Certified Medicaid Planner Designation

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Certified Medicaid Planner™ Designation Gets National Accreditation

FOR IMMEDIATE RELEASE

May 5, 2014

Washington, DC – The Certified Medicaid Planner™ Governing Board is pleased to announce that it has received full accreditation by the National Commission for Certifying Agencies (NCCA) – the gold standard in accreditation.

The certification known as “Certified Medicaid Planner™” or referred to by its acronym “CMP™” is the first-ever of its kind in the planning profession.  The certification program is designed to test the knowledge, skills, and abilities required to competently help people needing assistance with planning for and applying for long-term care Medicaid benefits.

According to the US Supreme Court¹, the long-term care Medicaid program is considered one of the most Byzantine and complex government benefits programs ever created.  Certified Medicaid Planners™ help their clients navigate the system and keep from running afoul of the complex and difficult rules.

The majority of Medicaid planners come from an elder law background or the financial planning community given the huge overlap in legal and financial issues.  However, because the federal Medicaid rules² allow for anyone to represent applicants before Medicaid agencies, long-term care Medicaid planning and Medicaid application assistance is often provided by other professionals – including accountants, social workers, nursing home administrators, funeral directors and geriatric care managers.

For the first time, the CMP™ Governing Board set out to develop a universal recognition of those who have achieved competency in this complex area regardless of their discipline.  Additionally, the CMP™ program has developed a nationally-recognized set of standards, as well as a system of accountability and professional discipline for those who choose to be recognized as outstanding in the field of Medicaid Planning.

With a single code of ethics and standards to encompass Medicaid Planners from various disciplines and backgrounds, national accreditation for the CMP™ program raises the bar for the planning community and gives seniors a source for knowledgeable and trained professionals who are held accountable to those standards.

Over 10,000 people turn 65 each day in America.  The growing senior population and extended life expectancies have caused an unprecedented need for long-term care in the US.  Medicaid accounts for nearly half all long-term care expenditures in America and has a host of cost-sharing rules – including the Medicaid Spenddown and Estate Recovery – which the average person finds difficult to understand.  Certified Medicaid Planners™ provide assistance with understanding how to properly comply with the rules and deal with the complex application process.

Candidates for certification must pass a thorough assessment of their work and education experience, and must successfully complete the certification exam covering a wide range of Medicaid Planning topics.  Certificants agree to be bound by and held accountable to the CMP™ Ethical Principles, which set out a universal standard of ethics and professional responsibility for the profession.  Certificants also subject themselves to the public complaint and formal discipline process.

Accreditation is the process by which the CMP™ program is evaluated by the National Commission for Certifying Agencies (NCCA) against defined standards and is awarded recognition if it is in compliance with those standards.  The NCCA officially notified the CMP™ Board of its decision late last Friday.

The CMP™ Governing Board is a subsidiary of the Wealth Preservation Institute (“WPI”), led by Roccy DeFrancesco, JD.  The WPI is a national leader in the areas of financial and legal planning education.  “The WPI has a high commitment to the professional development of the CMP™ program as the leading standard in long-term care Medicaid Planning.  We are thrilled to see the excellence of the program recognized by the NCCA,” said DeFrancesco.

For more information, contact the CMP™ Board at 216-220-6267 or by email at info@cmpboard.org.

 

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¹The United States Supreme Court has described the long-term care Medicaid law as “among the most intricate ever drafted by Congress”, with a “Byzantine construction” that is “almost unintelligible to the uninitiated.” Schweiker v. Gray Panthers, 453 U.S. 34, 43 (1981).

²42 C.F.R. § 435.908

Important 2015 Dollar Limits for Medicaid

CMS Releases 2015 Spousal Impoverishment Figures

CMS (Centers for Medicare and Medicaid Services) has released the new annual spousal impoverishment and SSI figures for 2015. The full numbers are contained in a pdf file which you can download by clicking on the link at the bottom of this post.

Here is a quick recap of the new figures and what they mean:

2015 ASSET LIMITS:

The 2015 minimum Community Spousal Resource Allowance (CSRA) is $23,844. The 2015 maximum CSRA is $119,220.

Reminder, in the straight deduction states (e.g., California, Florida, etc.) the Max CSRA is the asset cap. Any asset amount below that is sufficient to qualify for long-term care Medicaid. For example, if a couple has $90,000 in countable assets, then in the straight deduction states they do not need to spend down any further. Also, in straight deduction states the minimum CSRA is never a factor.

