Effective March 1, 2007, the figure used in West Virginia to calculate the penalty period for uncompensated transfers of assets in the long-term care Medicaid program changed. The WV Bureau for Medical Services (our state's Medicaid agency) divides this figure (which is the private pay nursing home rate) by the the fair market value of the transfer to determine how many months of penalty the Medicaid beneficiary will suffer. For about 8 years the figure they used was $3,380, which especially recently has been seriously below the true average private pay rate in the state. The new figure is $5,087 or $112.65 per day. http://www.wvdhhr.org/bcf/policy/imm/IMManualChanges/451/ch17_10.pdf
The per day fraction is important to know because once WV implements the changes in federal long-term care Medicaid law that were promulgated in the Deficit Reduction Act of 2005 (DRA), penalties will include fractions of the month. Before DRA the penalty period was rounded down to whole months only. Post-DRA implementation the period will also include fractions of a month, eliminating the benefit of transferring just under the value of the monthly private pay rate, which would formerly have resulted in rounding down to 0 months.
Friday, March 02, 2007
Thursday, February 15, 2007
Case of the Week 1/31/07
County: Randolph
Client's Age: 60
Client fell and was injured because of unsafe conditions, and the adverse party's insurance company told Client they would cover all his medical costs plus 60% of his suffering. Later insurance company told Client they were offering to be 60% liable overall. Client thought that meant he would have to pay 40% of his medical expenses out of pocket. Since Client has both Medicare and a Medicare supplement, we explained that Medicare and the supplement would cover whatever they would normally cover after AP's insurance paid their 60% (which is virtually everything), but the fight was between the insurance companies.
Client's Age: 60
Client fell and was injured because of unsafe conditions, and the adverse party's insurance company told Client they would cover all his medical costs plus 60% of his suffering. Later insurance company told Client they were offering to be 60% liable overall. Client thought that meant he would have to pay 40% of his medical expenses out of pocket. Since Client has both Medicare and a Medicare supplement, we explained that Medicare and the supplement would cover whatever they would normally cover after AP's insurance paid their 60% (which is virtually everything), but the fight was between the insurance companies.
Wednesday, January 24, 2007
Case of the Week 1/26/07
County: Hancock
Client's Age: 74
Client has not wanted divorce, but has been living separately from husband for a year and he has stopped giving her any income. Though they have already sold the house and divided the proceeds, she can't live on less than $400 a month which she gets from SS and they have about $10,000 in savings she is worried he will spend. She wants to file for divorce, but is not capable of representing herself and can't afford an attorney. Though she was initially turned down by LAWV, my conversation with her revealed her husband had terrorized her and threatened her with weapons, and she will now qualify for legal representation through a domestic violence program referral.
Client's Age: 74
Client has not wanted divorce, but has been living separately from husband for a year and he has stopped giving her any income. Though they have already sold the house and divided the proceeds, she can't live on less than $400 a month which she gets from SS and they have about $10,000 in savings she is worried he will spend. She wants to file for divorce, but is not capable of representing herself and can't afford an attorney. Though she was initially turned down by LAWV, my conversation with her revealed her husband had terrorized her and threatened her with weapons, and she will now qualify for legal representation through a domestic violence program referral.
Monday, November 27, 2006
Case of the Week 11/22/06
County: Wetzel
Client's Age: 78
Client's husband is applying for Nursing Home Medicaid, and NH is asking for financial information from client to complete the application. Client and husband, however, have been estraned and legally separated for over 30 years. Client was concerned about whether Medicaid Estate Recovery could apply to her home. We explained the federal right of spousal refusal in NH Medicaid law permits client to refuse to cooperate and therefore keep her home out of the consideration entirely.
Client's Age: 78
Client's husband is applying for Nursing Home Medicaid, and NH is asking for financial information from client to complete the application. Client and husband, however, have been estraned and legally separated for over 30 years. Client was concerned about whether Medicaid Estate Recovery could apply to her home. We explained the federal right of spousal refusal in NH Medicaid law permits client to refuse to cooperate and therefore keep her home out of the consideration entirely.
Tuesday, November 14, 2006
Case of the Week 11/14/06
County: Upshur
Client's Age: 67
Client's deceased husband was a coal miner. She had been receiving Black Lung benefits but was notified they were being terminated. We located an experienced attorney to represent her in filing an appeal, and he successfully got her benefits restored.
Client's Age: 67
Client's deceased husband was a coal miner. She had been receiving Black Lung benefits but was notified they were being terminated. We located an experienced attorney to represent her in filing an appeal, and he successfully got her benefits restored.
Monday, November 13, 2006
Case of the Week 11/10/06
County: Brooke
Client's Age: 77
Client's SS benefits have been affected by an overpayment SSA levied under the fairly recently-enacted fugitive felony provisions. Though the underlying warrant was an error that C corrected as soon as SSA notified him of the problem, SSA charged C with a significant overpayment of benefits, and notified him they would stop his check for several months for the repayment. We counseled client to appeal for a hardship waiver, and helped him identify evidence and arguments to support each element of the waiver for use in his appeal.
