A recent report by the Government Accountability Office revealed that information obtained by states about applicant eligibility for Medicaid long-term care varied widely from state to state and might not be sufficient to determine eligibility.  States are responsible for determining if an applicant’s income and resources fall within the threshold for receiving benefits and if an applicant transferred assets during the five-year look-back period in order to become eligible.

According to the report, “Thirty-one states reported requiring less than 60 months of documentation from applicants and financial institutions.”

What the report potentially means for applicants of Medicaid long-term care is increased scrutiny of their assets.  “It may be reasonable for states to adhere to a risk-based approach and focus their eligibility determination efforts on applicants who appear to be more likely to have assets or to have transferred assets that would make them ineligible,” according to the report.

For a detailed summary and the full GAO report, visit http://www.gao.gov/products/GAO-12-749.

For more information, contact Mark Addison, attorney at Chambliss, Bahner, and Stophel, (423) 757-0266, maddison@cbslawfirm.com; or Sally Brewer, Care Coordinator at Chambliss, (423) 321-0357, sbrewer@cbslawfirm.com.