Obtaining a Medicaid PAS for an Out of State Medicaid Applicant

HNWApplying for Medicaid Long Term Care Benefits

NJ MedicaidOur office recently did some research on a potential new matter involving an out of state resident looking to relocate to New Jersey to qualify for Medicaid nursing home care.  This person is currently in a nursing home in New York and receives NY Medicaid.

This is how the process works:  The social worker at the New York nursing home (or any other state the applicant is located in) will contact the regional office of OCCO and request an out of state PAS.  The family needs to know what facility the person will be moving to in NJ before ordering the out of state packet, and then contact the Southern district OCCO to identify the facility located under their region or contact the Northern district for the facility in their region.

Once the out of state packet is received by the nursing home where the applicant is currently residing, the social worker will complete the forms received and then the social worker will send it back to the NJ OCCO office.  Once NJ receives the completed package, the nurse at OCCO will review the PAS request and if the nurse feels that the applicant meets the guidelines to qualify for a NJ PAS, the nurse will approve the PAS for (6) six months only.  Once the person is situated here in NJ, the facility where the applicant is residing must immediately request a PAS from OCCO as if they did not have anything in place prior to placement.  Remember, the out of state PAS is only temporary (6 months) if approved.

To be clinically eligible for Medicaid, the OCCO nurse in NJ must approve the PAS that was previously in place for the applicant in NY.  As we all know, the financial portion of the application must be in place for the applicant not to lose any Medicaid benefits or avoid paying any private pay.

This research only addresses applicants in an out of state facility.  We did not do any further research for applicants living in the community.

To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com.  Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Medicaid Attorney

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