Client's Age: 77
Client's SS benefits have been affected by an overpayment SSA levied under the fairly recently-enacted fugitive felony provisions. Though the underlying warrant was an error that C corrected as soon as SSA notified him of the problem, SSA charged C with a significant overpayment of benefits, and notified him they would stop his check for several months for the repayment. We counseled client to appeal for a hardship waiver, and helped him identify evidence and arguments to support each element of the waiver for use in his appeal.
Friday, October 27, 2006
Case of the Week 10/27/06
County: Jefferson
Client's Age: 70
Client recently moved into apartment, landlord has ignored her requests to make several repairs. Though most are minor or cosmetic, client had been assured before she moved in they would be fixed and now the client wished she had never taken the place. We reviewed her lease and determined that because it listed no start and end dates, she was actually a month-to-month tenant, and therefore could be released from any further obligation merely by giving 30 days notice that she was moving.
Client's Age: 70
Client recently moved into apartment, landlord has ignored her requests to make several repairs. Though most are minor or cosmetic, client had been assured before she moved in they would be fixed and now the client wished she had never taken the place. We reviewed her lease and determined that because it listed no start and end dates, she was actually a month-to-month tenant, and therefore could be released from any further obligation merely by giving 30 days notice that she was moving.
Thursday, October 19, 2006
Case of the Week 10/19/06
County: Hardy
Age: 72
Client was being harrassed for collection of a debt. After reviewing her assets, income, and expenses she appears collection-proof, so we explained how to write a cease letter to stop the collections calls. Also we reassured her that the kind of income she gets enjoys federal protection from general creditors, and talked generally about how to prioritize her bills based on the different legal rights she has regarding each kind of expense.
Age: 72
Client was being harrassed for collection of a debt. After reviewing her assets, income, and expenses she appears collection-proof, so we explained how to write a cease letter to stop the collections calls. Also we reassured her that the kind of income she gets enjoys federal protection from general creditors, and talked generally about how to prioritize her bills based on the different legal rights she has regarding each kind of expense.
Friday, October 13, 2006
Case of the Week 10/13/06
County: Logan
Age: 75
Our client's former landlord had refused to give her back her security deposit of almost $700, though our client left the apartment clean and undamaged. We wrote a letter to him on her behalf explaining that by law he cannot charge her for normal wear and tear, and he returned her deposit.
Age: 75
Our client's former landlord had refused to give her back her security deposit of almost $700, though our client left the apartment clean and undamaged. We wrote a letter to him on her behalf explaining that by law he cannot charge her for normal wear and tear, and he returned her deposit.
Monday, September 11, 2006
Google Accessible Search for visually impaired users
Google has launched a search engine that "identifies and prioritizes search results that are more easily usable by blind and visually impaired users," according to the FAQ. They don't give much description of the criteria they use to define accessibility, but do link to the W3C accessibility guidelines.
Friday, September 08, 2006
WV Legislature's LOCHHRA committee focuses on Aged & Disabled Waiver
The Legislative Oversight Committee on Health and Human Resources Accountability (LOCHHRA) has an interim meeting scheduled for next Wednesday, Sept. 13 at 10:00am in the House chambers. The agenda for the meeting is the Aged and Disabled Waiver program.
The following legislators are on the committee:
Senator Prezioso Chair
President Tomblin Nonvoting, Ex Officio
Senator Boley
Senator Caruth
Senator Hunter
Senator Sharpe
Senator Unger
Delegate Leach Chair
Speaker Kiss Nonvoting, Ex Officio
Delegate Hall
Delegate Hatfield
Delegate Michael
Delegate Perdue
Delegate Susman
Delegate Boggs Nonvoting
Delegate Border Nonvoting
Delegate Brown Nonvoting
Legislative interim meetings such as this one are open to the public.
The following legislators are on the committee:
Senator Prezioso Chair
President Tomblin Nonvoting, Ex Officio
Senator Boley
Senator Caruth
Senator Hunter
Senator Sharpe
Senator Unger
Delegate Leach Chair
Speaker Kiss Nonvoting, Ex Officio
Delegate Hall
Delegate Hatfield
Delegate Michael
Delegate Perdue
Delegate Susman
Delegate Boggs Nonvoting
Delegate Border Nonvoting
Delegate Brown Nonvoting
Legislative interim meetings such as this one are open to the public.
Wednesday, August 30, 2006
Good website on Home & Community-based Medicaid Waivers
In searching for a copy of our current Aged and Disabled Waiver as approved by CMS (no luck yet), I discovered this website: www.hcbs.org/browse.php/state/188/West%20Virginia/
It's got a variety of interesting specific info on waivers state by state (everything from forms to reports and papers), as well as a variety of info that can help policy makers and advocates working toward more progressive and client-centered services through Medicaid waivers.
