The Elder Firm, LLC - Nathan J. Forck, Attorney

Showing posts with label Nathan Forck. Show all posts
Showing posts with label Nathan Forck. Show all posts

Tuesday, September 17, 2013

Landmark Jimmo vs. Sebelius Settlement Helps Medicare Patients Receive Skilled Nursing Care

No longer do individuals have to show "improvement" for Medicare to pay for the cost of their skilled care after hospitalization:


LINK

Monday, March 4, 2013

New Bottom Limit of MMMNA Announced

The Department of Health and Human Services has announced the new poverty income guidelines for 2013. The new guidelines mean that the lower limit of the minimum monthly maintenance needs allowance (MMMNA) will rise to $1,938.75 in the 48 contiguous states and the District of Columbia, effective no later than July 1, 2013. The current amount is $1,891.25.

The new figure will be $2,422.50 in Alaska and $2,231.25 in Hawaii. The minimum MMMNA is 150 percent of the monthly poverty guideline for a couple.

Thursday, February 7, 2013

Do You Find Annuities Confusing?



FROM www.medicaidannuity.com:

You're not alone. If you're not an insurance agent annuities can be confusing. I'm frequently asked questions regarding the difference of annuities, and how the difference kinds are treated for eligibility purposes. What purpose do they really serve? What kind is appropriate? How do you tell the difference between all the types?

Why Use an Annuity?
The primary reason for using an annuity is to convert excess assets into an income stream. Thus, the problem assets, whether they consist of cash, checking and savings accounts, stocks, bonds, mutual funds, cash value life insurance, or an IRA, can be converted into an annuity, without jeopardizing eligibility. Additionally, using certain types of annuities can provide a safe investment vehicle when preplanning for Medicaid or gifting assets.

Immediate Annuities
An immediate annuity is a financial contract that delivers regular payments from an insurance company to the payee that begins soon after the signing of the contract - there is no accumulation period. For Medicaid purposes, if the immediate annuity meets certain restrictions outlined in the Deficit Reduction Act of 2005, it is considered income only. For Veterans Benefits purposes, an immediate annuity is considered income only regardless of its provisions.

Tax-Deferred Annuities

A tax-deferred annuity is an investment with an insurance company which continues to grow until the owner makes a complete withdrawal or annuitizes the contract. Established under § 403(b) of the Internal Revenue Code, tax-deferred annuity owners have the opportunity to accumulate funds on a tax-deferred basis. Contributions and the investment returns can grow quickly in that taxes are deferred until the owner receives the funds. For Medicaid and Veterans Benefits purposes, a tax-deferred annuity is a countable asset, which becomes part of the applicant or spouse's net worth. Tax-deferred annuities are primarily used as investment vehicles in preplanning for Medicaid, or in gifting assets.


Copyright ©2013 Krause Financial Services

Wednesday, December 12, 2012

New VA Pension Rates for 2013

From Krause Financial (www.medicaidannuity.com): LINK is at the end of post.


For the Veteran
Service Pension $1,037
One Dependent $1,359
Housebound $1,259
One Dependent $1,570
Aid and Attendance $1,731
One Dependent $2,053
For the Surviving Spouse
Death Pension $695
One Dependent $911
Housebound $851
One Dependent $1,110
Aid and Attendance $1,112
One Dependent $1,327

"I Have to Make Medicaid a Beneficiary?!"

From Krause Financial (www.medicaidannuity.com): Link at end of article...


"Then what's the point of using a Medicaid Compliant Annuity?" I hear this quite often, in both working with newer elder law attorneys and families of the elderly.  With the state Medicaid agency required to be a beneficiary, then doesn't it make the purchase moot?
Not necessarily.  Consider these three common planning scenarios:

1: Individual Gifting Scenario.

An individual makes a gift and purchases a Medicaid Compliant Annuity.  The Medicaid Compliant Annuity is structured to provide income throughout the divestment penalty period associated to the gift.  Designating the state Medicaid agency is one of the requirements for the purchase of the Medicaid Compliant Annuity not to be deemed a transfer for less than fair market value.  However, in the event the individual predeceases the Medicaid Compliant Annuity, the Medicaid agency would not be entitled to any of the residual benefits remaining in that the agency did not provide any medical assistance benefits to the individual due to the divestment penalty period.  As such, the individual's intended beneficiaries would be entitled to receive any residual benefits remaining in the Medicaid Compliant Annuity.

