New South Carolina Medicaid Application Deadlines will be difficult to meet

Dec. 9, 2008-  Well, I wish my first substantive blogging topic was a little sexier...But I don't write the rules, the State of South Carolina Dept. of Health and Human Services (DHHS) does. And they have some new ones that may result in hardships upon families seeking to qualify for Mediciad to pay for nursing home costs. A Medicaid applicant now needs to, more than ever, make sure all documentation has been gathered and attached to the initial application because the new  DHHS deadlines allow only 10 days to provide missing documents! A Medicaid application is only several pages. But the documents that must be attached to it can be hundreds of pages. An applicant must supply at least 3 years of bank statements for every account owned within the 3 year "look-back" period. You need closing documents if a house sold, income tax returns, sales reciepts for  any and all stock transactions.  It is a paperwork nightmare for the average person. Imagine an adult child caregiver who is unfamilar with mom's finances who must gather all of mom's financial records for the past three years (and mom uses the covered shoebox filing system). READ MORE BELOW

The new rules only allow 10 days (changed from 21 days) for an applicant to provide supplemental documents. Oftentimes the document needed is not in the applicants possession. A single monthly bank statement from 31 months ago (when mom was still living in Ohio perhaps) could be missing and the bank says it will send it to you "tommorow". If "tommorow" turns into 2 weeks the caseworker is allowed to DENY the application and make you start over again. It may appear not to be such a big deal since most of the documents have been acquired (and it's not like the caseworker will throw all your papers away) and it's relatively easy to re-file. IT DOES MEAN that the date for which you seek medicaid benefits to begin will be pushed forward to the NEW application date. If there is no money to pay the nursing home bill the applicant remains responsible for it with NO money to pay it.

According to the another State law (the Admistrative Procedures Act) the state is supposed to follow certain procedures when issuing new rules which amend the state's Medicaid Policy and Procedure Manual. It appears that DHHS did not follow those rules in this case. If someone is denied Medicaid for an inability to produce a needed document they may have a legitimate case to have the denial decision reversed on this basis.  Hopefully, caseworkers will be little more lenient so that filing such appeals will be unecessary.