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Elder law lawyer in Florida

Statewide Medicaid Managed Care (SMMC) – Managed Medical Assistance Program

By Asset Protection Planning, Government Benefits, Long-Term Care, Medicaid Planning

Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services.

There are two different parts that make up the SMMC program:

  • The Managed Medical Assistance (MMA) Program
  • The Long-term Care (LTC) Program

Medicaid recipients who qualify and become enrolled in MMA will receive all health care services (other than long-term care) from a managed care plan. Medicaid recipients who qualify and become enrolled in LTC will receive long-term care services from a Long-term Care managed care plan.

What does the Statewide Medicaid Managed Care program provide?

Medicaid members receive their health care services through a managed care plan. MMA plans cover services such as prescriptions, doctors’ visits and hospital stays.

All MMA plans offer the following health care services:

  • Advanced Registered Nurse Practitioner
  • Ambulatory Surgical Center Services
  • Assistive Care Services
  • Behavioral Health Services
  • Birth Center and Licensed Midwife Services
  • Chiropractic Services
  • Dental Services
  • Child Health Check Up
  • Immunizations
  • Emergency Services
  • Emergency Behavioral Health Services
  • Family Planning Services and Supplies
  • Healthy Start Services
  • Hearing Services
  • Home Health Services and Nursing Care
  • Hospice Services
  • Hospital Services
  • Laboratory and Imaging Services
  • Medical Supplies, Equipment, Prostheses and Orthoses
  • Optometric and Vision Services
  • Therapy Services
  • Physician Assistant Services
  • Physician Services
  • Podiatric Services
  • Prescribed Drug Services
  • Renal Dialysis Services
  • Clinic Services
  • Transportation Services

Medicaid applicants will receive a letter once you are approved for Medicaid informing them of the MMA plan the state has enrolled them with. Applicants are allowed to switch to an alternate plan in the first 120 days.

If you have specific questions regarding your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 23, 2020
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How to Get on the Florida Medicaid Waiver Wait List

By Asset Protection Planning, Elder Law, Government Benefits, Long-Term Care, Medicaid Planning

In Florida, the Medicaid program that helps pay for long-term care in an assisted living facility or at home is called the Long-Term Care Diversion Waiver. There is a waitlist for this program. In order to get on the waitlist, you will need to do the following:

  1. Call your local Area Agency on Aging and request a “screening for home and community-based services.” Each county in Florida is assigned to an Area Agency on Aging. Your local agency can be found here.

The representative will collect some preliminary information and will schedule a time for the phone screening with the individual requiring assistance, primary caregiver ,or closest family member.

  1. Complete the screening interview. The interview usually lasts about 30 to 40 minutes. The interview covers basic demographic information for the applicant, as well as information regarding the applicant’s income and assets. The interviewer will also ask about the applicant’s needs for care, including the applicant’s ability to perform Activities of Daily Living. It is important to be honest and provide the interviewer with all health and care issues no matter the extent of the issue.
  2. Following the interview, you should receive a prioritization decision. This letter indicates the applicant’s priority score, which determines their place on the waitlist. The higher the score, the higher the priority the applicant receives on the waitlist.
  3. At this point, you do not actually need to submit a Medicaid application, so you do not need to be technically asset or income qualified for Medicaid. However, it is important to have a plan in place to become income and asset qualified for Medicaid, so that you are ready to apply when the applicant receives a spot off the waitlist. If the applicants’ condition deteriorates while on the waitlist, you can request a re-assessment to move higher up on the waitlist.
  4. Once you receive notification that the applicant has received a spot off the waitlist, you will be provided with a deadline to submit the Medicaid application.

If you have specific questions regarding preserving your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 19, 2020
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What are the Activities of Daily Living?

By Asset Protection Planning, Elder Law, Health, Long-Term Care

The Activities of Daily Living are a series of basic activities performed by individuals on a daily basis which are necessary for independent living at home or in the community. There are multiple variations on the definition of the activities of daily living, but most organizations agree that there are 5 basic categories:

  1. Personal hygiene – bathing/showering, grooming, nail care and oral care
  2. Dressing – the ability to make appropriate clothing decisions and physically dress/undress oneself
  3. Eating – the ability to feed oneself, though not necessarily the capability to prepare food
  4. Maintaining continence – both the mental and physical capacity to use a restroom, including the ability to get on and off the toilet and cleaning oneself
  5. Transferring/Mobility – moving oneself from seated to standing, getting in and out of bed, and the ability to walk independently from one location to another.
June 18, 2020
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Beware of Coronavirus Related Scams in Florida

By Elder Law, Long-Term Care

The IRS is warning taxpayers to be on the lookout for scams related the Coronavirus, or COVID-19, which can lead to tax-related fraud and identity theft. The IRS and its Criminal Investigation Division have seen a new wave of phishing schemes against taxpayers.  Senior citizens are among the most vulnerable to these scams and should be especially careful during this time.

