In the past week, we have had two cases in our office where Nassau County is making claims against the refusing spouse. For the past few years, we have not seen such claims being made. This may be a signal that Nassau County is going to be more aggressive in refusal cases.

Today, there was an article in the New York Times describing Lt. Governor Ravitch’s report on overhauling Medicaid. The report covers recommends major changes in the Medicaid program to control the increasing cost of the program here in New York.

The report, in part, has take aim at a policy called “spousal refusal,” which permits families that meet the standards to afford long-term care for an ailing spouse to shift assets so that Medicaid will pay the cost.

The doctrine of spousal refusal, the report says, is “vulnerable to abuses that divert resources from Medicaid’s legitimate purpose – serving as a safety net for the needy – and turn the program into an entitlement for the less needy.”

Before the community spouse signs a “spousal refusal,” we advise the spouse of the options that are available to her prior to the and post the filing of the Medicaid application. Steps can be taken to avoid spousal refusal while accessing Medicaid for the institutionalized spouse; as well as post-Medicaid application to minimize the refusing spouse’s exposure to a claim or lawsuit.