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Dear Clients, Colleagues, and Friends,

As we approach the end of 2025, we want to take this opportunity to thank you for your continued trust in our practice. Elder law and estate planning are deeply personal areas of practice, and it is a privilege to help individuals and families navigate important decisions that protect independence, dignity, and legacy.

This year has brought significant changes to estate planning and elder law, particularly affecting New York State residents. We're committed to keeping you informed about developments that may impact you and your loved ones.

CRITICAL MEDICAID AND ELDER LAW UPDATES

On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law, which included several provisions that directly impact Medicaid planning and long-term care access for New Yorkers. These changes make early planning more important than ever.

Home Equity Limits Being Capped

Beginning January 1, 2028, Medicaid will impose a firm $1,000,000 cap on home equity for long-term care eligibility, with no future inflation adjustments. Currently, the New York home equity limit is $1,097,000 and in 2026, New York will allow a home equity of up to $1,130,000. This change of capping the home equity will make it more difficult for individuals with substantial home equity to qualify for Medicaid long-term care benefits unless specific exceptions apply (such as having a spouse or disabled child living in the home).

Action Item: If you have significant home equity and anticipate needing long-term care in the future, now is the time to explore planning strategies such as irrevocable trusts or other asset protection techniques. Remember that Medicaid has a five-year look-back period for asset transfers, so planning well in advance is essential.

Home and Community-Based Services Restrictions

The new law imposes "budget neutral" requirements on the waivers states use to provide home and community-based services. For New Yorkers, this could lead to reduced availability of services that help seniors remain in their homes rather than entering nursing homes. Programs such as the Managed Long-Term Care (MLTC) and Consumer Directed Personal Assistance Program (CDPAP) may face increased scrutiny and potential limitations.

New York-Specific Home Care Changes

In addition to federal changes, New York State implemented new minimum needs requirements for certain Medicaid-covered home-care services starting September 1, 2025. Applicants for Personal Care Services (PCS), Consumer Directed Personal Assistance Program (CDPAP), and Managed Long-Term Care (MLTC) are now assessed under updated functional need standards, focusing more closely on Activities of Daily Living (ADLs) such as bathing, dressing, walking, and using the bathroom. If you were already authorized for these services before September 1, 2025, you are generally grandfathered under the old rules unless your coverage lapses.

Eligibility Re-determinations

After December 31, 2026, Medicaid eligibility re-determinations will occur every six months instead of annually, requiring more frequent documentation and oversight. This means New York Medicaid recipients will need to maintain careful records and be prepared to provide updated financial information twice per year.

Reduced Retroactive Coverage

The law reduces retroactive Medicaid coverage from three months to two months for applications made after December 31, 2026. This makes timely application even more critical, particularly for New Yorkers who may be facing unexpected nursing home costs.

Nursing Home Reimbursement Challenges

Changes to how nursing homes are reimbursed under Medicaid could lead to financial pressures on New York facilities, potentially resulting in closures, reduced services, or increased private-pay costs. The law also includes a 10-year moratorium on implementing national minimum staffing standards for nursing homes. Given New York's already high cost of long-term care, these changes may significantly impact the availability and quality of nursing home care in our state.

Community Spouse Resource Allowance (CSRA)

On a positive note, the maximum Community Spouse Resource Allowance will increase to $162,660 (up from $157,920 in 2025). This is the amount of assets a healthy spouse can retain when their partner receives Medicaid long-term care benefits. The minimum monthly maintenance needs allowance will increase in 2026, and in New York, where the maximum monthly maintenance needs allowance is utilized, healthy spouses can keep $4,066.50 of income per month (up from $3,948 per month in 2025). These increases provide some additional financial protection for community spouses in New York.

Understanding New York’s Medicaid Look-Back Rules

It’s important to remember that New York Medicaid continues to enforce a five-year look-back period for institutional (nursing home) care. Transfers or gifts made for less than fair market value within five years of applying for nursing home Medicaid can result in a penalty period of ineligibility. While legislation has authorized a 30-month look-back period for community (home care) Medicaid, its implementation remains uncertain at this time. Given these distinctions—and the potential for future changes—advance planning remains essential, particularly for individuals seeking to preserve assets while maintaining eligibility options.

