Thursday, June 23, 2011
In a continuation of the Obama Administration's effort to extend rights to same sex couples, the Centers for Medicare & Medicaid Services (CMS) issued a new State Medicaid Director Letter 11-006 (SMDL). There are currently federal protections against homelessness and financial ruin that apply to heterosexual couples. The SMDL sets out steps that states are permitted to take to extend these protections to same-sex spouses and domestic partners of individuals receiving Medicaid long-term care services. The SMDL, dated June 10, 2011, was written by Cindy Mann, Director of the Center for Medicaid, CHIP and Survey & Certification, CMS to all State Medicaid Directors. A copy is available at
The SMDL addresses provisions of Medicaid law having to do with the placement of liens against real property, the imposition of penalties for transferring assets without receiving fair market value and the recovery of property from a deceased Medicaid beneficiary's estate. It does not address provisions that allow a spouse receiving Medicaid for long-term care services to give a portion of his or her income to the non-Medicaid spouse to protect against impoverishment.