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Wednesday, October 14, 2009
Sunday, October 11, 2009
ABA GP Solo ELDER LAW COMMITTEE Newsletter Fall, 2009
ABA General Practice, Solo and Small Firm Division
Chairs - Kenneth Vercammen, Edison, NJ and Jay Foonberg, Beverly Hills, CA
In this issue:
1. Elder Law, Estate Planning & Probate forms available from ABA Elder Law, Estate Planning & Probate Seminar
2. PERSONAL INJURY SETTLEMENT PRESERVATION TRUSTS
3. REDUCING A MEDICAID LIEN
1. Elder Law, Estate Planning & Probate forms available from ABA Elder Law, Estate Planning & Probate Seminar
The ABA General Practice Division held its popular program Elder Law, Estate Planning & Probate- New ideas to expand & excel your practice at the American Bar Association Annual Meeting in Chicago on August 1, 2009.
Speakers: Jay Foonberg, Esq. - Author of Best Sellers "How to
Start and Build a Law Practice" and "How to get and keep good clients', Beverly Hills, CA
Kenneth A. Vercammen, Esq. - co-author "Nuts & Bolts of Elder Law", Edison, NJ
Deborah Cole, Chicago, Il
Articles and forms were provided on CD. Below is a list of articles provided. If you want a few of the forms, send an email to kenvnjlaws@verizon.net and indicate which articles/ forms you want and the number of the article or form [max 5]
List of Kenneth Vercammen, Esq. Forms, Documents and Articles on CD
Elder Law, Estate Planning & Probate- New ideas to expand & excel your practice
Sat. August 1, 2009 2:00pm -3:30pm
Hyatt Regency Hotel, Chicago ABA Annual Meeting
1 New Client schedule appointment
2 Confidential Will Questionnaire
3 Will bill
4 WILL DRAFT CO
5. Doctor Cert sign POA, will Dr
6 Thank you for Referral
7 POA DRAFT lt
8 Will Signing Instruction
9 Referral Out Another Atty fax
10 No rep
11 Recommend Will to Client
12 Post WILL
13 Client questionnaire end case.
14 POA Grantor Now
15 Wills article
16 POA Power of Attorney- article
17 LIVING WILLS
18 Gay and Lesbians- Advance Directives
19 Letter of Instruction
20 Remove Executor
21 Alzheimer, POA Guardianship
22 ANSWERS to Questions Probate
23 Estate Planning 10 Ideas
24 Executor Duties
25 Prenuptial Ag
26 Undue Influence article
27 Attorney- Client Confidentiality
28 Pick up Docs
29 Executor to Pay and Notify Creditor
30 NJlaws website & articles
31 Trusts
32 Caveat to Will
33 Central Jersey Elder articles
34 ABA Estate Plan Winter 2008
35 Estate Plan ABA Nov 2007
36 ABA ELDER News Aug 2007 GP
37ABA ELDER LAW COMMITTEE Newsletter July 2007 ABA General Practice
38 Estate Probate ABA news May. 2007
39 Elder Law ABA news February, 2007
40 INTESTACY
41 If no Will
42 Probate Release Refund Bond
43 Lincoln 17- no charge
44 Guardianship bill
45 RETAINER Probate ESTATE
46 WILL - sign front notary
47Confidentiality Lt to Client
48 Elective Share of Spouse
49 Joint Bank Accounts Upon Death
50 ABA ELDER News Spring2008
51 ABA Elder Law Newsletter • April 2008
52 ABA GP Solo ELDER LAW COMMITTEE Newsletter July , 2008
53 ABA ELDER News Fall 2008
54 ABA ELDER News Winter 2009
55 ABA ELDER News Spring 2009
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2. PERSONAL INJURY SETTLEMENT PRESERVATION TRUSTS
By Thomas D. Begley, Jr., Esquire
Studies show that over 90 percent of the time a person receiving a personal injury settlement dissipates the funds within five years. There are three reasons why this is true. The first reason is that most people are not good money managers. Many people who are victims of personal injuries have never had money and are receiving a large sum at one time. They are often unsophisticated and do not have contacts with professional investment advisors. What to most people would seem a modest sum of money appears enormous to many of these unsophisticated people, and they believe that they can spend without restriction and never exhaust the settlement funds.
