wide county by county variation in medicaid denials

Last Thursday the Rockefeller Institute of Government published a report on the county by county variation in denials of applications for Medicaid funding of long term care. Individuals in New York are eligible for Medicaid funding for nursing home care if they make less than $8,700 per year, and if their total assets are less than $13,500, not including their home. Federal law prohibits the transfer of assets by the elderly for five years prior to applying for Medicaid nursing home benefits; obviously the intention of the law is to prevent people would could afford a nursing home on their own from filing for benefits after giving their money family member, friend, etc. so they could access it later. The report, which analyzed the state's 57 counties outside New York City, studied the rate at which Medicaid benefits are denied because of a reported asset transfer.

In the last decade, 7% of the applications for Medicaid benefits for long term care have been denied on the basis of a recent asset transfer. However, the rate at which applications are denied varies wildly from county to county. Some of the counties that deny with the most frequency are: Rockland (24.2%), Ulster (22.6%), Saratoga (14.6%), and Suffolk (14.5%). Some that deny the least are: Westchester (0.5%), Duchess (1.0%), Schenectady (1.2%), Rensselaer (1.3%), Orange (1.4%), and Erie (2.1%). The report offered no opinion as to why the variation exists, but the authors did note their suspicion that the illegal asset transfers are underdetected.

New York has one of the most generous Medicaid programs in the country; in 2006, 42% of the $18.9 billion the State spent on Medicaid went to funding long term care.