2: Individual with a Diminished Longevity.

In a case where an individual has a very short life expectancy a stand-alone Medicaid Compliant Annuity may provide a greater advantage than a gifting plan (aka a half-a-loaf plan).  By purchasing a Medicaid Compliant Annuity over the individual's life expectancy, he or she is immediately eligible for Medicaid benefits.  The Medicaid Compliant Annuity payout becomes the applicant's Medicaid copay.  This type of planning is traditionally only advised if the applicant is expected to life for 12 months or less.  When the individual predeceases the Medicaid compliant Annuity, the state Medicaid agency is entitled to recover from the residual benefits up to the amount of Medicaid paid on behalf of the applicant.  If the individual passes shortly after the annuity has commenced, the state's claim amount will be very small, leading to a greater remainder amount for intended heirs.  But why even proceed with the annuity?  Why not just continue to privately pay until the individual passes? Because the state's claim amount will be at the Medicaid rate, not the private pay rate.  Even after repaying the state Medicaid agency, the family will have paid less than had they done zero planning at all.

3: Spousal Medicaid Compliant Annuity Planning.

In a traditional community spouse case, funds in excess of the community spouse resource allowance will be structured in a Medicaid Compliant Annuity owned by the community spouse.  The community spouse is usually entitled to keep all income, regardless of the amount.  However, the community spouse is also usually required to designate the state Medicaid agency as a beneficiary up to the amount of Medicaid benefits paid on behalf of the institutionalized spouse.  In light of this, should the community spouse predecease the Medicaid Compliant Annuity the state Medicaid agency is able to reocver what has been paid on behalf of the institutionalized spouse, leaving very little to potentially be transferred to intended heirs.  Due to this fact, more and more community spouse Medicaid Compliant Annuities are seeing shorter terms, dependent on the anticipated longevity of the community spouse.
As you can see, in most cases it is not a "lost cause" to utilize a Medicaid Compliant Annuity, even though the state Medicaid agency does need to be designated as a beneficiary. 

Monday, December 3, 2012

Spousal Impoverishment Standards from Elderlawanswers.com


The Centers for Medicare and Medicaid Services has released its Spousal Impoverishment Standards for 2013 and they confirm the earlier projections of Pennsylvania ElderLawAnswers member Jeff Marshall, who based his estimates on the consumer price index for urban consumers for September and which we reported in October. 

For the record, the official spousal impoverishment allowances for 2013 are as follows (we include Medicaid's home equity limits, which Mr. Marshall did not project):

Minimum Community Spouse Resource Allowance: $23,184

Maximum Community Spouse Resource Allowance: $115,920

Maximum Monthly Maintenance Needs Allowance: $2,898

The minimum monthly maintenance needs allowance for the lower 48 states remains $1,891.25 (2,365 for Alaska and 2,176.25 for Hawaii) until July 1, 2013.

Home Equity Limits:

Minimum:   536,000

Maximum:  802,000

LINK

Friday, November 30, 2012

Wednesday, October 17, 2012

Another WIN for Medicaid-compliant Annuities!


(From medicaidannuity.com)  "John Lopes was married, residing in a nursing home, and in need of assistance.  Amelia Lopes, John's spouse residing in the community, purchased a Medicaid Compliant Annuity, and shortly thereafter made a Medicaid application on behalf of her husband.  The Connecticut Department of Social Services denied the application after determining that the payment stream Amelia was receiving was a resource that rendered John ineligible for Medicaid.
The matter progressed to the United States District Court for the District of Connecticut, under the argument that the payment stream was income that did not count against John's eligibility in light of the annuity being non-assignable.  The district court granted summary judgment to the Lopeses, and Connecticut appealed.
The U.S. Court of Appeals for the Second Circuit upheld the district court ruling that the income stream from a Medicaid Compliant Annuity cannot be considered an available asset for the purposes of Medicaid eligibility.  Lopes v. Dept. of Social Services (2nd Cir., No. 10-3741-cv, Oct. 2, 2012).  The court further ruled that it was irrelevant that the Medicaid Compliant Annuity was purchased just prior to John's Medicaid application.  Thankfully the U.S. Department of Health and Human Services lent their opinion in this case, affirming that the Lopeses position was consistent with Medicaid's primary purpose of providing healthcare to the indigent and protecting community spouses from impoverishment."

