On April 7, 2020, New York State made changes to the qualification rules with respect to community Medicaid benefits (e.g., home health aides). The new law now imposes a 30-month financial lookback for individuals applying for community Medicaid benefits. This law changes the prior law which did not impose any financial lookback to receive these benefits. The rules were initially expected to go into effect in October of 2020, but lawmakers delayed the change until January 1, 2022. This delay is, in part, due to the federal government freezing protections enacted under the FFCRA Families First Coronavirus Response Act (“FFCRA”), which prohibits states from restricting eligibility until the quarter following the end of the Public Health Emergency.
How lookbacks work
The Medicaid laws and rules have an asset resource limit for those who apply for community Medicaid benefits (e.g., services in their home such as a home health aide). The lookback period is primarily designed to identify applicants who transferred (e.g., gifted) assets away so they could fall under the Medicaid resource threshold. The Medicaid caseworkers review all asset transfers within the lookback period to see if there are violations of the lookback rule. If violations occur, there is a resulting period of ineligibility (e.g., a “penalty period”) during which individuals cannot receive Medicaid assistance. There is no period of ineligibility if the transfers occur before the lookback period.
A big opportunity
In all likelihood, for applicants seeking community Medicaid benefits, New York State will begin to implement the 30-month lookback period starting January 1, 2022. Until such time, there is currently no lookback period for individuals seeking to qualify for community Medicaid benefits. Thus, there is still a great opportunity for individuals to legally transfer assets to loved ones (or to a Medicaid Asset Protection Trust) in an effort to qualify for these services. With all this in mind, now is the time to get Medicaid planning and other estate plans in order, particularly if applicants plan to use at-home assistance or community Medicaid.