January 15, 2010 

By: Aaron E. Futterman, CPA, Esq.

2010 MEDICAID REGIONAL RATES

Effective January 1, 2010, regional rates for calculating transfer penalty periods for 2010 were increased from 2009. The regional rates are:

Region                                                            Monthly Regional Rate

Long Island                                                                 $11,227.00

New York City                                                           $10,285.00

Northern Metropolitan                                                $10,163.00

Rochester                                                                    $9,058.00

Northeastern                                                               $7,927.00

Western                                                                       $7,694.00

Central                                                                        $7,264.00

These rates are based on average nursing home costs in each of the seven regions in New York State (i.e., Long Island, NYC, Northern Metropolitan, Rochester, Northeastern, Western, and Central (See below for the list of counties that make up each region)).

            What this means for families planning for Medicaid eligibility is the following. If a man, living in Suffolk County, transfers his sole asset, a bank account worth $112,270.00 to his only child, he will be ineligible for chronic care Medicaid benefits for ten (10) months ($112,227.00 transfer divided by $11,227.00 (regional rate for Long Island)). Despite what many have been led to believe, Medicaid does not attempt to take this transferred money from this family. Instead, what Medicaid does is deny the application of this father when he applies for benefits. Presumably, he is in a nursing home and in need of skilled nursing care. Again, Medicaid does not take this money, but effectively says to the family, “we are not paying his nursing home bills for ten moths, you pay it.” Usually, this results in the son spending the money that was recently transferred to him. 

Region            County                                   Region            County

Long Island:    Nassau                                     New York City:

                        Suffolk                                                            Bronx             

Kings (Brooklyn)

NY (Manhattan)

Queens

Richmond (Staten Island)

Northern Metropolitan:                                   Rochester:       Chemung         Seneca

Dutchess                                                         Livingston       Steuben

Orange                                                                        Monroe            Wyoming

Putnam                                                            Ontario            Yates

Rockland                                                         Schuyler

Sullivan                                                          

Ulster                                                             

Westchester                                                    

Northeastern:  Albany                                                Western:          Allegany

Clinton                                                            Cattaraugus

Columbia                                                         Chautauqua

Delaware                                                         Erie

Essex                                                               Genesee

Franklin                                                           Niagara

Fulton                                                              Orleans

Greene                                                             Wyoming

Hamilton

Montgomery

Otsego

Rensselaer

Saratoga

Schenectady

Schoharie

Warren

Washington

Central:           Broome           Madison

Cayuga            Oneida

Chenango        Onondaga

Cortland          Oswego

Herkimer         St. Lawrence  

Jefferson         Tioga

Lewis              Tompkins