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, but also affected how we received services and the changes that Medicaid could make. With the emergency orders in place as a result of the pandemic, Medicaid was not allowed to reduce the amount of medical assistance that any individual was receiving prior to the COVID-19 emergency period.

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 takes the position that, despite the cost-of-living increase that one may have received to their income, an increase in the NAMI being paid to the nursing home is reducing the amount of medical assistance for which an individual is eligible and is therefore 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.”

When the emergency period expires, and Medicaid starts to re-evaluate eligibility on recertification, the NAMI increase will go back into effect and 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 and subject to the Medicaid allowance (which is currently $15,900).

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