Some common abbreviations in regulations and in our office:

A/R – Applicant/Recipient

Authorized Representative – Individual and/or agency that has consent/authorization to represent the A/R with the DSS for the Medicaid application (that’s us!)

MA (also MCD) – Medicaid

MC – Medicare

Institutionalized Spouse – the spouse that is the facility

Community Spouse – the spouse who is still living at home or in an assisted living – NOT on Medicaid to pay the assisted living

NAMI – Net Available Monthly Income – the amount that is considered the “client share” to be paid monthly to the facility from the client gross income less allowable deductions

Resources – Asset balances that are considered when determining eligibility

Exempt Resources – A resource that meets an exemption standard

DSS – Department of Social Services

LDSS – Local Department of Social Services – seen frequently in the actual regulations

ECDSS – Erie County Department of Social Services – an abbreviation seen commonly in our office

NCDSS – Niagara County Department of Social Services – an abbreviation seen commonly in our office

GIS – General Information System – These are periodic updates and/or clarifications to the Medicaid regulations

Coverage Date – The date the A/R needs Medicaid coverage to begin. They must be at or below the eligibility limit AND have an unpaid nursing home bill that exceeds the total of any excess resources and/or NAMI for the month

Snapshot Date – The term used to refer to the date that the resource level is calculated on. The “snapshot” date is ALWAYS the first of the month. If you are not eligible on the first “snapshot” date, they move to the next “snapshot” date to evaluate resource level.

Uncompensated Transfer of Asset – A transfer for which the A/R did not receive full market value or a transfer of cash where A/R did not receive a product or service of equal value. This causes a sanction or penalty on the Medicaid coverage.

Sanction/Sanction Rate – Sanction is term for the penalty imposed for an uncompensated transfer of an asset. Sanction Rate is determined yearly by NYS and varies by area. We are in the Western NY region. This rate is used to determine how many months of a penalty to impose.