Bill Introduced to Regulate State Medicaid Nursing Home Applications Advisors


Nursing home care is wildly expensive — the average cost of a semi-private room in New Jersey is more than $11,250 per month.

In the past decade, a growing number of Medicaid specialists such as Advanta Medicaid Specialists have moved into the nursing home industry, persuading families — many suddenly facing the reality of expensive, long-term care that quickly can exhaust a lifetime of savings — they can help them qualify for Medicaid.

Medicaid, a joint federal and state program, serves as a safety net to help with medical costs, including nursing home care, for people with limited income and resources. But the program was never meant to help everyone — only those with almost nothing left to their names — and the eligibility rules regarding income limits are complicated.

Although the application is only about five pages, applying for assistance through the program can be befuddling. The review process requires gathering years of bank records, brokerage statements and other paperwork. That’s where Medicaid advisory firms have carved out a lucrative niche in the past decade or so. They promise to do all the work for families already coping with an ill or dying family member. For those struggling to care for elderly or frail parents while facing issues like incontinence, dementia, and confusion, having someone else handle the paperwork and red tape is one less worry.

But in the wake of the collapse of Advanta Medicaid Specialists — its CEO Nissim Aryeh agreed to pay $38,000 in plea deal — a bill introduced this past week in the Legislature would put significant restrictions on those who hold themselves up as Medicaid advisors.

The measure, S-3606, would prohibit Medicaid application assistors who are not attorneys from charging for providing Medicaid application assistance to nursing home residents or their families.

It also calls for other safeguards involving the control of the financial affairs of nursing home residents. In addition, nursing homes would mandate clear and written notice to prospective residents and their families that they have the option to hire an attorney to assist with the application of applying for Medicaid assistance.

Nursing home industry officials sharply criticized the proposals. According to Andrew Aronson, CEO of the Health Care Association of New Jersey, which represents the state’s long-term care industry, “This wrong-headed bill would primarily benefit attorneys, at the expense of this most vulnerable population. The legislature’s efforts should be spent easing access to care, rather than on making that access more expensive.”

It is possible to obtain Medicaid paperwork assistance for free through county welfare agencies, Boards of Social Services, Medical Assistance Customer Centers, Area Agencies on Aging and NJ Family Care.

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