In the one-half deduction states (e.g., Michigan, Ohio, etc.), the minimum and maximums are both used. Take the couple with the $90,000. In a one-half deduction state, the CSRA calculation would take the total countable resources and divide it in half ($90,000/2=$45,000) to determine CSRA amount of $45,000.

Where the maximum is used in a one-half deduction state is when the countable resources exceed double the maximum. For instance, a couple with $400,000 in countable assets would only be able to set aside $119,220 for the CSRA. The remaining assets would be exposed to the Medicaid spend down.

The minimum CSRA acts as a floor and only factors in when the total amount of assets divided in half fall below the minimum. For example, if a couple has $45,000, then the CSRA would not be $22,250 because that amount is below the minimum. The CSRA in that case would default to the minimum $23,884.

Remember, too, CSRA calculations in one-half deduction states are based on the snapshot date and not the application date.

2015 INCOME LIMITS:

The new Minimum Monthly Maintenance Needs Allowance (MMMNA) is $1,991.25 (for all states except Alaska and Hawaii). The new maximum amount is $2,980.50. The Maintenance Needs Allowances are set mid-year and these numbers go into effect on July 1, 2015. This figure is used to determine how much of the patient’s income a community spouse can keep.

The new Community Spouse Monthly Housing Allowance is $597.38 (for all states except Alaska and Hawaii). This number also changes mid-year and goes into effect on July 1, 2015.

2015 HOME EQUITY LIMITS:

The 2015 minimum Home Equity Limit in 2015 is $552,000. In the handful of states that have adopted an upper limit, that amount is $828,000 for 2015. This limit was set just before the collapse of the housing market. As the housing market has nearly seen a full recovery to pre-collapse values, this equity limit now becomes a serious factor for long-term care Medicaid applicants. NOTE: This limit does not apply to long-term care Medicaid applicants who are married.
pdf-logo-100025338-gallery  2015 Spousal Impoverishment Figures (Part Effective 1/1/2015; Part Effective 7/1/2015)

Major Circuit Court Ruling on Medicaid Compliant Annuities

The Sixth Circuit Court of Appeals released a favorable Medicaid annuity planning ruling.

Occasionally in the area of long-term care Medicaid the states like to overreach. States agree to run Medicaid in a way that is no more restrictive than the federal laws governing Medicaid.  Even still they try to go beyond their federal mandate to add little restrictions that they just hope everyone will follow.  The average Medicaid applicant has neither the time, nor the patience, nor the resources to force the state to line up properly with federal laws.

The federal law – especially after implementation of the DRA is very specific about what kind of annuity counts as an income or an asset and when they create a penalty.  The federal law puts no restriction on when a Medicaid Compliant Annuity can be purchased.  Quite often Medicaid Compliant Annuities are purchased in crisis planning cases to convert excess assets into an income stream for the community spouse.  This helps the community spouse to keep from going broke and to provide resources for the community spouse’s own care and wellbeing later on down the road.

In Ohio, the state Medicaid department tried to put an end to the use of Medicaid Compliant Annuities in asset conversion cases.  The state added a small requirement: if the annuity was purchased after someone had gone into the nursing home, it was treated as a transfer for less than fair market value and disallowed.

Any reasonable person that has worked in the Medicaid Planning field knows that there is no rule restricting when a penalty-free transfer can take place.  The thought is preposterous!  But that did not stop Ohio from trying to use that rule to deny people their rights created under federal law to properly transfer assets into the Medicaid Compliant Annuity.

Fighting these things can be difficult.  Even when you have the law and the facts on your side, the judicial process can go haywire on you.  That’s what originally happened in Ohio.  What should have been an easy slam dunk for the federal district court in favor the Medicaid applicant became a nightmare for Medicaid Planners in the region.

The district court actually upheld the state’s practice of disallowing the Medicaid Compliant Annuities.  When that happens, the effect only applies to the geographic region that the district court covers. In this case, it was essentially the northern half of Ohio.  While we were still having great success using annuities in southern Ohio, planners in north mostly stopped and waited to see where this case went.

For those that did not take civil procedure, a federal district court’s opinion is appealed first to the circuit court.  A circuit covers a number of states and when a circuit court rules on something it is binding in those states.  Taking a case to the circuit court is a large gamble.  If you win, you set precedent for a whole region of the country.  If you lose, you take a bad decision in one part of one state and expand it to all the states in the circuit.  In the Sixth Circuit, that could have spelled trouble for everyone in Michigan, Ohio, Kentucky, and Tennessee – and potentially set a bad precedent for other states.

