New York State has passed the 2020 State Budget Bill which included radical changes to the statewide community Medicaid program covering home and community-based services:

  • Effective October 1, 2020, all new applications for Medicaid community-based (home care) benefits will be subject to a 30-month (2½ years) lookback period when analyzing an applicant’s resources and income. This requirement is a drastic change from the prior rule, where there was no look-back period for the community Medicaid program.
  • If transfers are found within 30-months (2½ years) prior to the date of the Medicaid application submission, a transfer penalty or waiting period will be applied before services can be granted to that individual.

The anticipated effective date of this new rule is October 1, 2020; therefore, all Medicaid home care applications filed after October 1 will have to provide 30-months of financial statements for all resources.

If you are considering applying for home care services in the near future, we strongly recommend that you meet with us as soon as possible to discuss preparation of your Medicaid home care application so that it may be filed before October 1, 2020, in an effort to avoid the new lookback requirements and possible penalty period. This change will also likely cause the Medicaid application review process by the Department of Social Services to take longer.

Please note that the lookback period for Medicaid skilled nursing home benefits remains unchanged at a full 60 months (5 years).

If you have any questions about the above material or wish to speak to an attorney, please contact Pfalzgraf, Beinhauer & Menzies, LLP at (716) 204-1055. Pfalzgraf, Beinhauer & Menzies, LLP is located at 455 Cayuga Road, Suite 600, Buffalo, New York 14225.

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