What is about to change:
Due to the need to reduce the size of the
New York State Budget, Governor Cuomo set up a "Medicaid Redesign Team" to find ways to reduce the cost of the state's
Medicaid Program. Among the changes suggested was to impose a "Lookback" and a "Transfer Penalty"
on application for community based home care applications, similar to the lookback and transfer penalties that now exist for
Medicaid nursing home applications. This proposal was accepted and approved March 2021 as part of the New York State
budget for 2021, however *Actual implementation of the new look-back has been delayed until late
2025 or early 2026 due to the delays caused by the Covid Emergency.
Description
of what is about to change:
It is a manditory part of the Federal Medicaid Program that
application for nursing home coverage be subject to a five year "Lookback" and "Transfer Penalty". However,
each state that participates in the Medicaid Program has always had the option to impose a look back and transfer penalty
on applications for community based home care services. Starting some time in early 2026, New York State
will impose a 30 month (30 months = 2.5 years) lookback on applications for Medicaid home care services. If any non-exempt
transfers of assets or income were made by the applicant (or their spouse) in the lookback period, a penalty waiting period
will be imposed on the applicant based upon the value of the transfers. During the penalty period the applicant will
not be eligible to receive community based Medicaid home care services. The "Lookback" will only look for
transfers that occured on or after the new home care look-back rule is implemented. We shall provide updated information
as it becomes available.