TBA Law Blog

Posted by: Jenny Jones on Mar 31, 2015

1.     CS Retirement Funds: Practitioners have noticed arbitrary problems arising with processing financial applications for Long Term Services and Supports.  Primarily, it has been reported that on several occasions and with more than one case worker, TennCare has refused to exempt the Community Spouse’s retirement funds at the time of the resources assessment, providing an opportunity for advocacy.  When faced with this issue, we encourage you to brief the issue thoroughly using both the Medicaid Manual and POMS.  And, if necessary, encourage the case worker to consult with the TennCare attorney handling oversight on financial applications. Her name is Kim Hagan.

2.     Prepaid, Itemized, Irrevocable Funeral Plans: Our office recently encountered a case worker who characterized the purchase of an irrevocable, pre-paid funeral plan over $6,000 as a transfer of assets for the amount over $6,000.  We are arguing that issue presently and if necessary will appeal it.  This may stem from an October 10, 2014 “policy” that TennCare has issued which states: “Funds in an irrevocable burial contract in excess of $6,000 must be reviewed under transfer of asset and penalty period policy for institutionalized individuals, unless additional expenses are incurred for transporting the deceased to another city or state for burial purposes.”  Please be aware that there is no new rule to change the existing Medicaid Manual to limit itemized plans to $6,000 and it is unclear where TennCare’s authority is for such a policy.