On August 24, 2021, the New York State Department of Health (DOH) notified local departments of social services that certain Medicaid program “easements” implemented in response to the COVID-19 pandemic will be continued at least until January 1, 2022. This is a reversal of a DOH announcement made in July 2021 that pre-pandemic processing would resume on November 1, 2021.
The Medicaid easements, among other things, allow applicants to attest to most elements of eligibility, including income and resource levels. Applicants for chronic care (nursing home) coverage are ordinarily required to submit 60 months of financial statements. During the COVID-19 public health emergency, these requirements were eased, and applications have been accepted and approved on the basis of what the applicant reports their assets and income to be, without proof.
These Medicaid easements also apply to Medicaid recipients who have an active case that is scheduled for renewal or recertification. During the national COVID-19 public health emergency, no Medicaid cases may be closed for failure to renew or to provide documentation in connection with a renewal application. Accordingly, coverage has been automatically extended for 12 months for cases that have come up for renewal during the public health emergency. The DOH has made periodic announcements concerning these extensions, which now include cases with authorization ending in or before December 2021.
Many of the Medicaid easements are implemented to comply with the “maintenance of effort” requirements contained in the federal relief bills passed in 2020 and 2021. As part of these bills, the federal government has provided additional funds to states for Medicaid costs during the COVID-19 pandemic, on the condition that the states do not discontinue Medicaid benefits or make the eligibility requirements more restrictive for individuals who were enrolled in the Medicaid program as of March 18, 2020, or who apply and became enrolled after that date. The additional federal funds will be available, subject to the maintenance of effort requirements, through the end of the quarter in which the national public health emergency ends.
The national public health emergency has been repeatedly renewed, most recently on July 19, 2021, by order of Secretary of Health and Human Services Xavier Becerra. In a letter to state governors dated January 22, 2021, the Biden administration, through the secretary of health and human services, advised that the national public health emergency would likely be extended through the end of 2021, and that when a decision is made to terminate the declaration or to let it expire, states would be given 60 days’ advance notice. At this time, it is unclear whether New York State’s Medicaid easements will be extended beyond December 31, 2021.
Once these easements and other COVID-19 emergency measures wind down, the local departments of social services will have the authority to review Medicaid cases opened on attestation. At that time, the local departments may request documentation to confirm financial eligibility for the Medicaid program. If nonexempt transfers, gifts, or additional assets are discovered, it could result in a period of ineligibility or loss of benefits. Therefore, it remains important to make sure that Medicaid applications submitted during this period of easements meet the financial eligibility requirements of the Medicaid program to avoid a future interruption or loss of benefits.
Barclay Damon’s Elder Law & Medicaid Planning Team has been representing applicants throughout the COVID-19 pandemic, helping our clients navigate the continually changing landscape of rules and requirements. We will continue to monitor developments in to New York State’s Medicaid program in relation to the COVID-19 pandemic and will provide updates regarding the specific details of these developments.
If you have any questions regarding the content of this alert, please contact Bridget Dehmler, associate, at bdehmler@barclaydamon.com; Terry Emmens, Elder Law & Medicaid Planning Team co-leader, at temmens@barclaydamon.com; Lisa Arrington, partner, at larrington@barclaydamon.com; Naomi Levin, associate, at nlevin@barclaydamon.com; or another member of the firm’s Elder Law & Medicaid Planning Team or Trusts & Estates Practice Area.