D.C. Seniors May Lose Coverage Due to Shift in Income

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Seniors in D.C. who have a shift in income may no longer be able to afford their in-home care. One senior began to receive a little more money after her husband passed away. That money then put her over the income limitation for in-home care Medicaid benefits. This has been happening with many other seniors in D.C. and they are not able to pay for their care in-home without benefits so they are forced to go into a nursing home.

Suzanne Jackson, a professor of healthcare law at The George Washington University, has been fighting cases similar to this for the past few years. The state Department didn’t enforce this cutoff of income until recently which removed over a hundred people from Medicaid’s benefits. However, Jackson says this should not be allowed due to the federal law that requires them to apply “post-eligibility treatment of income” (PETI) to any additional income they receive.

To generalize, PETI would have the senior take the income that is over the limit and simply put it towards their care but PETI is not currently being applied to cases. The department says the federal law that supports PETI would not actually apply to a case such as the above mentioned. In most cases, the court has sided with the department. Jackson still has a few cases pending.