MAJOR ESTATE TAX CHANGES: THE ONE BIG BEAUTIFUL BILL ACT

The OBBBA also brought substantial changes to estate and gift tax planning. This legislation provides rare clarity in an area that has been marked by uncertainty in recent years.

Key Estate Tax Provisions

Federal Estate and Gift Tax Exemption Increase

The federal estate, gift, and generation-skipping transfer (GST) tax exemption has been increased to $15 million per individual ($30 million per married couple), effective January 1, 2026. This represents an increase from the current 2025 exemption of $13.99 million per person. Importantly, this new exemption amount is permanent and will continue to be adjusted for inflation in future years.

What This Means

The long-standing uncertainty surrounding the potential expiration of higher federal exemptions (the “sunset”) at the end of 2025 has now been resolved, providing greater clarity for long-term planning. Families with substantial estates have increased flexibility when structuring wealth transfer strategies, though thoughtful and strategic planning remains essential to fully maximize available tax benefits. Even with higher exemption levels, time continues to be one of the most powerful planning tools—making transfers sooner allows future appreciation to occur outside of a taxable estate.

Critical New York State Estate Tax Considerations

While federal exemptions have increased, New York State maintains its own estate tax with a significantly lower threshold. Currently, New York's estate tax exemption is $7.16 million per person, to increase to $7.35 million per person in 2026. It remains unclear whether New York will increase its exemption to match the new federal amount. This means that even with the higher federal exemption, many New York residents will still face state estate tax exposure.

Important: New York has a unique "cliff" provision where estates valued between 100% and 105% of the exemption amount face a phase-out of the exemption. For estates exceeding 105% of the exemption amount (about $7.7 million in 2026), no exemption is available at all, and the entire estate is subject to New York estate tax from the first dollar. This makes careful planning essential for New York residents with estates approaching or exceeding $7 million.

Annual Exclusion Gifts: Important Limitations

For 2025, individuals can gift up to $19,000 per recipient ($38,000 for married couples) to as many people as they wish without using any lifetime exemption or filing a gift tax return. It appears that this amount will remain the same for 2026.

CRITICAL WARNING: Annual exclusion gifting may not be appropriate for everyone:

• If your estate is well below the federal and New York exemption thresholds (under $7 million for individuals, under $14 million for couples), annual exclusion gifting provides no estate tax benefit and may be unnecessary.
• Annual exclusion gifts can trigger Medicaid penalties. Any gifts made within five years of applying for Medicaid long-term care benefits will result in a period of ineligibility. For example, a gift of $19,000 could result in more than one month of ineligibility based on current New York Medicaid rules. If you anticipate needing long-term care within the next five years, gifting could jeopardize your Medicaid eligibility.

Bottom Line: Estate tax planning and Medicaid planning often have conflicting goals. Making gifts to reduce estate taxes can create Medicaid ineligibility. Always consult with an attorney who understands both areas before making any substantial gifts.

WHY PLANNING MATTERS NOW MORE THAN EVER

While the increased federal exemptions may lead some to believe estate planning is no longer necessary, nothing could be further from the truth—especially for New York residents. Here's why thoughtful planning remains essential:

• New York State Estate Tax: With a $7.35 million exemption in 2026 and harsh cliff provisions, New York estate tax planning remains critical for many families, regardless of the higher federal exemption.
• Medicaid Planning Urgency: The new home equity cap and service restrictions make advance Medicaid planning crucial. The five-year look-back period means you need to plan today for potential care needs years from now.
• Protection Beyond Taxes: Estate planning ensures your wishes are honored, protects vulnerable family members, avoids probate delays, and provides for smooth business succession.
• Long-Term Care Costs: New York has some of the highest long-term care costs in the nation. Proper planning is essential to protect your assets while ensuring access to quality care.
• Balancing Competing Goals: Estate tax minimization and Medicaid eligibility often require different strategies. Professional guidance can help you navigate these competing priorities.