Federal retirement COLA of 1.7 percent announced (Washington Post)


"Federal retirees will receive an inflation adjustment of 1.7 percent in January, translating to about a $50 increase in the average monthly payment under the annuity program for most of them.
The increase, based on an inflation measure announced Tuesday, mirrors the cost-of-living adjustment (COLA) to be paid to Social Security beneficiaries."

LINK

Wednesday, September 5, 2012

NY Times Article: "For Veterans, an Alternative to the Nursing Home"



Paulia and Bienne Bastia set two dinner tables in their house in Mount Airy, Pa., each night, one for their three children, and another for themselves and the two older men the children call “Grampa.”
The Army veterans Booker Lovett, 79, and Wesley Ottis Furr, 95, are not related to the Bastias or to each other, but this has been their home since late winter. They’re participants in the Department of Veterans Affairs Medical Foster Home program, which places veterans who need round-the-clock care in private homes.
Mr. Lovett, who previously lived with his sister in Philadelphia, had a stroke — he still has trouble speaking — and has glaucoma. Mr. Furr, who maintained his own Philadelphia home, remains talkative and agile despite his age.
The Bastia children, ages 5, 6, and 7, consider the veterans family. Mr. Bastia thinks of them as father figures — he calls each “my king.”
“I felt at home as soon as I come here,” Mr. Furr said.
Mrs. Bastia, 36, a certified nursing assistant, and Mr. Bastia, 45, owner of a tax preparation business, drive the men to appointments, serve meals tailored to their dietary needs and administer medications. The Bastias can communicate with a nurse through a V.A.-provided telehealth monitor equipped with a video camera, blood pressure cuff and other equipment.
On a recent afternoon, Mrs. Bastia fastened the cuff on Mr. Furr’s thin arm while a nurse at the Philadelphia V.A. Medical Center 13 miles away observed. “Thank you, your blood pressure reading has been accepted,” said an automated voice from the monitor.
Medical foster homes provide an alternative to nursing homes for veterans who are unable to live safely and independently at home or lack a strong family caregiver. Conceived in 2000 by V.A. social workers in Little Rock, Ark., the program currently serves 535 veterans; it has cared for 1,468 since it began.
Though the veterans range in age from 23 to 101, their average age is 70. About half have some form of dementia. They often stay until they die, an average of 459 days.
“I know a lot of people suffering,” Mrs. Bastia said, explaining why she decided to participate. “I used to work in nursing homes. I know how it’s like when you get 14, 16 people to take care of. You don’t have time to do what you’re supposed to do. I figure out, if I take them to my house they can get more care.”
Now operating through 73 V.A. sites in 36 states, the medical foster homes program is scheduled to expand to 10 more states within two years. Eventually, the V.A. hopes to introduce the program to all 153 of the agency’s medical centers, said Dan Goedken, national program analyst.
It costs a site about $260,000 a year to introduce the program; each site can serve up to 30 vets. The V.A. finances each place for two years, after which the program is expected to be self-sustaining, said Dr. Thomas Edes, national director of geriatrics and extended care operations at the V.A.
Though medical foster homes are intended to provide better care, not to reduce costs, they operate for half the cost of nursing homes. “It is quite likely that it will save V.A. money and taxpayer money and veterans’ money,” Dr. Edes said.
The Bastias, who met in Florida after emigrating from Haiti, went through months of interviews and background checks to qualify as caregivers. A social worker, a nurse, a dietitian and a fire-safety expert inspected their two-story home on a quiet suburban street, and it will be reinspected annually.
Given the vulnerability of the older veteran population, the V.A. approval process is rigorous. Only one in 10 to 15 applicants are selected. People with no formal training can apply, however, and many with family caregiving experience do. Once a veteran is placed in a home, the V.A. provides training for tasks like cleaning wounds, managing incontinence and safely transporting the new residents.
And it provides periodic respite for caregivers. “It really is 24/7 care,” Mr. Goedken said. “This is a fairly intensive expectation on our part on what they’re going to do. Some willingly back away.”
Veterans pay $1,800 to $3,000 a month for care, depending on their medical needs, often using their combined V.A. and Social Security benefits. Mr. Furr and Mr. Lovett each pay the Bastias $2,000 a month for their shared bedroom and their care. The couple has another room available and is awaiting a third veteran, the maximum allowed.
A national V.A. study measuring veterans’ satisfaction and costs won’t be completed until 2013 and 2015. But 30 percent of veterans who would qualify for V.A.-paid nursing homes choose instead to pay out of pocket for medical foster homes — evidence, Dr. Edes said, that they prefer a home setting.
Even with dementia or mental illness, “they recognize this as their home. It’s very familiar,” he said. “They’re given a lot of autonomy. And it’s very one-on-one attention.”
Mr. Furr and Mr. Lovett get along well in their dorm-style room, with its twin beds and flat screen television. They take turns — Mr. Furr watches the news, while Mr. Lovett prefers football. One is a Democrat and the other a Republican, so they keep political talk to a minimum. Members of Mr. Furr’s congregation drive him to and from his Methodist church twice a week, and he often takes walks. He recently surprised his roommate, who prefers napping and relaxing at home, with a box of Lorna Doone cookies.
“I don’t expect him to be like me, and I can’t be like him,” Mr. Furr said. “So, I accept him as he is and he accepts me as I am. It’s a good deal.”

