containment System Administrator, No. CV-11-0891-PHX-GMS, 2011 U.S. Dist. LEXIS 113072 (D. Ariz. Sept. 29, 2011)(Medicaid applicant’s transfer of money to child coupled with child using funds to private pay for applicant’s care during applicable Medicaid look-back period resulted in trust-like device causing funds to be deemed available to applicant for eligibility purposes; transfer not deemed to be a gift so no penalty period triggered; court denies preliminary injunction (which would have allowed Medicaid benefits to be paid pending resolution of case) because plaintiff could not show likelihood of success on merits).
  • Lewis, et al. v. Alexander, et al., No. 06-3963, 2011 U.S. Dist. LEXIS 95109 (E.D. Pa. Aug. 23, 2011)(state of PA revised state Medicaid eligibility requirements that had the effect of making it more difficult for disabled persons to qualify for Medicaid benefits by placing strict requirements on pooled trusts; limits allowed the use of pooled trusts only by persons with special needs that were age 65 or under and disqualified all members of pooled trust from receiving exemption if one member failed to meet specified requirments; plaintiffs claimed that restrictions were invalid as exceeding federal law; PA claimed that restrictions did not involve Medicaid eligibility, but only regulated special needs trusts in general; court invalidated portion of law making persons ineligible that were Medicaid-eligible under federal law; court also invalidated portion of law that forced pooled trusts to use one-half of funds remaining in deceased beneficiary's account to reimburse PA for Medicaid services provided during life, and portion that forced trusts to only make expenditures reasonably related to beneficiary's needs).
  • Maxwell-Jolly v. Martin, et al., 198 Cal. App. 4th 347, 129 Cal. Rptr. 3d 278 (Cal. Ct. App. Aug. 11, 2011)(Medicaid benefit reimbursement case; decedent had received Medicaid benefits during life and state sought reimbursement; heirs of decedent claimed that state's claim was subject to one-year statute of limitations because it arose from promise or agreement with a decedent to distribte property from an estate or trust; court disagreed and held that three-year statute of limitations applied to the filing of state's claim because claim arose from statutory right).
  • Estate of Olivo v. Comr., T.C. Memo. 2011-163 (estate not entitled to deduction for $1.24 million of debt alleged owed to decedent's son as full-time caregiver for decedent for 11 years prior to decedent's death; claimed oral agreement with decedent that son would be compensated after decedent's death not sufficient to overcome state (NJ) law that services rendered to family member in same household are provided at no-charge).
  • Estate of Baral v. Comr., 137 T.C. No. 1 (2011)(payments to caregivers deductible as long-term care medical expenses; while caregivers not medical personnel, a medical doctor had determined that services were necessary due to taxpayer's dementia).

CALT does not provide legal advice. Any information provided on this website is not intended to be a substitute for legal services from a competent professional. CALT's work is supported by fee-based seminars and generous private gifts. Any opinions, findings, conclusions or recommendations expressed in the material contained on this website do not necessarily reflect the views of Iowa State University.

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