RECOMMENDED ACTIONS FOR YEAR-END

As 2025 comes to a close, you should consider the following action items:

• Review Your Existing Estate Plan: Ensure your documents reflect current New York and federal law, your wishes, and your family situation. If your plan was created before recent changes, it likely needs updating.
• Evaluate Your Estate Tax Exposure: If your estate approaches $7 million, consult with an attorney about strategies to minimize New York estate tax, such as lifetime gifts, trusts, or charitable planning.
• Start Medicaid Planning Early: Don't wait until care is imminent. With the five-year look-back period for nursing home care and possibility of implementation of the lookback for home care services, along with the new restrictions taking effect in 2028, now is the time to explore irrevocable trusts and other asset protection strategies.
• Be Cautious About Gifting: Before making any gifts—even annual exclusion gifts—consider whether you might need Medicaid within the next five years. A seemingly harmless gift today could cost you eligibility when you need it most.
• Update Beneficiary Designations: Review beneficiaries on retirement accounts, life insurance policies, and bank accounts to ensure they align with your overall plan.
• Document Your ADLs: If you may need home care services, work with your doctor to ensure your functional limitations are clearly documented in your medical records.

LOOKING AHEAD TO 2026

The estate planning and elder law landscape continues to evolve, particularly for New Yorkers who must navigate both state and federal regulations. While we now have greater certainty regarding federal estate tax exemptions, several critical questions remain: Will New York increase its estate tax exemption to match the federal amount? How will the state implement the new Medicaid restrictions? What impact will reduced federal funding have on New York's long-term care system?

We're monitoring these developments closely and will keep you informed as answers emerge. In the meantime, we encourage you not to delay in addressing your planning needs. The combination of New York's unique tax structure, impending Medicaid restrictions, and the five-year look-back period creates both challenges and opportunities that require prompt attention.

OUR COMMITMENT TO YOU

As we close out 2025, we extend our sincere thanks to our clients, their families, and our professional colleagues for your continued confidence and collaboration.

Whether you're creating your first estate plan, updating existing documents, navigating Medicaid eligibility, or planning for long-term care, we're here to help you protect what matters most. Please reach out to us to schedule a review or for anything else that we can assist you with.

Wishing you and your loved ones a healthy, peaceful, and prosperous New Year.

Warm regards,

Esther Zelmanovitz

DISCLAIMER: This newsletter is provided for informational purposes only and does not constitute legal advice. Estate planning and elder law are complex areas, and the information provided here is general in nature. Every situation is unique, and you should consult with an attorney about your specific circumstances. The information in this newsletter is current as of December 2025 and is subject to change. This newsletter is directed primarily to New York State residents and reflects New York law and practice.

Attorney Advertising.

When creating your estate plan, one of the most important decisions you'll make is selecting a fiduciary. This choice deserves careful consideration, as it will impact how your wishes are carried out and your loved ones are protected.

What Is a Fiduciary?

A fiduciary is someone who is legally obligated to act in your best interests with the highest degree of care, loyalty, and good faith. This legal standard—known as a fiduciary duty—is one of the strongest obligations recognized under the law. It means the fiduciary must put your interests above their own and act with complete honesty and transparency in managing your affairs.

What Does a Fiduciary Do?

In the context of estate planning, a fiduciary may serve in various roles. They might act as an executor of your will, trustee of your trust, or agent under a power of attorney. Depending on their role, they may be responsible for distributing your assets after death, managing investments for beneficiaries, making healthcare decisions on your behalf, or handling financial matters if you become incapacitated. This is not a ceremonial position—it requires time, attention, and often difficult decision-making during emotionally challenging times.

Key Qualities to Look For

Trustworthiness and Integrity: This may seem obvious, but it bears emphasizing. Your fiduciary will have access to sensitive financial information and control over your assets. Choose someone whose judgment and character you trust implicitly.

Financial Competence: Your fiduciary doesn't need to be a financial expert, but they should have basic financial literacy and the ability to work with professionals like attorneys and accountants. If your estate is complex, consider whether the person has the sophistication to manage investments, real estate, or business interests.

Organizational Skills: Estate administration involves significant paperwork, deadlines, and attention to detail. A disorganized person, no matter how well-intentioned, may struggle with the administrative demands of the role.

Digital Literacy: In today's world, technological competence is essential. Most financial business—whether estate administration or simply receiving statements and paying invoices—happens via email or online. Your fiduciary should be comfortable sending and receiving emails, uploading and organizing digital documents, accessing financial accounts through secure portals, and communicating with attorneys and financial institutions electronically. While they don't need to be tech experts, basic comfort with computers and online systems is increasingly essential for efficient estate management.

Availability and Willingness: Make sure the person you're considering actually wants the responsibility and has the time to fulfill it. Being a fiduciary can be time-consuming, sometimes taking months or even years depending on the complexity of the estate.