LINK TO NY TIMES ARTICLE

The 13 Most Frequent Medicaid Mistakes for Nursing Home Care

I wish I had written this!  What a great article that exposes many of the myths surrounding Medicaid planning and Medicaid eligibility.  Although it is written by a Florida Elder Law attorney (C. Randolph Coleman), almost everything that is mentioned in the article could apply to Missouri (or other state's) residents as well.  

As our population grows older, more and more families will face the need for long term care for their loved ones.  The cost of a skilled nursing home care in Florida averages about $7,000 to $8,000 per month.  That number increases each year. 
Medicare does not cover the cost of skilled nursing home care (except for rehabilitation usually with a limit of 100 days of coverage).  Beyond that limited coverage, the family must pay the full cost of skilled nursing home care.
Most studies suggest that the average family will exhaust the family's life savings within the first year of skilled nursing home care!  Without long term care insurance, practically all nursing home residents will eventually end up needing Medicaid to pay for the nursing home care.
When faced with the reality of the cost of nursing home care, and the almost certain eventual need for Medicaid eligibility to pay for the nursing home, most families engage in actions that can result in loss of eligibility for Medicaid benefits, or a long penalty period in which Medicaid benefits are not available to cover the costs of the nursing home care.
In an effort to help families avoid costly mistakes, that can cause them to lose their life savings unnecessarily, we have compiled this list of 13 most frequest mistakes that families make when a loved one enters a nursing home.

1. Failure to Take Advantage of the Avalable Spend-Down Options.
Many families assume when they are told the family must "spend-down" the family's assets to qualify for Medicaid benefits to pay for nursing home care, that the spend-down must be paid to the nursing home. The fact is, there are more than a dozen strategies that can be used to meet the Medicaid requirement for spend-down, without spending the money on nursing home care.  These strategies allow you to protect your assets from Medicaid and the cost of nursing home care.

2.  Transferring Assets to Other Family Members or Friends Without a Plan.
Probably the most common reaction to the realization that you must spend-down your assets to qualify for Medicaid nursing home benefits is to gift the assets to other family members or friends. There are Medicaid rules and regulations that create negative consequences, sometimes severe, when gifts of assets are made in contemplation of applying for Medicaid benefits for nursing home care.  These same Medicaid rules, however, when used properly, can result in the protection of substantial assets for the family.  You must understand how to use those rules and regulations to make them work in your favor.

3.    Assuming Your Existing Annuity Provides Asset Protection from Medicaid Spend-down.
Prior to the passage of the Deficit Reduction Act of 2005 (which became effective in 2006, "DRA"), annuities were widely used as effective planning to preserve assets from Medicaid spend-down.  The rules changed dramatically with the DRA.  Most all of the annuities that were effective prior to the DRA no longer provide asset protection.  There are a few annuities that are "DRA Compliant" that can be purchased in today's market.  These DRA compliant annuities can provide significant asset protection.  If an annuity is not DRA compliant, it is not likely to provide any meaningful protection.