Fortunately the gamble paid off.  The Sixth Circuit issued a well drafted opinion that struck down the state’s view on Medicaid Compliant Annuities and affirmed the common planning technique used by Medicaid Planners throughout the country.

The effect of this ruling cannot be understated.   It is uncertain if the state will appeal or if the Supreme Court would even hear the appeal.  This case marks one of the highest rulings in favor of Medicaid Compliant Annuity planning.  It gives judicial support to the common asset conversion techniques used by Medicaid Planners.

Asset conversion is essential for the ability to take retirement assets and turn them into something akin to a pension plan for the healthy spouse.  Without the ability to do that, Congress recognized that it would be a huge disincentive for people to save their resources for retirement.  If Congress had wanted to put a limit on when the conversion could take place, they would have done so specifically.  For a state to add on a limit is reprehensible, but they often get away with this because not enough people stand up and challenge it.

Remember, when a state gets more restrictive they violate a patient’s rights; if that is allowed to happen, everybody loses.

For the full opinion, click on the following link: Hughes-v-McCarthy

CMP™ Ethical Principles

All program certificants are required to uphold the highest ethical principles.

As the premiere standard setting body in the Medicaid Planning field, the CMP™ Governing Board established an ethics panel made up of professional Medicaid Planners.   Together they have formulated a unifying set of client-first principles to guide Certified Medicaid Planners™ in the proper and ethical practice of of the profession.

The field of Medicaid Planning overlaps multiple disciplines.  Medicaid Planners are often a sub-set of the legal community, the financial community or the geriatric care/social worker community.  Some of these professions have their own set of ethical rules and professional responsibilities.  However, before the CMP™ Ethics Panel was created, there was no set standard of ethical professional principles to unify the cross-discipline professionals.  The CMP™ Ethical Principles provides the first-ever multi-discipline code of professional conduct for Medicaid Planners and a yardstick by which to enforce standards among the certified population of planners.

The public and consumers of Medicaid Planning services will know that when dealing with a CMP™, the certificant has agreed to uphold this unifying set of ethical principles.  Furthermore, the certificant also agrees to be held accountable by the CMP™ Governing Board for their conduct in the profession.  Through the grievance process, the public can have conduct of the CMP™ reviewed for ethical lapses and the CMP™ Governing Board has a strict discipline policy that can include sanctioning the certificant or decertifying the planner.

To view the CMP™ disciplinary policy, click here.

To file a grievance against a CMP™, click here.

To view a copy of the CMP™ Ethical Principles, CMP™ Ethical Principles.

pdf-logo-100025338-gallery

CMP™ Exam Guidelines

The Certification Exam:

The CMP™ examination is a 160-question test covering a broad number of Medicaid Planning topics.  The test type is multiple-choice.

The test is administered at a local testing site by a professional proctor.  The candidate can choose from a list of pre-approved testing centers.  Most are located a major universities throughout the US.  90% of the population is within a two-hour drive of an approved testing center.  If a candidate needs a closer testing center than those pre-approved, a request can be made and additional testing centers may be available.

Test takers have 3 hours to complete the test unless additional accommodations have been made.n English.  It is a closed-book exam; however, a standard formula sheet is provided.

For more information about the test administration email: testadmin@cmpboard.org

To find a testing center nearest you, click here.

CMP™ Certification Activities:

The chart below contains information regarding CMP™ Certification Activities, including the pass/fail rate, for the CMP™ certification exam:

Total CMP

 

 

 

Test Blueprint:

A thorough Job Analysis and Test Specification Report was drafted by Assessment Systems Corporation which used psychometrically valid principles to formulate a test blueprint. For the 160-question exam, the weight of each subject matter area is indicated in the table below:

Test Blueprint

 

 

 

 

 

 

 

 

For a full copy of the Job Analysis and Test Specification Report, click here.

Important 2013 Dollar Limits for Medicaid

Medicaid figures are released annually by the Centers for Medicaid and Medicare Services (CMS), effective at the beginning of the year.

