Follow
Share

Our family memeber's SS and retirement checks are deposited directly to the NH each month. Last month, one of the checks for the first time in years, slipped our memory and got left in the glove compartment of our car. When this months check was deposited, we realized our mistake and immediately located and deposited May's check. Upon communicating this honest mistake (no payments were missed and nothing went delinquent etc), we were threatened with an audit and an $8000 fine because "Medicaid will be dropped" because the check was not deposited in time, "its black and white, no exceptions." What can I do? Who can I reach out to? I need help and I don't even know where to begin.

This question has been closed for answers. Ask a New Question.
Vesna,

The nursing home my Mom was in misplaced a check I had given them. After about 3 weeks I realized the check had not cleared. I had the receipt from the nursing home. BUT the check did not clear, the end of the month rolled around and Mom's funds stacked up in her checking account. We got it cleared up but I did call Medicaid so they could make a note in my Moms case/file as to what happened. I also stuck a note on Moms bank statement so I wouldn't forget when renewal time rolled around.

I would call Medicaid direct and explain what happened and ask that they document what happened in their file.
Helpful Answer (1)
Report

That's it!!! Wow. Makes so much more sense. I think there was a lot of "ugly" and accusatory tones from them (rightfully if they thought we were hiding assets or something...) and so much confusion and panic on my end that I didn't know what in the world they meant.

Thank you all for taking the time out of your day and responding!!! I'm so glad I reached out.

So a lawyer would be the only option here or is there a simplier appeals process..?

Has anyone had to go through this before and has anyone been forgiven for the slip up? We literally cannot afford for it to be dropped (as I'm sure is often the case.)

Thank you all again!
Helpful Answer (0)
Report

Vesna, Medicaid is re-certified in every state to determine eligibility after a person is initially approved. Some states do it every year. Because it is so thorough, some NH personnel refer to it as an audit. Medicaid personnel check transactions in and out, bank accounts/checks that should have been deposited/and other income, and they verify assets held by the Medicaid recipient at various points in time set by the state for Medicaid. NO EXCEPTIONS. The difficulty may be the fact that a "live check" for your mother was not deposited in time with the nursing home to pay your mother's Share of Cost and that would have been a reason for your mother's assets to go over the $2000 limit for any given month. The fact that you didn't deposit the check in the bank doesn't mean that she didn't have the funds available to her at any moment during that period of time. It sounds like the NH personnel are worried that the timetable for asset limits on a MONTHLY basis were violated and that Medicaid will determine that Mom was ineligible for benefits for a given month and will "claw-back" payments to the NH (nursing home) on your mother's behalf. If this is an honest mistake, PLEASE consult a lawyer and see what your state's options are so that you can make sure you can answer any questions when they review your mother's monthly assets in the next year. The NH personnel are not trying to be ugly, but they have to deal with situations like this all the time. Frequently family "was holding onto a check" turns into keeps a check. And then it gets nasty with Medicaid.
Helpful Answer (1)
Report

You say the check was not deposited in the allotted time for May 2017, and we will owe back $8000 in fees/fines.... why???? I don't understand why they would tell you this.

I am new to all of this so I am interested to hear what others say of your situation. As for my own mother's, she has been approved Medicaid since January and as of June 1, her social security check goes directly to the nursing home. However, she owes them a balance of $4,200 for the payments from January through May. She has yet to pay them. Nobody has said anything to us about fees/fines or dropping Medicaid. We very may well be in the same boat.
Helpful Answer (0)
Report

Yea the nursing home and Medicaid is telling us this - that next May (in a year) an audit will be completed and they will that the check was not deposited in the allotted time for May 2017, and we will owe back $8000 in fees/fines. They're saying it's irrelevant that the check was deposited as soon as the mistake was realized.

I'm sorry for the confusion, the funds go only toward nursing home care, but get mailed to us (we - our mom - have the power of attorney and accesses to deposit the checks into her acct etc)

Thank you SO much for taking time to help. I'm new to learning all of this and... wow... feels like the deck is stacked against you every time, huh?
Helpful Answer (0)
Report

I'm not sure I understand your question. If the SS and retirement checks are deposited directly to the NH each month, how did one get left in the glove compartment?
If no payments were missed and nothing was delinquent, then why is Medicaid being dropped because the check wasn't deposited in time?
Who is telling you this? The nursing home?
I would contact Medicaid directly and ask them.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.