Expanding Health Care Coverage

Grantee Name

The Nelson A. Rockefeller Institute of Government, The State University of New York

Funding Area

Expanding Health Care Coverage

Publication Date

December 2012

Grant Amount


Grant Date:

November 2009 – January 2011


Under Medicaid’s rules, an individual’s income and assets are taken into consideration when determining his or her eligibility for long-term care coverage.

Those having either income or assets that exceed the annual limits are not eligible. Applicants who transferred their assets (to other family members or to a trust, for example) within five years of applying for Medicaid long-term care coverage are also not eligible. According to a March 2009 report published by the Nelson A. Rockefeller Institute of Government (Rockefeller Institute) and funded by the New York Health Foundation (NYHealth), there is substantial variation and difference in the magnitude of Medicaid denial rates of long-term care coverage across New York’s 62 counties. With a Phase 2 grant from NYHealth, the Rockefeller Institute conducted a study to uncover possible reasons for discrepancies in denial rates and provide actionable recommendations to standardize practices throughout the State.

Outcomes and Lessons Learned

  • Met with 16 counties to better understand their eligibility determination processes.
  • Developed a set of recommendations to standardize the approval process and minimize denial rate variation for Medicaid long-term care benefits.
  • Released a report, “Room for Interpretation: Causes of Variation in County Medicaid Asset Transfer Rates, Opportunities for Cost Reduction,” which laid out potential and actionable changes that could be implemented at the Federal and State levels.

Read the report associated with this grant, “Room for Interpretation: Causes of Variation in County Medicaid Asset Transfer Rates, Opportunities.”