Transfer Penalty no longer applies for Lombardi Program!

November 2, 2007

On September 24, 2007, the New York Office of Health Insurance Programs issued a directive stating that the penalty period for gifts will no longer apply to applicants for the Lombardi program. “Effective immediately: if an individual applies for Medicaid coverage of home and community-based waiver services, the applicant is only required to provide documentation of his/her current resources. The individual is not subject to a transfer of assets look-back period nor is the individual subject to a transfer penalty period. Spousal impoverishment budgeting continues to apply to a waiver A/R who has a community spouse.”

The Long Term Home Health Care Program (LTHHCP), also known as “The Lombardi Program” or “Nursing Home without Walls” provides eligible patients and their families with a popular alternative to institutional care. Based on an individualized plan of care, a comprehensive package of coordinated services is designed to meet the specific needs of eligible patients in their homes. The program serves chronically ill and disabled persons over the age of 18 who have ongoing health care needs. The hallmark of this program is case management by a Registered Nurse. An interdisciplinary team of health care professionals provides assessments, visits and delivery of ongoing quality care in the home. Services may include but are not limited to Nursing Care; Physical, Occupational and Speech Therapy; Personal Care Aides; Transportation; PERS, etc.

The elimination of the penalty period for the Lombardi Medicaid program is a brand new development. In recommending transfers prior to application for the Lombardi program, there still remains the concern that a recipient of the Lombarid program may need nursing home care in the future. Gifts will be reviewed and possibly penalized for the nursing home applicant even though they were not considered in the Lombardi application. Therefore, prior to planning for and applying for the Lombardi program, legal advice from a certified elder law attorney should be sought.