Why is my Medicaid NAMI staying the same?

It has been over a year since the world abruptly halted.  The pandemic not only affected how we interacted with each other. It also affected how we received services and the changes that Medicaid could make.

As a result of the emergency orders put in place due to the pandemic, Medicaid was not allowed to reduce the amount of medical assistance. This restriction applied to any individual who was receiving assistance before the COVID-19 emergency period.

CMS Guidance on NAMI Increases

Recently, The Centers for Medicare and Medicaid Services (CMS) issued an alert to clarify their position on the increase of Net Available Monthly Income (NAMI) for Medicaid Nursing Home recipients.  The clarification states that, despite the cost-of-living increase that one may have received to their income, an increase in the NAMI paid to the nursing home is reducing the amount of medical assistance for which an individual is eligible.

Therefore, this situation is inconsistent with Section 6008(b)(3) of the FFCRA. CMS has determined that “any income a recipient may retain as a result of this policy, becomes an available resource for the recipient.”

What Happens When the Emergency Period Ends

When the emergency period expires, and Medicaid starts to re-evaluate eligibility on recertification, the NAMI increase will go back into effect. In addition, the available resources will be considered at that time.

In summary, any increases in income that a Medicaid recipient may have received during the pandemic period may be retained by the individual and not paid toward the NAMI contribution. However, post-pandemic recertifications will consider that additional income as a resource. This income will be subject to the Medicaid allowance (which is currently $15,900).

If you would like to speak with an experienced elder law attorney regarding your situation or have questions about something you have read, please do not hesitate to contact our office at 1 (800) 680-1717. We look forward to the opportunity to work with you.

Disclaimer: The information provided above is for general informational purposes only and is not legal advice.