LTC Bullet:  LTC Embed--Report from the Front 

Wednesday, February 1, 2006 

Seattle-- 

LTC Comment:  Over-the-top Medicaid planner maxes political contributions to pliant Republican Congressman who opposes DRA's Medicaid reform.  Details after the ***news.*** 

*** LTC COUNTDOWN.  The big day is here.  The Deficit Reduction Act, including its critical provisions to curb Medicaid abuse and encourage responsible LTC planning, comes to a vote in the House of Representatives today.  Catch the debate and vote on C-Span starting this afternoon Eastern time.  The vote will come around 3PM EST according to a Dallas Morning News reporter who interviewed me this morning. *** 

*** LONG KNIVES OUT.   "Opponents of a $39 billion budget savings package the House is expected to pass Wednesday hope a last-minute flurry of activity will sink it."  Nevertheless, a new positive CBO analysis released yesterday trumped the one of the day before highlighted by the New York Times and Boston Globe.  According to the new CBO report, because of the DRA "115,000 children would gain Medicaid coverage by 2015 under the 'Family Opportunity Act' provisions of the bill" and "the bill would allow states to provide additional home- and community-based services to about 120,000 Medicaid beneficiaries and long-term care services in a community setting to individuals who currently receive Medicaid services in nursing homes."  (Source:  Mary Agnes Carey, "Reconciliation Foes Continue to Press for Measure's Defeat," CQ Healthbeat News, January,. 31, 2006) ***

LTC BULLET:  LTC EMBED--REPORT FROM THE FRONT 

LTC Comment:  I'm not in DC for the action today, but I might as well be based on the information that is pouring in from our many sources on the political battlefront there.  

We'll send you this missive ASAP, but for the remainder of the day, go directly to the "Moses LTC Blog" at www.centerltc.com for minute-to-minute news on developments in the House.  

For now, get a load of this! 

We learned today that Armond Budish, a Medicaid planner in Cleveland, Ohio, has maxed out on political contributions to Steven C. LaTourette, a Republican Congressman from Ohio who opposes Medicaid reform.  Budish gave LaTourette $2,000 in this election cycle. 

What did Budish hope to get for his investment in LaTourette?  We don't know if there is any connection, of course, but according to CQ Today, LaTourette tried to insert an "amendment to the [DRA] bill that would eliminate a provision aimed at cracking down on the elderly who give assets to their relatives to qualify for Medicaid."  (Source:  CQ Today, February 1, 2006, p. 9.) 

Budish is a member of the National Academy of Elder Law Attorneys (NAELA is the Medicaid planners' trade association).  He is the author of a best-selling book on Medicaid planning (Avoiding the Medicaid Trap) and another volume on how to game all government programs (Golden Opportunities).  He also writes frequently on Medicaid planning for national magazines such as Family Circle and Modern Maturity. 

Following below are quotes from Budish's two books.  If you don't think cash collected from such egregious conduct should go to influence Members of Congress against responsible Medicaid reform, call LaTourette's office at 202-225-5731 and tell him to vote responsibly on the DRA.  You might also suggest that he return any ill-gotten Medicaid planning gains to his Medicaid planner contributors. 

While you're at it, call Chris Shays, Republican of Connecticut, a supporter of the DRA who is now also wavering according to CQ Today:  202-225-5541. 

Quotes from Armond Budish's books: 

From Armond Budish's Avoiding the Medicaid Trap: 

"So is there any practical way to juggle assets to qualify for Medicaid--before losing everything?  The answer is yes!  By following the tips on these pages, an older person or couple can save most or all of their savings, despite our lawmakers' best efforts...Here are the best options:  Hide money in exempt assets...Transfer assets directly to children tax-free...Pay children for their help...Juggle assets between spouses...Pass assets to children through a spouse...Transfer a home while retaining a life estate...Change wills and title to property...Write a durable power of attorney...Set up a Medicaid Trust...Get a divorce...."  

(Source:  Armond D. Budish, Avoiding the Medicaid Trap:  How to Beat the Catastrophic Costs of Nursing-Home Care, Henry Holt, New York, 1989, p. 34) 

From Amy and Armond Budish's Golden Opportunities:  Hundreds of Money-Making, Money-Saving Gems for Anyone Over Fifty: 

"We have committed an act of piracy--we have broken into the Fort Knox of Government benefits and uncovered the best legal strategies available to you for claiming your share of the gold from the Government's treasure chest. . . .  We'll explain how you can 'strike gold' in the Social Security [including SSI], Medicare, and Medicaid programs. . . .  With this book we are handing you the treasure map, deciphered from a mine of unintelligible government rules and regulations." (p. xiii) 

"Are you having trouble making ends meet on Social Security or other retirement benefits?  Relief could be available from a surprising source:  your Uncle Sam may have a monthly check for you under the Supplemental Security Income (SSI) program!"  (p. 433) 

"As many as HALF of all eligible persons are NOT receiving money that is rightfully theirs--usually because they don't even realize there's money set aside for them.  Don't you pass up this Golden Opportunity."  (p. 433, emphasis in the original) 

"Qualifying for SSI may also open up a variety of other Golden Opportunities too, such as Medicaid, food stamps, rehabilitation, hot meal programs, and home care."  (p. 434) 

[On page 437, the author lists 27 kinds of income that SSI does not count in determining income eligibility, including income tax refunds, grants, scholarships and fellowships, free medical care and services, medical insurance premiums paid by someone else, food stamps, housing assistance, public assistance, loan proceeds, principal payments on a loan you made to someone else, payment of your bills by someone else, airline or train tickets received as gifts, interest on excluded burial funds, etc.] 

