Category: Elder Care and Special Needs Law
MA-EPD Law Updates Expand Eligibility for Coverage
December 17, 2024 | Cathryn Reher
We are nearing one year since the Minnesota Department of Human Services expanded those persons with disabilities who may qualify for Medical Assistance for Employed Persons with Disabilities (MA-EPD). Persons with disabilities participating in MA-EPD must have an earned monthly income of $65.01 or more. This program provides for not only state plan health coverage but also waivered services through CADI, CAC, BI, and DD waivers. The 2024 law change removed any asset limit to qualify. For self-employed persons, there was a mid-year law change that self-employment tax filings suffice as proof of appropriate tax withholdings. The most amazing aspect of the 2024 law changes is that MA-EPD became available to persons residing in skilled nursing facilities (nursing homes) as well as community-based settings. Our firm has successfully converted several clients from community-based MA-EPD to MA-EPD while residing in a skilled nursing facility. As an example, a long-term CADI client needed more care and entered a nursing home. His MA-EPD premium was $68. We assisted with his conversion to a nursing home on MA-EPD, where his monthly obligation remained $68. The client was not required to pay the alternative long-term care income spenddown, which would have been approximately $1,526. The reserved income is being used to pay for a private room as well!…
Read MoreChanges Are Coming to Medicare Part D
November 14, 2024 | Cathryn Reher
The Good and Bad of These Changes First, the good news: the Inflation Reduction Act (IRA) will cap the out-of-pocket maximum at $2,000 for all Medicare Part D plans starting January 1, 2025. Medicare Part D plans provide coverage to enrollees for prescription drugs. This will enable Medicare Part D enrollees to better budget if they have had historically high out-of-pocket prescription drug costs. The difficulty of the law change will be the impact for those who are Medicare-eligible but are enrolled through an employer or other health insurance plans. These plans are required to provide health insurance coverage that is just as good or better than Medicare standards. A plan that is as good or better than Medicare standards represents “creditable alternative coverage.” If a plan is not creditable, individuals run the risk of accruing a Late Enrollment Penalty (LEP) for each month they are not enrolled in a plan providing creditable coverage. The specific concern with the Part D law change is that prescription drug coverage under alternative insurance plans may not be as good as the new Medicare Part D coverage and therefore may not meet the creditable alternative coverage requirement. This would then require individuals to drop their employer or other health insurance plans, which are generally more cost-effective than Medicare health insurance plans. The…
Read MoreProposed Rule Amendments Governing Minnesota Veterans Homes Disapproved
July 20, 2022 | Cathryn ReherOn April 15, 2022, Administrative Law Judge Jessica A. Palmer issued her order rescinding the Minnesota Department of Veteran Affairs Additional Notice Plans and disapproving in toto the proposed changes to the Minnesota Veterans Homes Rules (Minn. R. Ch. 9050). The proposed amendments related to admissions, discharges, and billing procedures. Members of the Elder Law Section along with many stakeholder groups over a three-month period committed significant time to research, raised substantive written objections, and testified at the public rule-making hearing on January 31, 2022. The resulting order found the “Department did not establish that it complied with all procedural requirements of law and rule, or that the proposed rules are needed and reasonable. The Department failed to adequately address all of the regulatory factors required for consideration in the Statement of Need and Reasonableness (SONAR) under Minn. Stat. § 14.131. This is a prejudicial defect and not a harmless error.” Further, the ALJ determined “the MDVA misrepresented its engagement with the public in the development of the proposed rules. The Administrative Law Judge would not have approved the MDVA’s Additional Notice Plan as proposed had she known that the SONAR’s description of the level of prior stakeholder involvement was not true.” The MDVA committed five years to the rule-making process and all…
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