The second reason personal injury victims tend to squander their settlements is that many disabled people suffer from low self-esteem and tend to buy friendship by showering people with whom they would like to be friendly with gifts. Often, unscrupulous people learn of the existence of the personal injury settlement and feel that they are entitled to a portion of the settlement. This is particularly true in some family situations. It also could be true with strangers.
The third reason that personal injury plaintiffs exhaust their settlement funds quickly is that many of them are suffering from significant pain and are constantly receiving pain medication. This medication often clouds their judgment and leaves them prey for unscrupulous people.
The real purpose of a Settlement Preservation Trust is to protect the personal injury victim from their own weaknesses and to prevent them from exploitation by others. The trust is irrevocable and, if the recovery is significant, should involve a professional trustee as either sole trustee or co-trustee with a family member. The professional trustee is responsible for managing the lump sum portion of the settlement.
A Settlement Preservation Trust can be used in conjunction with a structured settlement. In this way, the benefits of the structured settlement, including utilization of a rated age and the income tax-free nature of the payments, can be preserved. Despite the existence of the Structured Settlement Protection Act, millions of structured settlement beneficiaries manage to sell their income stream each year. The Settlement Preservation Trust can restrict the sale of the structured settlement income stream by its terms, and the involvement of a professional trustee will make such a factoring transaction both unnecessary and unlikely.
In some cases, the entire settlement can be placed in a Settlement Preservation Trust, but in most instances it may be appropriate for the personal injury victim, assuming they are not receiving means-tested public benefits, to have control over a certain percentage of the recovery with the Settlement Preservation Trust being used as a safety net for the remaining settlement.
Copyright 2009 by Begley & Bookbinder, P.C., an Elder & Disability Law Firm with offices in Moorestown, Stone Harbor and Lawrenceville, New Jersey and Oxford Valley, Pennsylvania and can be contacted at 800-533-7227. The firm services southern and central New Jersey and eastern Pennsylvania.
Tom Begley Jr. is one of the speakers with Kenneth Vercammen at the NJ State Bar Association's Annual Nuts & Bolts of Elder Law & Estate Administration and co-author with Kenneth Vercammen, Martin Spigner and Kathleen Sheridan of the 500 plus page book on Elder Law.
Begley & Bookbinder, provides services in connection with protecting assets from nursing home costs, Medicaid applications, Estate Planning and Estate Administration, Special Needs Planning and Guardianships. If you have a legal problem in one of these areas of law, contact Begley & Bookbinder at 800-533-7227.
3. REDUCING A MEDICAID LIEN
By Thomas D. Begley, Jr., Esquire
There are three ways to reduce a Medicaid lien. These strategies can be used separately or in combination.
• Procurement Costs. Under New Jersey law, where a Medicaid recipient settles a case against a third party, the Medicaid lien can be reduced by attorneys’ fees and costs and expenses. Many lawyers simply ask for and receive a one-third or 25% reduction, depending on the engagement letter with the plaintiff. Expenses should always be included in the reduction. The procurement costs are based on a pro rata share. If the attorney’s fee is 33-1/3% and the costs and expenses are 10%, the total procurement cost should be 43%.
• Ahlborn. The second way to reduce a Medicaid lien is through the application of an Ahlborn argument. The Supreme Court discussed the Federal Anti-Lien Statute prohibiting liens against the property of an individual prior to his death on account of medical assistance paid. The court held that based on this statute, a state is prevented from attaching the past non-medical portion of the settlement. In the Ahlborn case, it was determined that the plaintiff received only one-sixth of the overall damages so that the right of the State of Arkansas was limited to one-sixth of the past medical claim. In order to determine the pro rata share to which the state is entitled, it is necessary to establish the reasonable value of the case. In the Ahlborn case, this was accomplished by a stipulation with the State Medicaid Agency. It is unlikely that will happen again. The stipulation could possibly be made by the defendant, but it would have to be a bona fide stipulation. A common method of arriving at the full value is to obtain a report from an expert witness, or finally a court order may be necessary. If the case is to be resolved by a settlement prior to trial and the State Medicaid Agency is unwilling to agree on a satisfactory reduction, it may be necessary to give notice to Medicaid and have the court enter the order.