For the uninitiated, waivers are optional programs states can use to get federal Medicaid matching dollars to provide services beyond what is included in their state Medicaid plans. There are several different types of waivers available through CMS, and some states have very creative and progressive waivers in place. Unlike state plan services which are generally entitlements for any eligible applicant, the state may limit the number of eligible applicants the waiver will serve, so waitlists are a common problem on waivers.
It's got a variety of interesting specific info on waivers state by state (everything from forms to reports and papers), as well as a variety of info that can help policy makers and advocates working toward more progressive and client-centered services through Medicaid waivers.
For the uninitiated, waivers are optional programs states can use to get federal Medicaid matching dollars to provide services beyond what is included in their state Medicaid plans. There are several different types of waivers available through CMS, and some states have very creative and progressive waivers in place. Unlike state plan services which are generally entitlements for any eligible applicant, the state may limit the number of eligible applicants the waiver will serve, so waitlists are a common problem on waivers.
Monday, August 14, 2006
Case of the Week: 8/18/06
County: Barbour
Age: 85
Our client had moved into senior housing with her husband 25 years ago and have been in the same unit that entire time. The unit is handicapped accessible. When my client moved in, she and her husband signed a document acknowledging that the unit is for handicapped residents and agreed to move out should someone with disabilities need the unit. Since that time, both the client and her husband have developed disabilities. They received a notice from management that a resident who uses a wheelchair requested that unit. I sent management a letter explaining that my client and her husband are both disabled under their definition of disability. Working with their attorney, I was able to keep my client in her unit. Management found another suitable handicapped accessible unit for the other resident.
Age: 85
Our client had moved into senior housing with her husband 25 years ago and have been in the same unit that entire time. The unit is handicapped accessible. When my client moved in, she and her husband signed a document acknowledging that the unit is for handicapped residents and agreed to move out should someone with disabilities need the unit. Since that time, both the client and her husband have developed disabilities. They received a notice from management that a resident who uses a wheelchair requested that unit. I sent management a letter explaining that my client and her husband are both disabled under their definition of disability. Working with their attorney, I was able to keep my client in her unit. Management found another suitable handicapped accessible unit for the other resident.
Thursday, July 06, 2006
Case of the Week: 7/7/06
County: Ohio
Age: 76
Our client had to leave her apartment due to medical reasons. She had paid her rent to the end of the lease agreement and the landlord agreed to return her security deposit. Our client waited for months without seeing the deposit. The landlord claimed she sent the deposit out and that there was probably a delay with the hospital mail. However, my client received her deposits from her electric and cable companys. I sent the landlord a letter demanding she remit my client's deposit of $139. Two days after the landlord got my letter, the deposit was delivered to our client via UPS.
Age: 76
Our client had to leave her apartment due to medical reasons. She had paid her rent to the end of the lease agreement and the landlord agreed to return her security deposit. Our client waited for months without seeing the deposit. The landlord claimed she sent the deposit out and that there was probably a delay with the hospital mail. However, my client received her deposits from her electric and cable companys. I sent the landlord a letter demanding she remit my client's deposit of $139. Two days after the landlord got my letter, the deposit was delivered to our client via UPS.
Friday, June 23, 2006
Case of the Week: 6/23/2006
County: Randolph
Age: 80
Our client contacted us after he had returned a vacuum cleaner he ordered from a TV advertisement. Although he was promised a refund, the New York based company never made good on it's promise. C contacted the West Virginia Attorney General; however, the company was not cooperative and there was little the Attorney General could do. I sent the company on a letter on the client's behalf threatening legal action based on Consumer Protection Law should they fail to remit C a full refund. With the threat of legal action, the company quickly refunded my client his $276.70. My client is grateful for all the help he received from both the Attorney General and West Virginia Senior Legal Aid.
Age: 80
Our client contacted us after he had returned a vacuum cleaner he ordered from a TV advertisement. Although he was promised a refund, the New York based company never made good on it's promise. C contacted the West Virginia Attorney General; however, the company was not cooperative and there was little the Attorney General could do. I sent the company on a letter on the client's behalf threatening legal action based on Consumer Protection Law should they fail to remit C a full refund. With the threat of legal action, the company quickly refunded my client his $276.70. My client is grateful for all the help he received from both the Attorney General and West Virginia Senior Legal Aid.
Thursday, June 01, 2006
Case of the Week: 6/5/2006
County: Boone
Age: 70
Our client contacted us after she received a letter from Citi Bank claiming that a payment of $6588.60 was return due to insufficient funds. The payment was made by Discover in October of 2005 as a balance transfer. She recieved the letter from Citi Bank nearly 4 months after the balance transfer. After several failed attempts to work with Citi Bank she contacted us. I sent a letter of dispute on her behalf asking that Citi Bank conduct an investigation of the charges. After two billing cycles my client received a statement from Citi bank crediting her all the charges, including late fees and finance fees, leaving her with a zero balance.
