Why a "Medicaid Specialist" isn't Enough
Lisa Nachmias Davis
Davis O'Sullivan & Priest LLC
Lately, individuals who are not lawyers have been hawking their services as "Medicaid specialists." They claim they can help you apply for Medicaid for a loved one, inexpensively and effectively. Why doesn't that make sense? Why should you seek help from a lawyer instead, or in addition?
First, let's be clear. When I say "a lawyer" I don't mean any Tom, Dick or Harry who hangs out a shingle and claims to practice "elder law." This is happening more and more as the population ages. You should do your homework. "Elder law" and Medicaid law change constantly, sometimes from day to day. Just because someone helped a person apply for Medicaid entering a nursing home two years ago doesn't mean that person is qualified to tell you what the rules are today or what all the options may be. When looking for an attorney, get as much information as you can about the person's expertise and constant involvement in this field of law, keeping current, giving presentations, belonging to organizations that keep current in the field, peer and client recommendations, etc. It's helpful if the person is a member of the National Academy of Elder Law Attorneys (www.naela.org) or has been "certified" by the National Elder Law Foundation (www.nelf.org) although neither is a guarantee of a good attorney, of course. And of course the lawyer should be in the state where Medicaid is being sought. So when I saw "lawyer" I mean a lawyer who practices actively in the field of elder law, and keeps current.
Why use a lawyer and not a "Medicaid specialist"?
Rules Committee of the superior court of this state." (Rule 7.4 and 7.4A.) Nothing other than general rules about fraud prohibit anyone who is not a lawyer from claiming to be a "specialist" in anything.
Don't get me wrong. Lawyers certainly don't know everything and people who aren't lawyers can be very helpful. I call my assistant my "Benefits Specialist." She helps people with the nitty-gritty of applying for and keeping benefits of various kinds, including but not limited to the Medicaid that pays for nursing home care. She knows the insider rules, inside and out. (And her hourly rates are less than mine.) She knows who to call and where the forms should be filed. She works tirelessly to get the information you can't seem to find or didn't know was important. BUT -- she works with me and under my supervision. I can tell her when the law changes, and that the rulebook is now out of step. I can tell her when the rules conflict with federal law and are illegal. I'm the one who keeps current on what DSS is doing and not putting in the rule-books. I'm the one who can argue with the Policy Unit, or go to probate court to implement a strategy. She knows what she doesn't know and wasn't trained to know, and doesn't tell you you don't need a lawyer.
So -- a "Medicaid Specialist" is not enough. At a minimum, you need to consult an attorney who practices actively in the field of elder law to discuss options, strategies, and have the lawyer spot the issues you will miss. There is no substitute.*
*Of course, I don't guarantee that every lawyer is a good lawyer, returns calls, or charges fair fees (although unfair fees are also a violation of the Rules). Get information about fees up-front. Make sure there is a written agreement unless it's just a brief consultation. Don't be rushed into agreeing to anything. Be savvy when choosing a lawyer, too.