New York Proposes Shorter Look-Back Period for Medicaid

The State of New York has proposed a 30-month transfer of assets look-back period for coverage of community-based long-term care (CBLTC) services. The Medicaid Redesign Team II recommended the statutory change adopted by the New York State Legislature to ensure that individuals do not use Medicaid payments when their income or transferred resources can cover CBLTC services if the transfer is subject to the imposition of a transfer of asset penalty period.

Initially meant to begin on January 1, 2021, the amendment will now take effect on March 31, 2024. The delay is a result of the Families First Coronavirus Response Act and the American Rescue Plan Act, according to health.ny.gov.

Improvements for beneficiaries

Federally, the look-back period for Medicaid is 60 months. This move to decrease the period to 30 months will reduce the required documentation and result in fewer disqualifications or penalties from asset transfers during the look-back period. New York intends to exclude Medicaid mainstream managed care (MMC) beneficiaries from the transfer of assets penalties for CBLTC services if the proposal gets approval.

Services that will benefit

The proposal will impact various community-based long-term care services, including adult day health care, assisted living program (ALP), certified home health agency (CHHA) services, personal care services, consumer-directed personal assistance programs, limited licensed home care services, private duty nursing services, and managed long-term care in the community.

Applying for Medicaid in New York will become more difficult on March 31, 2024. The increased look-back period means applicants are more likely to face penalties for asset transfers. However, the proposal has already experienced two delays, so do not count on the new rules if you want to apply for Medicaid soon.