• Collateral Source Rule. A third argument that could be made to reduce the Medicaid lien is the Collateral Source Rule. If a state has a Collateral Source Rule, such as exists in New Jersey, a Medicaid lien may not apply. Under the New Jersey statute, if a plaintiff receives or entitled to receive benefits for injuries allegedly incurred from any other source other than a joint tortfeasor, the benefit shall be disclosed to the court and the amount thereof which duplicates any benefit contained in the award shall be deducted from any award recovered by the plaintiff. The purpose of this type of statute is to avoid double recovery and reduce insurance costs. The statute prevents insured plaintiffs from seeking payment for costs for which they have already been compensated. In an interesting case, the plaintiff sought to enforce an ERISA lien against a personal injury settlement. The defendant argued that the money held in escrow could not be the specific funds that belong to the plaintiff ERISA plan, because the personal injury victim never came into possession of such funds as a matter of law. The personal injury plaintiff claimed that property recovered in New Jersey is not money on which the ERISA plan has an equitable claim. The personal injury victim took the position that the plan must pursue the tortfeasor itself. The court acknowledged that it must dismiss the claim, if the beneficiary never received such money in the tort action for medical benefits. "If state law prohibits a plaintiff's claim for medical benefits paid by his or her own insurance, there would be nothing to which Rhodia could attach its equitable lien or constructive trust and the court could not grant relief."
N.J.S.A. 30-4D-7.1(b).
2 Arkansas Department of Health and Human Services v. Ahlborn, 126 S. Ct. 1752 (2006).
3 42 U.S.C. §1396p(a)(1).
WE PUBLISH YOUR FORMS AND ARTICLES
To help your practice, we feature in this newsletter edition a few forms and articles PLUS tips on marketing and improving service to clients. But your Editor and chairs can't do it all. Please mail articles, suggestions or ideas you wish to share with others in our Tort and Insurance Committee.
Let us know if you are finding any useful information or anything you can share with the other members. You will receive written credit as the source and thus you can advise your clients and friends you were published in an ABA publication. We will try to meet you needs.
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You can become a published ABA author. Enjoy your many ABA benefits.
Send us your articles & ideas
To help your practice, we feature in this newsletter edition a few articles and tips on marketing and improving service to clients. But your Editor and chairs can't do it all. Please send articles, suggestions or ideas you wish to share with others.
General Practice, Solo and Small Firm Division:
Elder Law Committee and the ESTATE PLANNING, PROBATE & TRUST COMMITTEE
Who We Are
This committee focuses on improving estate planning skills, substantive law knowledge and office procedures for the attorney who practices estate planning, probate and trust law. This committee also serves as a network resource in educating attorneys regarding Elder Law situations.
To help your practice, we feature in this newsletter edition a few articles and tips on marketing and improving service to clients. But your Editor and chairs can't do it all. Please send articles, suggestions or ideas you wish to share with others.
Let us know if you are finding any useful information or anything you can share with the other members. You will receive written credit as the source and thus you can advise your clients and friends you were published in an ABA publication. We will try to meet you needs.
We also seek articles on Elder Law, Probate, Wills, Medicaid and Marketing. Please send your marketing ideas and articles to us. You can become a published ABA author.
________________________________________
The Elder Law Committee of the ABA General Practice Division is directed towards general practitioners and more experienced elder law attorneys. The committee consistently sponsors programs at the Annual Meeting, the focus of which is shifting to advanced topics for the more experienced elder lawyer.
This committee also focuses on improving estate planning skills, substantive law knowledge and office procedures for the attorney who practices estate planning, probate and trust law. This committee also serves as a network resource in educating attorneys regarding Elder Law situations.
Kenneth Vercammen, Esq., Co-Chair
Jay Foonberg, Beverly Hills, Co-chair, Author of Best Sellers "How to
Start and Build a Law Practice" and "How to get and keep good clients', Beverly Hills, CA JayFoonberg@aol.com>
KENNETH VERCAMMEN & ASSOCIATES, PC
ATTORNEY AT LAW
2053 Woodbridge Ave.
Edison, NJ 08817
(Phone) 732-572-0500
(Fax) 732-572-0030
Central Jersey Elder Law www.centraljerseyelderlaw.com
NJ Elder Blog http://elder-law.blogspot.com/
Estate Planning Ideas for Professionals and People who advise Seniors
Free Seminar- 2009 update Wills and Estate Planning
WHEN: Wednesday October 14, 2009 12:15-1:00 PM
WHERE: Law Office of Kenneth Vercammen, 2053 Woodbridge Ave, 2nd floor, Edison, NJ
The cost for this program previously at Middlesex County College was $29.00. If you email back prior to October 10 you can attend for free.
