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Hello. Mom ended up in a nursing home. She has cognitive issues. Medicaid is making life very, very, very difficult. But there is a nasty person perpetrating and causing the difficulties.... So, I know they are allowed to ask if there are any outstanding lawsuits, how much is being sought, etc. But, are they allowed to ask "the circumstances which prompted the lawsuit"? Isn't that asking insider information regarding the plaintiff's side? The background info is that my mother is suing her son, yes, my brother. Now, my sister, who is clearly on my brothers side of the situation, actually works at medicaid, she is a supervisor, is vehemently antagonistic against my mother, and is in cohoots with the current worker. My sister has made my mothers medicaid case difficult since day 1. She has thrown up road blocks each and every step of the way. Of course, hiding behind every case worker that handles my mother's case. So, are they allowed to ask the details of the case? Or only if there is a pending suit and the amount? Here is what the paperwork is asking for(verbatim, poor grammar and all, blanks are where my mothers name are):
"Provide Statement as to Current law suit.
1. Provide who is ___ ____ is suing and amount of law suit.
2. Provide who is ___ ___ attorney that is handling current law suit.
3. Provide the circumstances which prompted the law suit.
4. Provide verification as to monies received from Law suit settlement once ___ ___ goes to court, or settlement out of court."
So, are they allowed to ask what prompted it, and all else?
Of course my biggest question would be how do I prove my sister has been messing with my mothers case, but we all know that is next to impossible. I have tried. Every time I catch them in an obvious breach, they back off their attack and come back at me a month or two later for more useless information "or else her case will be denied"
Thank you,
Christina

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Thank you all so very much. So, I didn't think that the medicaid stopped if she won a settlement. I thought that they just take the money, of course after any medicare claims. This lawsuit started years ago before the need for the nursing home. And actually, at this point, I don't even care about the lawsuit, since it started, all I cared about was getting mom into a safe, healthy environment. My brother stole her house that she lived in for 40 years and basically forced her to live in a hunting cabin that did not have floors, had holes exposed to the outside, barely had running water, no bathing or shower ability, couldn't flush in the winter, no heat, and we live in upstate New York... try having a 75 year old woman who is physically diminished live there. And our local Office of the Aging did not consider it Elder Abuse... but guess what, they are in the same office as Medicaid and have worked hand in hand with.... my sister ... for many, many years. I was able to move my mother into a senior apartment for a few years, but I think when my brother ripped her out of her home of 40 years and then forced her to live in that hunting cabin/shack for two years (before I could convince her he couldn't hurt her any longer and she could move someplace safe...) I think it diminished her mentally. The senior apartment only lasted for a little while. So, as much as a nursing home is not ideal, it is for her. It is safe, warm, good food, social activities, medical attention. And so my thoughts are, if she wins, and he looses the house, even if the state gets it, it would really be ok with me. Mom is safe and warm and healthy. I would really be ok with that. I am not looking to get rich, just keep her healthy for her last years, and out of his clutches. Does that make sense? I would not be overjoyed with the state, or medicaid, owning the historic stone house I grew up in, but I would be happier with that than him owning it. Maybe they would make a historic museum out of it. But, if it doesn't pan out, and he swindles again and walks away with it, I still don't care, she is still safe and warm and healthy. That last day when I finally got her out of that hunting cabin shack, it was 17 degrees inside there, two weeks before Christmas 2 years ago. She was coming out of there no matter what. My heart still breaks thinking that she spent one day there feeling like she had to live there or he would punish her. Oh well, thank you all for listening to me vent and for the advice and encouragement. I will give the medicaid letter to the attorney, and give the medicaid worker the attorney name and address and suggest she contact him for any questions and concerns. After all, it is not my lawsuit, it is not my right to tell the details, and it may be illegal for me to even speak about what I heard my mother and her attorney speak about. So, thank you all again !!!
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Medicaid will use that information so they can attach the judgment. Medicaid will STOP as soon as the recipient comes into money from a substantial judgment. If she dies and the judgment settlement goes to her estate, Medicaid will place a lien on it. So there really is nothing to gain from a lawsuit.
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Great answers above. Your mom's attorney should be in on this application and/or an expert in the Medicaid process. AND I'd explore subrogation rights if there is any recovery for treatment they paid for. I was aware of Medicare's subrogation, but, not Medicaid. Oh well.... I suppose I shouldn't be surprised. But, I would be concerned that any settlement or award would disqualify the recipient from Medicaid.
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Both answers are egg-cellent! Your mom's lawyer should know what to disclose and not disclose. Also remember you must answer questions the state needs for Medicaid approval. If you decide not to disclose information and they deny the application you can always appeal the denial. They don't like to receive a lot of appeal forms. Have your ducks in a row! If you have given them the answers they ask for and you believe someone is messing with the process of the Medicaid approval, APPEAL, APPEAL, APPEAL! Don't go on he said/she said or hearsay. Don't even mention the connections of the relatives unless their names are on the denial process. Show the judge you have done what has been asked and you are still getting denied. If someone is messing with that process you need an impartial judge to determine if you are doing things right. Once mom receives her settlement you will NEED to get an Elder Law Attorney to properly fund her money so she can continue to receive Medicaid. You cannot do what you think you want to do with the money! It must be done legally and an Elder Law Attorney knows what can be done with it to keep her on Medicaid. As the previous responder said the lawsuit award will probably take her over the Medicaid asset limit causing her to be ineligible. I hope that helps too.
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Your atty should be doing any responses as its in litigation.

Regarding state wanting to know about "monies", couple of things
- are you aware of SECONDARY PAYOR Acts? Basically what they can do for both Medicare & Medicaid, is IF $ is paid to a person by a lawsuit AND their medical treatment or care was paid by the M&M's, they are to be repaid from settlement $. So say your 70 years old & got 100k from a slip & fall but hospitalization & rehab of 40k paid by Medicare. 40k is due back to Medicare. A good tort attorney usually holds the settlement funds - less fees - in some sort of escrow-like account for a period of time to repay any secondary payers & get a release, and then you get final settlement.
- the eventual settlement is income / asset. If your mom is on medicaid, the $ will probably take her over any eligibility as too much $.
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Thank you. As I was typing my snarky letter to the woman this morning, and I paused to post the question on this site, that is actually part of my letter to her, that I believe it is posted in public records someplace, and I believe that "if I can not find the document in my mother's storage unit either she (the worker) or I could get it from the county records" ... but I, like I think you are, am not opposed to being as difficult as I can be if I feel as if I am being bullied. But thank you, that is a brilliant idea. I think I will actually go directly to the county clerk and pull whatever document they have and present them with that. I think you are correct. They can not complain about being given public record documents with clerk stamps on them, right? Brilliant, thank you!!!!
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I would go to the courthouse and get a copy of any PUBLIC records related to the case and attach them and only them as a response. But, then I am a big proponent of showing someone's ignorance by proving how easy it is to find the record.
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