The following are important limits for long-term care Medicaid for 2013:

Community Spouse Resource Allowance (maximum): $115,920

Community Spouse Resource Allowance (minimum): $23,184

Maximum Monthly Maintenance Needs Allowance: $2,898

Minimum Monthly Maintenance Needs Allowance (lower 48): $1,181.25

Minimum Monthly Maintenance Needs Allowance (Alaska): $2,365.00

Minimum Monthly Maintenance Needs Allowance (Hawaii): $2,176.25

Home Equity Limit: $536,000

Expanded Home Equity Limit: $802,000

Figures effective:  January 1, 2013 – December 31, 2013

 

Court Ruling on DOMA Expands Medicaid for Same-Sex Couples

The good news for same-sex couples is that the rulings handed down on June 26, 2013 by the Supreme Court of the United States (SCOTUS) will expand the definition of spouse for Medicaid purposes to include a same-sex spouse.[1]  The opinion resulted in repeal of the Defense of Marriage Act (known as “DOMA”) as it came to federal benefits.

This has great impact in the field of long-term care Medicaid planning in three major areas:

Community Spouse Resource Allowance

One of the major advantages in the Medicaid spenddown is the ability for a married couple to shield a certain amount of funds under the spousal impoverishment statute.  This amount is called the Community Spouse Resource Allowance or CSRA for short.  For 2013, the maximum amount that a community spouse is $115,920.  This is over and above the amount the nursing home patient can keep, which in most states is usually around $2,000.

In a memorandum issued by CMS, the government agency that runs Medicaid and Medicare, it was explicit that the Defense of Marriage Act would prohibit states from giving a same-sex spouse “community spouse” status and the asset protections that came with it.  Of course, that didn’t stop a state like New York from expanding at the state level how those benefits were distributed once their state adopted same-sex marriage.

Before the SCOTUS’s opinion, the same-sex spousal relationship was ignored for benefit purposes completely.  Each person in the same-sex marriage would have been treated as a single person, having to spend down his or her assets to the paltry personal limit also called the “ICRA” (the Individual Countable Resource Allowance).

Unlimited Transfers Between Spouses

Because married couples’ assets are considered available regardless of ownership, the SCOTUS decision now exposes the assets of the same-sex community spouse to the Medicaid spenddown.  That could be a downside if you have a situation where the community spouse has a higher net worth than the patient.  Before the ruling, only the patient’s assets would be considered.  After the ruling, the total of all the married couple’s assets have to be factored into the spenddown.

While the CSRA will help protect a great deal more than would have otherwise been considered exempt, the door is now open to advance planning concepts that are highly beneficial to married couples – and would now include same-sex couples.

Assets can flow freely between married couples for Medicaid purposes without a penalty.  Medicaid assesses divestment penalties for any gifts or uncompensated transfers of assets.  There are several exceptions to the transfer rules which include the ability to give assets to a disabled child or a trust for a disabled child.  The most useful exemption is the ability to transfer assets to a community spouse without a penalty.

Since those assets are still considered available regardless of which spouse owns them, it would not appear to be a boon.  However, when planning for eligibility it is helpful to convert excess resources into an income for the community spouse through the use of a spousal annuity trust or the popular Medicaid Compliant Annuity.  In most states, the income of the community spouse does not factor into the patient’s liability (i.e., co-pay for care at the nursing home or assisted living facility).

This is probably the biggest benefit to the same-sex couples facing the long-term care costs and an added tool for Medicaid Planners to assist same-sex couples with planning.

Spousal Income Allowance

When a patient’s liability is determined on Medicaid, they usually get to pay for their health insurance premiums, if any, and keep a small personal needs allowance which is usually between 40 and 60 dollars a month.  The rest of the patient’s income becomes the patient’s co-pay to the nursing home. Medicaid then picks up the difference.

A married couple has the advantage that if the community spouse’s income is too low, then part or all of the co-pay can be diverted to the community spouse as part of a spousal income allowance.  Without the status as a community spouse, a same-sex couple would not be able to use the patient’s income to support the at-home spouse no matter how destitute he or she is.

Without DOMA, the states will now be able to recognize same-sex spouses for the purpose of transferring income.  A patient’s income can now be legally shifted to his or her same-sex spouse.  Same-sex spouses will not have to worry about having their needs met if the higher income earner is in the nursing home.

 

Estate Recovery

States are prohibited from recovering against a patient’s assets is there is a spouse living at the time of the patient’s death.  In same-sex marriage states, the Medicaid program was prohibited by DOMA to recognize the same-sex spouse as a community spouse and the automatic protections afforded.

This creates a complicated case where the same-sex spouse is living in a home owned by the deceased patient and the state attempts to recover against the home.  Public policy supported the retention of that home by the community spouse, but a same-sex spouse would be at risk of eviction.  States where same-sex marriage is legal were starting to liberally apply hardship waivers to allow the same-sex spouses to avoid recovery – but there was no presumption.  The same-sex spouse had to show that they would, in fact, face a hardship by having to move.

