Medicaid Issues with COVID-19

Posted on Aug 27, 2020 by

COVID-19 has been hard on all of us, but especially on residents of nursing homes.  Because nursing homes house our most vulnerable population, extra precautions needed to be implemented to protect them.

This resulted in nursing homes being “locked down,” meaning residents were not allowed to leave, nor were they allowed visitors.  Early on during the pandemic, we all saw heartbreaking pictures of families waving at a loved one through a window.

In addition to worrying about contracting the virus, many nursing home residents also had to worry about the impact of COVID-19 on their Medicaid benefits.  The State published a helpful FAQ document detailing all of the changes.  A few of the most pertinent items for elder law attorneys are highlighted here.

Economic Impact Payments

Because of the negative impact COVID-19 had on the economy, Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act.  The Act included a massive economic stimulus plan to provide some relief for Americans who were suffering financially.  People who qualified, which would include almost anyone on Medicaid, received a $1,200 payment.

Only in the Medicaid world is the receipt of such a financial windfall a cause for stress.  Recipients were concerned the stimulus check would either put them over the asset eligibility limit and jeopardize their continued benefits, or it would count as income and have to be paid to the facility as part of their patient liability.

Thankfully, the Social Security Administration and State of Wisconsin issued a clarification saying that the economic impact payments would not be counted as income when they were received, and that the payments would be excluded as a resource for 12 months.  This means recipients have one year to “spend down” their $1,200 before it would affect their eligibility.

Medicaid Renewals and New Applications

Each year, on roughly the anniversary of qualifying for Medicaid, recipients must renew their benefits by providing financial information evidencing they are still eligible.  Because of the coronavirus, however, nursing home residents weren’t able to go out and family members couldn’t visit them.  In addition, most financial institutions closed their lobbies, so obtaining the necessary evidence was extremely difficult.

Thankfully, the State postponed Medicaid renewals during the pandemic.  March and June renewals have been postponed until September of 2020.  April and July renewals have been postponed until October.  Finally, May and August renewals have postponed until November.  According to the Wisconsin Department of Health Services, renewals will continue to be postponed during the federal public health emergency.

Likewise, because new applicants would also encounter difficulties obtaining verification from most employers, health care providers, banks, and other business during the pandemic, as of April 13, 2020, intake workers could use member-reported information as the best available information when making an eligibility decision about an application.

Retention of Benefits

The DHS also announced that as of March 18, 2020, members enrolled in Medicaid would not lose eligibility during the federal COVID-19 public health emergency.  This means that actions that would normally disqualify members from receiving benefits, such as exceeding asset limits or even divesting assets, would not jeopardize their eligibility during the pandemic.  If WHEN the public health emergency declaration is over, members who are over the asset threshold will have to spend down these excess funds, convert them to unavailable assets, or create a special needs trust, such as through WisPact (www.WisPact.org) to retain their benefits.  It is unclear how a divestment will be handled during once the pandemic declaration is lifted.

New Divestment Penalty Periods

While existing MA recipients will not lose their benefits due to a divestment or being over assets, applicants seeking MA eligibility are still being assessed penalties based on the value of the divestment.

Functional Screens

Traditionally, the first step in seeking Family Care benefits is a functional screen to determine that an applicant meets the functional eligibility requirements for the program.  Those screening appointments were almost always conducted in person.  With visitation restrictions, the state provided intake workers with permission to conduct screens over the phone.  Phone screenings allow new applications to move forward without an in-person interview to start the process.

Summary

Navigating Medicaid eligibility rules, applications and renewals are tricky when everything is right in the world.  COVID-19 has made all aspects of life-challenging.  So, applying for or renewing Medicaid benefits during the pandemic has created a Perfect Storm for many recipients.  Thankfully, the IRS, the SSA, and the DHS have thrown Medicaid recipients (and their attorneys!) some bones during the pandemic by providing economic benefits, delaying deadlines, and relaxing some rules.

Hopefully, readers will find this blog informative.  Who knows – it might just go viral.

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Jon L. Fischer

Estate Planning and Elder Law Attorney at McCarty Law LLP
Jon focuses his practice on estate planning, probate matters, and Medicaid planning as he aims to help clients in their time of need.