COST: Free if you pre-register. This program is limited to 15 people
Complimentary Sandwiches to pre-registered persons at 12:10
SPEAKER: Kenneth Vercammen, Esq.
(Author- Answers to Questions About Probate)
The new NJ Probate Law made a number of substantial changes in Probate and the administration of estates and trusts in New Jersey.
Main Topics:
1. The New Probate Law and preparation of Wills
2. 2009 increases in Federal Estate and Gift Tax exemption
3. NJ Inheritance tax
4. Power of Attorney
5. Living Will
6. Administering the Estate/ Probate/Surrogate
7. Question and Answer
COMPLIMENTARY MATERIAL: Brochures on Wills, "Answers to Questions about Probate" and Administration of an Estate, Power of Attorney, Living Wills, Real Estate Sales for Seniors, and Trusts.
Here is your opportunity to listen to an experienced attorney who will answer questions how to distribute your property as you wish and avoid many rigid provisions of state law.
Co-Sponsor: Middlesex County Estate Planning Council
To attend or for Information: Mike McDonald 732-572-0500
or email kenvnjlaws@verizon.net
Can’t attend? We can email you materials
Send email to kenvnjlaws@verizon.net
Our Summer 2009 NJ Probate Email Newsletter discussed increased duties of the Executor or Administrator. The email newsletter also discussed how the revised NJ Probate Law makes a number of substantial changes in Probate and the administration of estates and trusts in New Jersey. If you send us your e-mail address we can provide you with a Free report on the changes in the law which may affect you. We also recently established the NJ Elder Law blog at http://elder-law.blogspot.com.
Website www.njlaws.com now provides Legal Information on Probate and Elder Law.
Very truly yours,
KENNETH VERCAMMEN
Chair ABA Elder Law Committee, Solo & Small Firm Division
To receive the njlaws Free Legal newsletter via email with Estate Administration & Probate information, email us at kenvnjlaws@verizon.net or fax us your email address.
Fax 732-572-0030
We send the newsletter via email only.
Email address: __________________________
Saturday, October 10, 2009
§ 10:49-14.6 Contracts with county welfare agencies | ||||
Payment shall be made by the Department of Human Services/Division of Medical Assistance and Health Services to the CWA for conducting investigations and for determining whether applicants qualify for benefits under the New Jersey Medicaid or NJ FamilyCare program. | ||||
HISTORY: | ||||
Amended by R.1997 d.354, effective September 2, 1997. | ||||
See: 29 N.J.R. 2512(a), 29 N.J.R. 3856(a). | ||||
Amended by R.1998 d.154, effective February 27, 1998 (operative March 1, 1998; to expire August 31, 1998). | ||||
See: 30 N.J.R. 1060(a). | ||||
Inserted a reference to NJ KidCare. | ||||
Adopted concurrent proposal, R.1998 d.487, effective August 28, 1998. | ||||
See: 30 N.J.R. 1060(a), 30 N.J.R. 3519(a). | ||||
Readopted the provisions of R.1998 d.154 without change. | ||||
Amended by R.2003 d.82, effective February 18, 2003. | ||||
See: 34 N.J.R. 2650(a), 35 N.J.R. 1118(a). | ||||
Amended by R.2008 d.230, effective August 4, 2008. | ||||
See: 40 N.J.R. 984(a), 40 N.J.R. 4531(a). | ||||
Section was "Contracts with county boards of social services". Substituted "CWA" for "county boards of social services (CBOSS)". | ||||
§ 10:49-14.5 Administrative charges/service fees
(a) A provider shall not pay nor require payment of an administrative charge or service fee for the privilege of doing business with another provider or for services for which reimbursement is included as part of the Medicaid or NJ FamilyCare fee.
1. An example of a prohibited practice is that a nursing facility may not require a pharmacy to pay an administrative charge or service fee to the facility for handling of the nursing facility resident's medications, drugs and/or related pharmaceutical records.
HISTORY:
Amended by R.1997 d.354, effective September 2, 1997.
See: 29 New Jersey Register 2512(a), 29 New Jersey Register 3856(a).
Deleted (a)2.
Amended by R.1998 d.154, effective February 27, 1998 (operative March 1, 1998; to expire August 31, 1998).
