Quite often I get asked if Nursing Home Medicaid is the same in every state. The short answer is no. The federal government has provided the states with parameters of what can and cannot happen when it comes to their rules for Medicaid qualification. Failure to comply with these federal guidelines can result in a state not receiving Medicaid funds from the federal government. Interestingly, not all states comply and essentially “get away” with deviation from the federal rules. Case in point is the state of California. The California legislature has opted to call their program “MediCal.” In contrast to Michigan, California has only a thirty (30) month lookback for gifts or what we call in the business “divestments” which are transfers in violation of the federal mandate. Here in Michigan, we’re at compliance with the federal five (5) year or sixty (60) month lookback. Another deviation in California is that in cases where there is an “at home spouse”, a couple can convert cash monies or any other assets into “income” for the benefit of the “at home spouse” with no strings attached by the state for future claim. How is this happening? For some time the Federal government seems to have just turned a “blind eye” to the uniqueness of California’s Medicaid qualification rules and to date has not “dis-enrolled” the state from receiving Long term care Medicaid funds. Will the Federal government change its mind and decide “enough is enough” and come down hard on the California legislature? Only time will tell. I’ll be sure to keep you up to date!