Good News Regarding Medi-Cal

        This
past weekend I attended a very informative legal education seminar in Sacramento
regarding Medi-Cal.  It focused on the proposed
(draft) Medi-Cal regulations that will eventually implement the dreaded 2005 federal
Deficit Reduction Act (DRA) legislation; that greatly constrict Medicaid
eligibility nationwide.  There was also a
1 hour question and answer session where State personnel discussing various Medi-Cal
topics under existing law.  Now, let’s
examine some of the important highlights. [NOTE:  This article is not a substitute to obtaining
legal advice from a qualified attorney.]

          DRA greatly
constricts Medicaid eligibility in the following ways:  First, it lengthens the look back period to
60 months (from 30 months); Second, it commences the penalty period at the time
when a Medi-Cal applicant would otherwise become eligible to receive Medi-Cal, but
for the disqualifying penalty creating transfers; and, Third, requires that the
value of all such transfers of countable assets (made within the 5 year look
back period) be added together to compute a single penalty period. 

          DRA
is, therefore, drastically different from the present law where, generally
speaking, each transfer of a countable non exempt asset during the relevant
look-back period at the time of application has its own separate penalty period
and begins when each transfer was made and runs concurrently with any other
ineligibility periods created by other transfers.  Thus, currently Medi-allows penalty periods for
transfers to expire or be greatly reduced at time of Medi-Cal application.  This is because separate penalty periods run
from when each transfer was made, and not consecutively as will be required
under DRA, i.e., one after the other, so that each penalty is added on to the
others. 

          Commentators
said the following regarding DRA:  First,
it continues to be delayed till at least next year, 2012, if not the following,
2013, when final DRA regulations might then have been approved;  Second, anyone presently receiving Medi-Cal (and
others who will become eligible before DRA is implemented) will continue to
receive Medi-Cal under DRA (even if that they would otherwise be ineligible
based on DRA’s rules) as DRA will not be retroactively applied; and, Third, the
draft DRA regulations contain important safeguards that protect otherwise
ineligible persons where disqualification would seriously jeopardize personal
well-being. 

          In
addition, State employees answered certain other recurring questions under
existing Medi-Cal law.  First, if the
surviving spouse of a deceased Medi-Cal recipient gifts assets that were
received wholly or partially from the deceased spouse, prior to the surviving
spouse’s own death, then such gifted assets will not later become subject to
estate recovery when the surviving spouse in turn dies.  Second, generally speaking, Medi-Cal Estate
Recovery does not pursue those assets of a deceased Medi-Cal recipient which
are worth less than $5,000 (such as ordinary items of personal property).  Third, when examining a bank account to see whether
the $2,000 Medi-Cal resource limitation on countable assets has been exceeded,
the State computes the monthly value of a checking account by using the lowest account
balance on any given day in the month in question and by subtracting all income
deposits made during that same month and any checks still outstanding on that
day.

          In
sum, the good news for now is that DRA continues to be further delayed and when
it does eventually come into effect anyone already receiving on Medi-Cal will
not be required to re-qualify under DRA Medi-Cal eligibility standards.  Lastly, fortunately, there will be important
hardship exceptions to protect otherwise ineligible persons.