See: 30 New Jersey Register 1060(a).
In (a), inserted a reference to NJ KidCare.
Adopted concurrent proposal, R.1998 d.487, effective August 28, 1998.
See: 30 New Jersey Register 1060(a), 30 New Jersey Register 3519(a).
Readopted the provisions of R.1998 d.154 without change.
Amended by R.2003 d.82, effective February 18, 2003.
See: 34 New Jersey Register 2650(a), 35 New Jersey Register 1118(a).
(a) A provider shall not pay nor require payment of an administrative charge or service fee for the privilege of doing business with another provider or for services for which reimbursement is included as part of the Medicaid or NJ FamilyCare fee.
1. An example of a prohibited practice is that a nursing facility may not require a pharmacy to pay an administrative charge or service fee to the facility for handling of the nursing facility resident's medications, drugs and/or related pharmaceutical records.
HISTORY:
Amended by R.1997 d.354, effective September 2, 1997.
See: 29 New Jersey Register 2512(a), 29 New Jersey Register 3856(a).
Deleted (a)2.
Amended by R.1998 d.154, effective February 27, 1998 (operative March 1, 1998; to expire August 31, 1998).
See: 30 New Jersey Register 1060(a).
In (a), inserted a reference to NJ KidCare.
Adopted concurrent proposal, R.1998 d.487, effective August 28, 1998.
See: 30 New Jersey Register 1060(a), 30 New Jersey Register 3519(a).
Readopted the provisions of R.1998 d.154 without change.
Amended by R.2003 d.82, effective February 18, 2003.
See: 34 New Jersey Register 2650(a), 35 New Jersey Register 1118(a).
§ 10:49-14.4 Recoveries involving a county welfare agency (CWA) | ||
(a) The purpose of this section is to define areas of responsibility and establish basic principles and procedures in those collection activities in which the Division of Medical Assistance and Health Services (DMAHS), the Division of Family Development (DFD) and/or a county welfare agency (CWA) may be involved. It is intended that maximum conservation of public funds be effected without duplication of effort. It is recognized that certain situations may fall into more than one of the following categories. Any such matter will be processed in accordance with the provisions of the first occurring applicable category. | ||||
(b) The following pertain to incorrectly granted assistance (cash and/or medical assistance): | ||||
1. In instances involving incorrect eligibility for medical assistance, whether or not in combination with cash assistance, the CWA shall determine the period(s) of ineligibility and ascertain from DMAHS the amount of medical assistance incorrectly granted. The CWA shall then attempt recovery of medical assistance incorrectly granted either by administrative collection, or by way of restitution in a criminal or disorderly persons proceeding. | ||||
i. Recoveries or attempts at recoveries can be made from those persons specified in N.J.S.A. 30:4D-7i. | ||||
2. When recovery cannot be obtained by these methods in a case generated by the Internal Revenue Service (IRS) unearned income component of the Income and Eligibility Verification System (IEVS), the case shall be referred by the CWA to DMAHS for possible initiation of recovery proceedings. | ||||
3. When, in any other case not generated by IEVS, recovery cannot be obtained by these methods, the CWA is authorized, after securing DMAHS approval, to initiate recovery proceedings as DMAHS' agent. If the CWA does not initiate such recovery proceedings, it shall refer the case to DMAHS for possible initiation of recovery proceedings. | ||||
4. When collection occurs in a case involving both cash assistance and medical assistance, the CWA shall, in the absence of court instruction to the contrary, apply the proceeds to the repayment of cash assistance and the reimbursement of DMAHS for medical assistance. The reimbursement shall be made payable to the Treasurer, State of New Jersey, which shall then reimburse the CWA in the amount of 25 percent of the gross recovery on a periodic basis to be determined by DMAHS. | ||||
5. When a CWA recovers only for medical assistance improperly granted, the CWA shall remit the proceeds to DMAHS. The reimbursement shall be made payable to the Treasurer, State of New Jersey, who will then reimburse the CWA in the amount of 25 percent of the gross recovery on a periodic basis to be determined by DMAHS. | ||||
6. When any CWA action, whether alone or in combination with DMAHS, results in a recovery of improperly granted medical assistance from a case generated by the Internal Revenue Service (IRS) unearned income component of the IEVS match, all funds recovered shall be remitted to DMAHS payable to the Treasurer, State of New Jersey, which shall then reimburse the CWA in the amount of 25 percent of the gross recovery on a periodic basis to be determined by DMAHS. | ||||
