A large long term care facility in northeast Maryland was dealing with two very difficult Medicaid collection cases. Each case was approaching six months and no clear outcome was in sight for the facility administrator. Accent on Elder Law brought in Medicaid Case Experts to assess each situation. In each case, the main issues were uncooperative families and lack of verification to approve the Medicaid cases. The Accent team worked each case from scratch and obtained everything necessary to complete the applications that had been present prior to the team's involvement. Working with administration, staff and family members both were resolved - each case paid out for the six months prior for approximately $70,000 with a total cost to resolve each situation - $9,000 in fees. Proven, cost effective results.

Often times some of the more challenging of problems relate to family members of patients. While working for a large facility, we performed audits of various cases outstanding for Medicaid eligibility. One case in particular showed problem signs with the fees for service on this case in excess of $68,000 and increasing. Investigation into this case with the facility management indicated that Medicaid was applied for and no results were seen for two months. Deeper investigation determined that the son of the patient had used his power of attorney to change the title on the home property which created a transfer of assets, he cashed out of the patient's life insurance (which was intended for burial expenses), and withdrew significant amounts of money from the patient's bank account. Research and collection of the patient's various documents that were missing in the file, bank statements, life insurance verification, and proof of income showed that the patient's son had inappropriately accessed the patient's funds and accounts. This case was reported to the States Attorney and the Attorney General's office to file reports and request investigation of the son for his inappropriate actions under the power of attorney document. The power of attorney document did not include a provision allowing gifts to be made on behalf to the patient nor did the patient have knowledge or give consent to the son to make such gifts. Therefore, gifts were not made with the intent to qualify for Medicaid Benefits. We obtained a guardianship to remove the son as power of attorney in an effort to stop any further inappropriate action. Accordingly, Medicaid benefits were applied for and numerous appeals were developed that ultimately resulting in a winning case for benefits retroactive 18 months in excess of $100,000. This case took approximately 1 year for Accent to investigate with approximately $15,000 in legal fess. If this case had not been pursued, the patient would not have received Medicaid benefits, the facility’s A/R would still remain unpaid to a much higher value.

A husband and wife were both in the same facility. The husband was covered 100% by VA benefits the wife needed Medicaid. The couple also had a disabled son. The couple owned a home property and a second property. The husband's monthly income was being given to the son. This case required extensive research and found that 1.) the second property was not marketable, 2.) the son was disabled and receiving SSDI income so the monthly transfers were not penalized and 3.( the wife's assets were treated separately because both individuals had been institutionalized for more then 7 months. The net results of this investigation were the protection of assets for the disabled son, the facility was paid for the Medicaid benefits for the wife retroactive 6 months and the second property was no longer an issue. This case required real property verification as to the value of the property, data supporting why it was not marketable and proof that efforts had been made to sell the property and list it on the market. It was demonstrated through doctor reports and the Social Security Administration that the son was disabled and therefore the income he received from his father should not be penalized. We achieved approximately $68,000 for the facility by maintaining efficient records in this case and properly investigating the various facets that would later become issues. This allowed Accent to resolve the issues before they became deterrents to Medicaid eligibility. The cost to complete this investigation in this case was approximately $8,000 for complete resolution.