4.    Having No Plan or Procrastinating Too Long to Take Action.
This year hundreds of millions of dollars will be lost to nursing homes or other long term care providers because families failed to take any action. Often this is a result of the family assuming, wrongly, that after the loved one is in the nursing home there is nothing that can be done.  In almost all cases, most of the family's assets could have been saved for the spouse living at home, or other family members, if action had been taken immediately after the family member enters the nursing home.  The reality is, the longer you wait to take action, the more money will be lost to the nursing home that could have been protected from the Medicaid spend-down.

5.    Trying to Hide Assets from Medicaid.
Sometimes families try to hide assets from Medicaid.  Sometimes they conveniently "forget" about some assets.  How will Medicaid know about the family farm or vacation home in another state?  Or, the coin collection in the safe deposit box?  The reality is that Medicaid has access to all the real property records in the US, as well as access to the most sophisticated asset databases.  Be aware that failure to disclose known assets is a federal crime (Medicaid fraud), conviction of which can result in signficant monetary fines and prison terms.  Medicaid can also pursue legal action to recover the cost of the benefits paid to someone who procures Medicaid benefits through fraud.  Do not ever seek to hide or otherwise perpetuate Medicaid fraud.  There are legitimate and legal options that allow protection of signfiicant assets without violating the law.

6.    Taking the Advice of the Medicaid Case Worker.
The Medicaid case worker, employed by the Department of Children and Families in Florida, has no interest in helping you preserve your family's assets from spending down those assets on long term care.  In fact, the Medicaid case worker's responsibility is to process and evaluate whether you are eligible for Medicaid benefits to pay for nursing home care.  The Medicaid case worker is not allowed to give financial or legal advice. To protect your family's assets as much as you legally can you need your own advocate - one who is looking after your best interests.  The Medicaid case worker is not that person.
7.    Relying on Advice from Friends and Neighbors.
It is appalling how many people rely on their neighbors, hair stylist, insurance agent, or others who are not Medicaid professionals for Medicaid advice.  Even more appalling is relying on information from friends and relatives who live in other states.  The Medicaid rules and regulations have been referred to as the most complex laws in the country, second only to the Internal Revenue Code (tax law). To further complicate this area of the law, Medicaid is a federal program that is administered by the various states.  Each state is free to establish its own rules and regulations, within certain parameters.  The law is implemented differently by each state.  What applies in New York, or Pennsylvania, or New Jersey or Ohio, does not apply in Florida.  So not only do you want to restrict your source of advice to a qualified Medicaid professional, but you want to restrict your counsel to those within the state in which you reside.  For those who are familiar and experienced with the particular state's rules and regulations, Medicaid asset protection can be quite effective.

8.    Choosing the Wrong Attorney
In most cases, the family is going to need an attorney to achieve the most favorable outcome for preserving the family's assets.  There are legal documents that are often required, such as a qualified income trust.  Attorneys, like all professionals in other disciplines, usually have a specific area of the law in which they are knowledgeable and experienced.  To obtain the proper counsel and advice you will want to work with an experienced elder law attorney to deal with Medicaid spend-down planning for asset protection.  You do not want to rely on the advice of a divorce attorney, personal injury attorney, real estate attorney, corporate attorney, or attorneys who practice in other disciplines.  Probably less than 10 lawyers out of a 100 have experience in elder law and Medicaid asset protection planning.  Of those 10, probably only 2 or 3 of them have substantial experience over a number of years.  Your most effective Medicaid spend-down plan for nursing home care will likely come from one of the elder law attorneys with substantial experience.

9.    Making Transfers Without Authority
Some families, in a desperate attempt to protect the assets of a family member who is no longer legally competent, will transfer assets without the property authority.  For instance, we sometimes find that deeds have been signed by the legally incompetent senior, or assets have been transferred un the authority of a power of attorney that does not include the authority to make the kinds of transfers involved. Such actions may be viewed as harmless (that's what Dad would have wanted) or convenient.  However, those actions may actually be fraudulent, create title problems for future transfers of real property, or may be considered "financial abuse of the elderly" (which is a criminal act in Florida).  Furthermore, such transfers may ultimately be challenged by Medicaid as uncompensated transfers that result in signficant penalty periods during which no Medicaid benefits can be received.