(c) The following pertain to third-party liability claims in tort actions: | ||||
1. Whenever either a CWA or DMAHS learns of a situation in any case in which the other may have a claim, it will notify the other. | ||||
2. Unless the individual case circumstances intervene, the first claim after settlement or judgment is for any payments by New Jersey Medicaid or NJ FamilyCare program arising from the occurrence, notwithstanding any CWA claim for recovery of cash assistance. The next claim is that which the CWA may assert in accordance with an agreement to repay or similar document. The DMAHS and the CWA will, insofar as their controls allow, maintain priority of payment in the above order. | ||||
(d) The following pertain to liquidation of potential resources: | ||||
1. The CWA will participate in the liquidation of potential resources according to the Program requirements under which eligibility has been established, regardless of whether cash assistance is being granted. Notification of the potential resource to be liquidated shall be forwarded to DHSS, enabling it to seek a voluntary contribution. Sale of real property to which title is held by a CWA is subject to DFD approval in all instances regardless of the proposed distribution of the proceeds. | ||||
2. All funds arising from the liquidation of resources and which, by action of law, regulation, or agreement with the owner, fall under the jurisdiction of either a CWA or DHSS for distribution will, insofar as possible, be allocated as follows: | ||||
i. Proceeds will be first applied to the cash costs of liquidation, such as advertising costs and filing fees, but not including costs, such as CWA staff time, supplies, counsel fees or overhead. | ||||
ii. Proceeds will be next applied to any claims superior to that of the CWA (for example, taxes). | ||||
iii. Proceeds will be next applied to any funds owing to and collectible by the CWA. | ||||
iv. Any residue remaining after the above payments are allocated would, in the absence of circumstances to the contrary, be the property of the client and thereby subject to (d)3 below. | ||||
3. All funds properly belonging to a beneficiary free of any agency claim are to be remitted to the beneficiary as promptly as possible or otherwise disbursed at the beneficiary's instruction. The CWA will promptly reevaluate eligibility following such distribution, taking into consideration any voluntary repayment to the New Jersey Medicaid or NJ FamilyCare program. | ||||
(e) The following pertains to recovery from estates of deceased beneficiaries: | ||||
1. The CWA shall normally undertake recovery activity as agent for DMAHS in any case in which the CWA is or will be undertaking activities on its own account. However, in those cases where the recovery of medical assistance is possible and where the entire CWA claim is for burial expenses only, DMAHS shall initiate recovery activity inclusive of CWA burial costs. DMAHS may, in certain cases, assume direct jurisdiction in recovery of its claim concurrent with CWA activity. DMAHS shall make the CWA aware of its activity in such cases. | ||||
2. CWA recoveries and distribution shall be in accord with the following procedures: | ||||
i. From the proceeds of liquidation, the CWA shall first recover the amount necessary to satisfy its own claim, including costs of liquidation and the claims of other New Jersey CWAs. The CWA shall recover funds from the clearing account in the order in which the funds were received in the clearing account. If any part of any remaining surplus has been received from the proceeds of assigned life insurance for which there was a named beneficiary other than the client's estate, that surplus or the policy benefit, whichever is less, is the property of the beneficiary and should be so directed. | ||||
ii. All other surplus funds are part of (or the entire) the client's estate and are payable to the legally designated representative of the estate. If the representative of the estate is unknown or if no representative has been appointed and there are no known next of kin, the CWA shall forward to the DMAHS an amount not to exceed the amount of the proper medical assistance claim as determined by communication with the Administrator, Bureau of Administrative Control, DMAHS. Any remaining funds will escheat to the State of New Jersey. | ||||