Age: 70
Our client contacted us after she received a letter from Citi Bank claiming that a payment of $6588.60 was return due to insufficient funds. The payment was made by Discover in October of 2005 as a balance transfer. She recieved the letter from Citi Bank nearly 4 months after the balance transfer. After several failed attempts to work with Citi Bank she contacted us. I sent a letter of dispute on her behalf asking that Citi Bank conduct an investigation of the charges. After two billing cycles my client received a statement from Citi bank crediting her all the charges, including late fees and finance fees, leaving her with a zero balance.
Friday, May 26, 2006
Case of the Week: 5/26/06
County: Marion
Age: 74
Our client contacted us after having visited a dentist for a bridge. The dentist had begun the process of getting her a bridge. A mold of her mouth was already made and she was wearing temporaries. Unfortunately, her dentist passed away. The client made several, unsuccessful attempts to contact the dentist office regarding her bridge work. Since she was having trouble and she needed her bridge, she contacted us. I sent the office a letter asking that they give her the bridge, so that she can go to another dentist to have the work completed. I gave a deadline of May 22. The office contacted our client on May 22 and offered to have another dentist complete the bridgework at no extra charge.
Age: 74
Our client contacted us after having visited a dentist for a bridge. The dentist had begun the process of getting her a bridge. A mold of her mouth was already made and she was wearing temporaries. Unfortunately, her dentist passed away. The client made several, unsuccessful attempts to contact the dentist office regarding her bridge work. Since she was having trouble and she needed her bridge, she contacted us. I sent the office a letter asking that they give her the bridge, so that she can go to another dentist to have the work completed. I gave a deadline of May 22. The office contacted our client on May 22 and offered to have another dentist complete the bridgework at no extra charge.
Case of the Week: 5/26/06
County: Marion
Age: 74
Our client contacted us after having visited a dentist for a bridge. The dentist had begun the process of getting her a bridge. A mold of her mouth was already made and she was wearing temporaries. Unfortunately, her dentist passed away. The client made several, unsuccessful attempts to contact the dentist office regarding her bridge work. Since she was having trouble and she needed her bridge, she contacted us. I sent the office a letter asking that they give her the bridge, so that she can go to another dentist to have the work completed. I gave a deadline of May 22. The office contacted our client on May 22 and offered to have another dentist complete the bridgework at no extra charge.
Age: 74
Our client contacted us after having visited a dentist for a bridge. The dentist had begun the process of getting her a bridge. A mold of her mouth was already made and she was wearing temporaries. Unfortunately, her dentist passed away. The client made several, unsuccessful attempts to contact the dentist office regarding her bridge work. Since she was having trouble and she needed her bridge, she contacted us. I sent the office a letter asking that they give her the bridge, so that she can go to another dentist to have the work completed. I gave a deadline of May 22. The office contacted our client on May 22 and offered to have another dentist complete the bridgework at no extra charge.
Thursday, May 18, 2006
Case of the Week: 5/19/06
County: Mon
Age: 87
This client contacted after he had contracted with a construction company to replace his screen door. In the process of replacing the screen door, the frame and main door were damaged. Our client could barely use the door. I sent the construction company a letter requesting that they repair the damage they caused. 10 days later, the construction company went back to the client's home and repaired the damage. Our client is happy. He paid a total of $1266 for the job and is now satisfied with the results.
Age: 87
This client contacted after he had contracted with a construction company to replace his screen door. In the process of replacing the screen door, the frame and main door were damaged. Our client could barely use the door. I sent the construction company a letter requesting that they repair the damage they caused. 10 days later, the construction company went back to the client's home and repaired the damage. Our client is happy. He paid a total of $1266 for the job and is now satisfied with the results.
Monday, May 01, 2006
Case of the Week: 5/5/06
County: Cabell
Age: 64
Our client received a notice from Social Security that she received an overpayment in Supplemental Security Income (SSI) payments and would have to repay a total of $3494. I researched her issue and reviewed her legal position. I explained that she could request a waiver of the overpayment. We discussed possible arguments and strategies. After requesting the waiver, she was happy to learn that Social Security granted it. She is relieved that she does not have to pay back the $3494.
Age: 64
Our client received a notice from Social Security that she received an overpayment in Supplemental Security Income (SSI) payments and would have to repay a total of $3494. I researched her issue and reviewed her legal position. I explained that she could request a waiver of the overpayment. We discussed possible arguments and strategies. After requesting the waiver, she was happy to learn that Social Security granted it. She is relieved that she does not have to pay back the $3494.
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