10.    Mistakenly Giving $13,000 (or $10,000) Won't Impact Medicaid Eligibility.
The Internal Revenue Code (tax code) currently allows an individual to transfer $13,000 (up from the original $10,000) to another person as a gift, without incurring any gift tax liability.  For Medicaid eligibility purposes, the tax code doesn't matter.  ANY gift or transfer of property, including cash, to another person within five years of the date your loved one applies for Medicaid benefits to pay for nursing home care, will result in a penalty period during which the nursing home resident will not be eligible to receive Medicaid benefits.  In Medicaid planning, if you are going to make any gifts, make sure it is according to a specific plan and that you have properly evaluated the potential consequences of the gfit.

11.    Relying on a Revocable Living Trust to Protect Assets from Medicaid Spend-down.
Many people have used revocable living trusts as their primary estate planning tool, in an effort to avoid probate.  Many believe that the revocable living trust provides some asset protection value for Medicaid spend-down plan purposes.  Notwithstanding the benefits provided by revocable living trusts from the perspective of estate planning and probate avoidance, such a trust provides no asset protection - either from Medicaid spend-down planning, nor for any other purpose.  Any and all assets titled to the revocable living trust will be considered available resources for purposes of Medicaid eligibility.

12.    Applying for Medicaid Too Early.
Some families file the application for Medicaid eligibility for nursing home benefits for the sole purpose of determining whether they qualify for benefits.  The belief is the worst thing that can happen is that the application is declined.  However, the Medicaid rules and regulations have many issues that could result in an application that is filed too early to cause substantial penalty periods during which Medicaid benefits cannot be received by the applicant.  These penalty period can be for a longer time than the 5 year look back period.  You should never file a Medicaid application unless you fully understand the possible consequences of the application being denied.

13.    Failure to Avoid Estate Recovery.
Often someone can qualify for Medicaid benefits to pay for nursing home care and retain the ownership of some assets.  Each state has the right to "Medicaid Recovery."  Medicaid recovery is a procedure where the state can recover from the estate of the person receiving Medicaid benefits, after the person has died.  The State can recover the value of the benefits paid on behalf of the deceased person.  Most states can recover only from the "probate estate."  Other states have defined the "estate" to include assets that are not included in the deceased person's probate estate.  To effectively protect assets from Medicaid estate recovery, you must first understand what constitutes the "estate" for a particular estate, and then understand how you can title assets to avoid estate recovery for the specific state that is involved.

Conclusion
These 13 mistakes cost families millions upon millions of assets every year that are paid to nursing homes when those assets could be preserved for the spouse or other family members.  If you have a loved one in a nursing home, or about to enter a nursing home, there are many actions you can legally take to avoid spending down the family's assets for nursing home care.
Our attorneys can help you protect your family's assets from the costs of nursing home care.
LINK

Wednesday, May 16, 2012

Medicaid and Veterans Benefits Seminar at 6 PM tomorrow night at my office for any that are interested.  The address is 2701 W. Main Street, Jefferson City, MO.  If you have questions about the seminar or anything else, please feel free to contact my office at (573) 635-3436.

Monday, May 7, 2012

Upcoming Seminars for May 2012

Upcoming Seminars

6:00-7:00PM)

May 10, 2012 at Knights of Columbus, Taos, MO (6:00 PM-7:00 PM)


May 17, 2012 at Millard Family Chapels Annex, 2701 W. Main Street, Jefferson City, MO (


May 29, 2012 at Heisinger Bluffs (Media Room), 1002 W. Main Street, Jefferson City, MO (6:00-7:00PM)


May 31, 2012 at Millard Family Chapels, 919 E. Main Street, Linn, MO (6:00-7:00PM)