W ith DOMA’s repeal, the estate recovery exclusions will become automatic for same-sex spouses.  This will allow the same-sex community spouse the same protections as ordinary community spouses from liens and estate recoveries that would otherwise have left a same-sex spouse destitute.

Separate But Unequal?

The principle behind overturning DOMA is based on an Equal Protection theory.  The two classes of people that were treated different were heterosexual married couples and same-sex couples in the states that allowed same-sex marriage.  But around the country, the effect of DOMA in Medicaid was essentially equal treatment for all same-sex couples regardless of whether they were in a same-sex marriage state or not.  Now the disparity in treatment will be huge.

The effect of the recent SCOTUS opinion may be a huge benefit – literally and figuratively – to same-sex married couples across America.  But only to those who are lawfully married in one of the dozen states that allow for such unions and only for those who seek Medicaid benefits in states that recognize the union.

Under the guise of Equal Protection, now same-sex couples in states without the state recognition of same-sex marriage are going to be treated far differently for the same federal/state benefits than those in states recognizing same-sex marriage.  Under the SCOTS opinion, the principles of Federalism recognized that each state could recognize same-sex marriage or not.  Only in the states that do allow it, will those same-sex couples be entitled to this equal treatment (i.e., the same as other married couples).  So if you don’t live in one of those states, you and your same-sex partner are still out of luck.

This means that not only is there a disparity between the states in recognizing same-sex marriage, but in the availability of equal treatment for Medicaid benefits and the like for same-sex couples.

This creates a huge financial incentive for same-sex couples to relocate to a state that will give them spousal benefit protections, especially later in life.  In those states that don’t recognize same-sex marriage it places a huge burden to do Spousal Equivalency Planning so that same-sex partners can still provide for their loved ones.

Planning Opportunities

The SCOTUS decision opens up a whole new range of options to help same-sex couples in states that will now be forced to grant community spouse status to the same-sex spouse.  The ability to use the Spousal Annuity and Spousal Trust provisions of the federal Medicaid rules will add more solutions to same-sex spouses.

In states that do not allow for same-sex marriage, there will need to be an emphasis on early pre-planning.  Through effective pre-planning strategies there are numerous ways to help a person treat their same-sex partner with love and compassion by supporting them in retirement and still maximize the availability of public benefits.  While the same hurdles still exist for same-sex couples in those states after the repeal of DOMA, creative planning solutions will allow same-sex couples to achieve similar results.

The end of DOMA changes the law and expands the coverage and protections for same-sex couples.  This will undoubtedly bring more financial security to same-sex couples facing the long-term care Medicaid system.  It will also expand the amount of people who can be helped by spousal Medicaid Planning.



[1] United States v. Windsor, 570 U.S. ___ (2013).

Why You Should Become a CMP™

With the growth in the aging population, Certified Medicaid Planners™ are in high demand.  As the need for long-term care services rises, more people are forced to look at Medicaid planning to avoid financial ruin.  Without help, often a patient can overspend on the cost of long-term care — draining valuable resources from the healthy spouse.

With the help of a Certified Medicaid Planner™ families can have a knowledgeable and experienced guide to navigate the often confusing Medicaid system and to help understand the myriad of rules.  As a CMP™, you will be recognized as a stand out in the field.

Because federal Medicaid rules allow anyone to assist a patient with their Medicaid application, Certified Medicaid Planners™ come from a variety of backgrounds including:

  • Legal Services
  • Financial Planning
  • Certified Accounting
  • Geriatric Care/Social Work
  • Medicaid Program Service

Families in crisis often don’t know where to look to get help for their Medicaid planning issues.  They turn to the CMP™, the only credential of its kind, to find help they can trust.  Through the education and experience requirements, the public know that a CMP™ isn’t a Johnny-Come-Lately to the Medicaid planning field.  Each CMP™ must agree to uphold the highest professional/ethical standards and submit themselves to the CMP™ program disciplinary process.  To stand out in your profession, earning the CMP™ designation will show that you have proven yourself by passing a tough certification exam.

At the end of the day, the mission of a CMP™ is to help people. A career as a CMP™ is one of the most rewarding because there’s nothing that beats the ability to help families in crisis provide for their loved ones.  As the Baby Boomers age, more people will need help and when they turn to a CMP™ for assistance, they can turn to you.