In its press release, the IRS reminded taxpayers that the IRS is never going to call you asking to verify or provide your financial information so you can get an economic impact payment or refund faster.  Taxpayers should watch out for emails, text messages, websites, and social media attempts that appear to be from the IRS and request money or personal information. If you receive an email that appears to be coming from the IRS, do not open it or click on attachments or links. You should go to the IRS official website, www.IRS.gov for the most up-to-date information.

The IRS also provides the following items to keep in mind, in order to protect yourself and your loved ones:

  • Scammers may emphasize the words “stimulus check” or “stimulus payment.” The official term is economic impact payment.
  • Scammers may ask the taxpayer to sign over the economic impact payment check to them.
  • Scammers may ask by phone, email, text, or social media for verification of personal and/or banking information, saying that the information is needed to receive or speed up their economic impact payment.
  • Scammers may suggest that they can get a tax refund or economic impact payment faster by working on the taxpayer’s behalf. This scam could be conducted by social media or even in person.
  • Scammers may mail the taxpayer a bogus check, perhaps in an odd amount, then tell the taxpayer to call a number or verify information online in order to cash it.

 

Taxpayers who receive unsolicited emails, text messages, or social media attempts to gather information that appear to be from the IRS should forward it to [email protected].

Fred Jacobs is a Florida Board Certified Tax Lawyer and Sean Byrne is an elder law litigator.  Contact Fred or Sean at Bach, Jacobs & Byrne, P.A. if you or a senior you know has been the target of elder exploitation or needs assistance with tax matters. Call (941) 906-1231 to schedule an appointment.

June 9, 2020
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Can a Florida Nursing Home or Assisted Living Facility Take My Stimulus Check?

By Elder Law, Government Benefits, Long-Term Care

The recently enacted federal Coronavirus Aid, Relief, and Economic Security (CARES) Act provided for a direct payment of up to $1,200.00 to most taxpayers, including many residing in nursing homes and assisted living facilities. Unfortunately, the Federal Trade Commission has received several reports of nursing home and assisted living facilities requiring their residents who are on Medicaid to sign over the stimulus funds to the facility. There have been reports of facilities claiming that because the resident is on Medicaid, the facility gets to keep their stimulus payment. This claim is not true.

According to the CARES Act, the stimulus payments are a tax credit. Under the Internal Revenue Code, tax credits do not affect eligibility for federal benefits programs, like Medicaid, and they are not counted as a resource that an individual must use to pay for those benefits.

Because most nursing homes and assisted living facilities are currently closed off to the public due to COVID-19, it can be more difficult to monitor your loved one’s finances. If you are managing a facility resident’s financial affairs (such as an agent under power of attorney) or your loved one lives in a nursing home or assisted living facility and you are not sure what happened to their stimulus payment, talk to the facility’s management.

If you find out that a Florida nursing home or assisted living facility has taken your loved one’s stimulus payment, you should report it to the Florida attorney general’s office immediately and file a complaint with the Federal Trade Commission.

If you have specific questions regarding your stimulus payment and preserving your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 8, 2020
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How to Stay Connected to Loved Ones in Nursing Homes During a Pandemic

By Health, Long-Term Care

 

Family caregivers have now faced weeks or even months of physical separation from their loved ones in nursing homes and other long-term care facilities in order to protect them from Coronavirus. The restrictions on in-person visitation in long-term care facilities during the pandemic have made it challenging for family caregivers to stay close and present in the lives of their loved ones. The lack of family contact and attention can create feelings of isolation and anxiety for a resident, and additional stress for already worried families and friends, who are used to visiting in person.

While you may be unable to visit your loved one in-person, it is possible to brighten their day and try to ease feelings of isolation. Here are some ideas for staying emotionally connected to loved ones while visitor restrictions are in place:

  • Plan a virtual visit. There are several apps that will allow you to meet with your loved one virtually, including FaceTime, Zoom, and Skype. Most facilities are more than willing to assist your loved one in dialing in to a call. Some facilities even have iPads for easier viewing.
  • Send snail mail. Cards and letters are an easy way to tell someone you are thinking of them. Write an update about routine family activities. Have your children draw a picture. Include a photo showing your quarantine activities. Receiving updates will be reassuring to your loved one that you are okay during this health crisis and will provide your loved one with a genuine connection to you.
  • Create a photo book. Create a photo book with photos of what you, family, and friends have been up to. Include captions identifying family members and friends, with a small description. It can be as simple as a few pages printed from your home printer and stapled together, a poster board assortment, or a professionally bound book from Shutterfly or another online printing company. Most facilities will accept envelopes or packages at the front desk and will have staff members deliver to your loved one’s room, or they can always be sent in the mail.
  • Have a window visit. Many facilities will schedule a specific time for your family to “meet” your loved one through a window on the ground floor. You will be on the outside, and your loved one will be safely on the inside. You can chat, share smiles and laughs, and a touch through the glass. You can make special occasions, like a birthday or holiday, extra special with handmade signs.
  • Create a phone chain. Create a schedule of different family members and friends to each call your loved one on a specific day. This is a great way to connect others also feeling isolated, especially seniors and those living alone, with your loved one. Plus, a regular daily phone call gives your loved one something to look forward to.
June 4, 2020
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COVID-19: Tips for Supporting Loved Ones with Dementia Living in Nursing Homes During the Pandemic