"GEM:  Have Your Child Give You a Life Estate."  (p. 439) 
"GEM:  Take Food and Shelter as a Loan."  (p.439-440) 
[These techniques evade having SSI count free food and shelter as income against eligibility limits.] 

"GEM:  Separation or Divorce Can Pay Off with SSI. . . .  Your ineligible spouse's income is only deemed against you if you are living together as husband and wife.  If you are divorced, or even just living apart for a month, your spouse's income won't reduce your SSI benefits."  (p. 444) 

[On page 446, the author lists nine kinds of assets that SSI does not count in determining asset eligibility, including a residence, household goods and personal effects, an automobile, life insurance, burial and funeral costs, jointly owned real estate, real estate that can't be sold, etc.] 

"GEM:  Promise to Come Home--in Writing.  If you leave home, keep it protected by stating IN WRITING your intent to return.  . . .  If you enter a nursing home, try to get your doctor to state, in writing, that there is at least some chance you'll be able to return home.  That, coupled with your state intent to return, should allow you to keep the house and qualify for SSI."  (p. 447, emphasis in the original) 

"You can buy burial spaces (any amount) not only for yourself and your spouse but also for your adult children, brothers, sisters, parents--and their spouses.  None of these will be counted as part of your assets."  (p. 448) 

"GEM:  Borrow and Rent Your Second Home!  . . .  "Rent it for a couple of weeks, maybe to a child, and the property has 'magically' become protected."  (p. 450-451) 

"GEM:  Grow Crops on Vacant Land and Reap Benefits! . . .  As long as you sample the fruits of your labor, the property should be protected!"  (p. 451) 

"Cashing in on SSI.  If your income or assets are too high to get SSI benefits, does that mean you're out of luck?  No!  By using our gems, you may be able to cash in on hundreds of dollars each and every month!"  (p. 452) 

"GEM:  Use a Little Alchemy to Change Countable Assets into 'Gold.  You can take money from bank accounts, stocks, bonds, CDs, and so on--all of which would count against you for SSI--and put it into your home.  No, we DON'T mean that you should take cash out of the bank and hide it under the bed.  But because a home generally is protected, adding to your equity can qualify you for SSI. . . .  Putting countable assets into the home can have a double benefit because it reduces both assets and income.  This helps you kill two of the SSI requirement birds with one stone."  (p. 452, emphasis in the original) 

"GEM:  Buy a Home for Your Child.  "If you've got too much cash to qualify for SSI, you can get yourself an SSI check by using that money to buy a home for a family member!"  (p. 453) 

"GEM:  Buy Other Protected Assets.  Let's say you've got $15,000--which is well over the $2,000 SSI threshold.  You could put those funds into other protected assets, so they will not count against you for SSI qualification.  Need a new refrigerator?  Is the stove on its last leg?  Time to buy a new coat for the winter? . . .  How about a new car?"  (p. 454) 

"GEM:  Give Assets Away.  . . .  Until recently, making a gift or transfer would cause you to be disqualified for SSI for up to two years.  But now there is NO disqualification period for SSI.  You can give your money away and IMMEDIATELY qualify for SSI!  (p. 455, emphasis in the original)  [This particular SSI loophole does not apply to Medicaid which does retain a transfer of assets eligibility penalty, albeit one that is easy to evade.] 

"GEM:  Create an Irrevocable Trust.  Another way to minimize the risks involved in giving money to children is to set up an irrevocable trust."  (p. 457) 

"GEM:  Check Medicaid.  Creating a Medicaid Trust is not the only Medicaid gem that can be a gold mine for SSI benefits.  Because the Medicaid rules are so much like the SSI rules, the gems are almost interchangeable. . . .  In fact, by opening up the treasure chest of one program, you should be able to find the gold in the other as well."  (p. 457) 

"Most people know nothing about SSI.  And that's sad, because a lot of folks are missing out on money that is there for the asking.  The Golden Opportunities we've presented in this chapter can add enough income to make a real difference in your everyday life-style."  (p. 462)  

Source:  Amy and Armond Budish, Golden Opportunities:  Hundreds of Money-Making, Money-Saving Gems for Anyone Over Fifty, Henry Holt and Company, New York, 1992.