iii. When there are known next of kin, the CWA shall request the next of kin to take appropriate legal action to be appointed administrator if the amount to be disbursed is greater than the claim of the New Jersey Medicaid or NJ FamilyCare program. If the claim of the New Jersey Medicaid or NJ FamilyCare program will equal or exceed the estate, the CWA shall request the next of kin to sign a consent to transfer his or her rights to the New Jersey Medicaid or NJ FamilyCare program and, upon receipt of such signed consent, the CWA shall forward the funds to DMAHS. | ||||
iv. When the next of kin will not sign a consent to transfer his or her right to the Medicaid Agent and DMAHS and will not file to become the administrator, the CWA may, at its option, arrange for someone to file to become administrator or the CWA may refer the information to DMAHS for action. | ||||
v. In any questions or dispute among two or more claimants on surplus funds, the CWA shall withhold payment pending resolution by mutual consent of all claimants or by court order. | ||||
3. The Medicaid Agent or DMAHS recoveries and distribution shall be in accordance with the following procedures: | ||||
i. DMAHS shall undertake recovery activity in medical assistance payment cases in which no CWA shall be submitting a claim. However, should information from the CWA be necessary to such DMAHS activity, the CWA shall communicate with DMAHS, supplying such material as may be required. | ||||
ii. In cases in which DMAHS is acting for a CWA in collection of burial expenses, DMAHS shall accord payment of the burial claim priority over its own recovery. | ||||
(f) The CWA may at any time accept an offer of voluntary repayment, either on its own behalf or on behalf of the New Jersey Medicaid or NJ FamilyCare program, up to but not in excess of the amount of assistance granted. To any inquiry as to amount granted, the CWA shall supply the appropriate information, identifying the respective amounts granted by the CWA and the Medicaid Agent or DMAHS. In the absence of instruction from the payer, the CWA will reimburse cash assistance first and then remit any balance to DHSS. | ||||
1. Compromise settlements of medical assistance are subject to DHSS approval. | ||||
(g) Regarding compromise settlements: | ||||
1. Compromise settlements of cash assistance are subject to DFD approval. | ||||
2. Compromise settlements of medical assistance are subject to DMAHS approval. | ||||
(h) This section shall apply to all pending and future recovery cases, except that: | ||||
1. The 25 percent incentive payments provided for in (b)4 and 5 above shall apply to all non-IEVS incorrect payment recoveries received by the CWA on or after July 1, 1993. | ||||
2. Paragraph (b)6 above applies to all IEVS-related recoveries received on or after July 1, 1989 by either DMAHS or the CWA, whichever agency is handling the recovery. | ||||
HISTORY: | ||||
Amended by R.1995, d.105, effective June 19, 1995. | ||||
See: 26 N.J.R. 3348(a), 27 N.J.R. 2466(a). | ||||
Amended by R.1997 d.354, effective September 2, 1997. | ||||
See: 29 N.J.R. 2512(a), 29 N.J.R. 3856(a). | ||||
In (a), amended and deleted Division references and substituted "New Jersey Medicaid program" and "Medicaid Agent" for "DMAHS" throughout; and added (f)1. | ||||
Amended by R.1998 d.154, effective February 27, 1998 (operative March 1, 1998; to expire August 31, 1998). | ||||
See: 30 N.J.R. 1060(a). | ||||
In (c), (d), (e) and (f), inserted references to NJ KidCare throughout; in (e)2iv, inserted a second reference to DMAHS; and in (e)3 and (f), inserted references to DMAHS. | ||||
Adopted concurrent proposal, R.1998 d.487, effective August 28, 1998. | ||||
See: 30 N.J.R. 1060(a), 30 N.J.R. 3519(a). | ||||
Readopted the provisions of R.1998 d.154 with changes, effective September 21, 1998. | ||||
Amended by R.2003 d.82, effective February 18, 2003. | ||||
See: 34 N.J.R. 2650(a), 35 N.J.R. 1118(a). | ||||
Rewrote the section. | ||||
Amended by R.2008 d.230, effective August 4, 2008. | ||||
See: 40 N.J.R. 984(a), 40 N.J.R. 4531(a). | ||||
Section was "Recoveries involving county board of social services (CBOSS)". Substituted "CWA" for "county board of social services (CBOSS)" throughout; in (a), substituted "welfare agency (CWA)" for "board of social services (CBOSS)"; in (b)3, inserted a comma following "When", "authorized" and "approval"; in the introductory paragraph of (c), substituted "third-party" for "third party"; in (c)2, inserted a comma following "occurrence" and substituted "CWA" for "(CBOSS)"; in (d)2i, inserted a comma following the first occurrence of "fees" and the second occurrence of "costs"; in the introductory paragraph of (e)2, substituted "CWA" for "County board of social services (CBOSS)"; and in (e)2i, substituted "CWAs" for "county board of social services (CBOSS)s". | ||||
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