By Elder Law, Health, Long-Term Care

There is no evidence to suggest that dementia itself increases the risk for Coronavirus, just like dementia does not increase risk for flu. However, behaviors, increased age, and common health conditions that often accompany dementia may increase risk. For example, people with dementia may forget to wash their hands or take other recommended precautions to prevent the illness. Viruses like COVID-19 or the flu may worsen cognitive impairment due to dementia.

 

The CDC has provided guidance on the prevention and control of COVID-19 in nursing homes. Precautions may vary based on local situations. If you have a loved one with dementia living in a nursing home:

 

  • Check with the facility regarding their procedures for managing COVID-19 risk. Make sure the facility has your emergency contact information and contact information for another family member or friend as backup.
  • Do not visit your loved one in the facility if you have been exposed to COVID-19, or have any signs or symptoms of illness.
  • Depending on the situation in your local area, facilities may limit or not allow visitors, in order to protect the residents.
  • If visitation is not allowed, ask the facility how you can have contact with your loved one. Options may include telephone calls, video chats, or emails to check in.
  • If your loved one is unable to engage in calls or video chats, ask the facility how you can keep in touch with staff in order to get updates.
June 3, 2020
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How Can I Spend Funds in A Qualified Income Trust?

By Asset Protection Planning, Medicaid Planning

There are very specific rules regarding how the funds in a Qualified Income Trust (QIT) may be spent. It is very important that the Trustee ensures that only allowable expenses are paid out of the QIT account because if funds in the QIT are spent improperly, it could jeopardize the recipient’s Medicaid eligibility.

Only the following expenses can be paid out of a QIT account:

  1. The Patient Responsibility due to the nursing home (as determined by the Department of Children and Families)
  2. Health insurance premiums
  3. The Community Spouse Allowance (as determined by the Department of Children and Families)
  4. Medical expenses not covered by insurance (i.e. medical durable supplies, additional home health care agency hours, therapies not covered by Medicaid)
  5. Uncovered portions of an assisted living bills

If you have specific questions regarding managing a Qualified Income Trust account or your duties as the Trustee of a Qualified Income Trust, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 2, 2020
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Does the Qualified Income Trust Need a Taxpayer Identification Number?

By Asset Protection Planning, Medicaid Planning

Some banks may request that you obtain a Taxpayer Identification Number for the Qualified Income Trust (QIT, also referred to as a Miller Trust).  However, In Part 21, Chapter 7, Section 13 of “Assigning Employer Identification Numbers (EINs),” the IRS specifically provides that “If the trust is a Miller type of trust, do not assign an EIN. Instead, inform the trustee that he/she must …Use the SSN of the beneficiary or trustee to report trust activities.” A Qualified Income Trust (QIT) is a “grantor trust”, which means that for tax reporting purposes, the trust’s finances are the same as the Settlor’s finances.  Therefore, the bank must use the Social Security Number of the Settlor (the Medicaid recipient) when setting up the QIT checking account.

If you have specific questions regarding establishing a Qualified Income Trust,  the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 1, 2020
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How much of my income should be deposited into the Qualified Income Trust?

By Asset Protection Planning, Medicaid Planning

The Trustee must deposit the amount of the Medicaid recipient’s income that exceeds the income cap into Qualified Income Trust (QIT) each and every month.  In 2020, the gross monthly income cap is $2,349.00. So, for example, if the Medicaid recipient’s gross monthly income was $4,000.00, the Trustee would need to deposit a minimum of $1,651.00 into the QIT each month.  If the Medicaid recipient’s gross monthly income was $4,500.00, the Trustee would need to deposit a minimum of $2,151.00 into the QIT each month.  In order to account for any discrepancies or fluctuations that may arise in monthly income, we always advise our clients to deposit more than the minimum amount each month.

Properly managing and funding a QIT is very important for maintaining Medicaid Eligibility.  If you have specific questions regarding funding a Qualified Income Trust account or your duties as the Trustee of a Qualified Income Trust, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

May 29, 2020
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