Tuesday, March 20, 2012

Missouri Estate Recovery Claim Fails

A Missouri court of appeals rules that in a state's claim for recovery of Medicaid benefits against an estate, computerized records showing checks were issued to the Medicaid recipient's health care providers is insufficient evidence that payment was made to the providers, so the claim must fail. Estate of Nelson v. Missouri Dept. of Social Services (Mo. Ct. App., W. Div., No. WD73957, March 20, 2012).
When Katherine Nelson died, the state filed a claim against her estate for reimbursement of Medicaid benefits paid on her behalf. As proof of the claim, the state provided computer records of expenditures made for Ms. Nelson's care.
The trial court denied the claim, ruling that the state did not present evidence that checks it issued to Ms. Nelson's health care providers were in fact presented and paid. The state appealed, arguing that it need only provide proof that a check was sent.
The Missouri Court of Appeals, Western Division, affirms, holding that the state's evidence is insufficient because it does not establish that the checks it issued in payment of Ms. Nelson's health care services were either presented or honored. According to the court, computerized records providing the date a check was issued are not sufficient evidence of payment.
For the full text of this decision in PDF, go to: http://www.courts.mo.gov/file.jsp?id=53156.

Wednesday, February 29, 2012

Medicaid-Compliant Annuities

If anyone has any questions on "Medicaid-Compliant" Annuities, please feel free to call my office.  In my opinion, these annuities are an outstanding vehicle for asset protection, especially for a married couple. However, there is a lot of misinformation about what can and cannot be done with these annuities and how they work within the framework of an application for Medicaid vendor nursing care benefits with the Missouri Family Support Division.

Please understand that while a financial advisor may understand the product itself, he or she does not understand how the annuity works within the context of an application for Medicaid benefits.  Consequently, it is very important to discuss these products with an elder law attorney that is familiar with the Missouri Medicaid system and with how it treats these products.

Upcoming Seminars: March and April

March 20, 2012
12:00-1:30 PM
Lunch and Learn Basics of Medicaid and Veteran's Aid in Attendance Eligibility


Millard Family Chapel
540 South Summit Drive
Holts Summit, MO
RSVP: Mark (573) 680-7880

March 29, 20126:00-8:00 PM
Estate Planning and Medicaid Eligibility

Crestview Home
1313 South 25th Street
Bethany, MO
RSVP: Sherry (660)425-3128

 

March 22, 2012

6:00 pm - 8:00 PM
Estate Planning and Medicaid Eligibility

Frene Valley Health Center
1800 Wein
Hermann, MO
RSVP: Jenny (573) 486-3155

 

April 24, 2012

12:15-1:00 PM
Basics of Medicaid Eligibility

Senior Center @ the Mall
3600 Country Club Drive
Jefferson City, MO

 

April 26, 2012

12:15-1:00 PM
Basics of Veteran's Aid in Attendance Eligibility

Clarke Senior Center
1310 Linden Drive
Jefferson City, MO

Thursday, November 17, 2011

IRA vs. Long-Term Care Asset Protection

This is something that I run  into a lot as well.  In order to protect the cash value of an IRA for long-term care planning purposes, it must be cashed out and a tax will have to be paid on that withdrawal.  However, for most clients, the cost of long-term care will be far greater than any tax consequences of cashing out an IRA.  And keep in mind, the tax will have to be paid on that IRA at some point in the future.

http://protectingseniorsnews.com/2011/10/03/dont-let-your-ira-keep-you-from-protecting-your-life-savings-against-long-term-care-costs/

Friday, November 4, 2011

November Veteran's Benefits Seminar!

Veteran's Benefits Seminar
November 17, 2011
6:00 PM
Heisinger Bluffs
1002 West Main Street  Jefferson City, MO 65109
Jefferson City, MO 65109
(573) 636-6288

Tuesday, September 20, 2011

I sat behind the Westboro Baptist Church

members that were attending yesterday's hearing in the Eighth Circuit in St. Louis.  They were the first ones to be heard, of course, and it looked like the Westboro Baptist Church was challenging the constitutionality of a Missouri statute that was apparently enjoined by the district court.  Apparently, the statute requires protesters at a funeral to stay a certain distance away from the funeral.  At any rate, it was a nice palate cleanser before my oral argument.

After the Westboro Baptist Church oral argument concluded, about 75% of the courtroom cleared out.  Hey, I thought you guys were here to hear my Missouri Medicaid case?

Monday, September 19, 2011

First case before a federal appellate court.

I just argued my first case today in front of the Eighth Circuit Court of Appeals in St. Louis, Missouri. I think it went well. No marks on me that I know of. Maybe they're saving that for the decision.