Longevity and Proximity: Consider the person's age and health relative to your own. You want someone who will likely be available when needed. Geographic proximity can also matter, though modern technology has made distance less of an obstacle than it once was.

Family Member, Friend, or Professional?

Many people default to naming a spouse, adult child, or close friend as their fiduciary. While this can work well, it's not always the best choice. Family dynamics can complicate matters, especially if the fiduciary must make decisions that affect other family members. Some beneficiaries may question decisions or feel the fiduciary is showing favoritism.

Professional fiduciaries—such as trust companies, banks, or professional trustees—offer objectivity, expertise, and continuity. They won't be influenced by family politics and have experience navigating complex estate administration. The downside is cost, as professional fiduciaries charge fees for their services, and they may lack the personal connection a family member would bring.

A hybrid approach can sometimes offer the best of both worlds: naming a family member and a professional as co-fiduciaries, allowing the personal touch while providing professional expertise.

Don't Forget to Name Successors

Life is unpredictable. Your first-choice fiduciary may be unable or unwilling to serve when the time comes. Always name at least one successor fiduciary, and consider including language in your documents that allows for the appointment of additional successors if needed.

Have the Conversation

Once you've made your decision, talk to the person you've chosen. Explain what the role entails, where important documents are located, and what your wishes are. This conversation can prevent surprises and ensure your fiduciary is prepared for the responsibility.

Choosing a fiduciary is a deeply personal decision that requires balancing practical considerations with emotional factors. Take your time, think it through carefully, and don't hesitate to consult with an estate planning attorney who can help you make the choice that's right for your unique situation.

How Are Retirement Accounts Treated for Medicaid Long-Term Care Eligibility in New York?

If you or a loved one is considering applying for Medicaid to cover long-term care in New York—such as nursing home care or home care services—it’s essential to understand how retirement accounts (like IRAs and 401(k)s) are treated during the Medicaid eligibility process. These accounts can significantly impact whether you qualify, how much you may have to spend down, and what planning options are available.

Medicaid Basics: Income and Resource Rules

To qualify for Medicaid long-term care, applicants must meet strict income and asset limits. In 2025, an individual applying for Medicaid in New York can have $32,396 in countable assets. If they are applying for nursing home Medicaid coverage, they can only keep $50 of their monthly income. If they are applying for home care coverage, the income limit is $1,799.95 (some deductions and allowances apply, and further planning can be done to allow income above that limit to be preserved).

Retirement Accounts: Countable or Exempt?

Whether a retirement account is counted as a resource depends on whether the account is in “Pay Out Status.”

Payout Status means that the Medicaid applicant is receiving Required Minimum Distributions (RMDs) from the retirement account, paid in monthly payments.

The monthly payments are considered countable income by Medicaid.

This rule applies to retirement accounts such as:

• Traditional IRAs
• 401(k)s
• 403(b)s
• Other qualified plans

There are differences in the definition of “Payout Status” under IRS rules and Medicaid rules:

• Under IRS rules, a retirement account owner doesn’t have to take RMDs until they reach a certain age (73), but under Medicaid rules, regardless of your age, you would have to take the RMDs in order for Medicaid to exempt the principal amount of the retirement account.
• IRS only requires an annual payout, whereas Medicaid requires that the payments from the retirement account be made monthly.
• Even though a ROTH IRA, which is funded with post-tax income, doesn’t have to be put in payout status under the IRS rules, Medicaid would require that it be in “Payout Status” to be an exempt resource for Medicaid eligibility.
• The Department of Social Services uses its own life expectancy table, which could be shorter than the IRS table, which could result in the retirement account owner having to take a higher distribution amount under Medicaid rules to exempt the account as a Medicaid resource.

Example:
A 75-year-old applicant has a $200,000 IRA and takes the required annual distribution payable in monthly installments. The $200,000 principal is not counted toward the $32,396 asset limit. However, the monthly RMD amount (e.g., $1,000/month) is added to the applicant’s countable income.

If the retirement account was not in payout status, meaning the applicant is not receiving monthly distributions as per the life expectancy table, then the entire retirement account is treated as a countable asset.

Planning Strategies for Retirement Accounts

Before applying for Medicaid, if the applicant has not yet been taking RMDs, or the RMDs have not been distributed in monthly payments, the applicant should begin taking the payouts or restructure to monthly payments to exempt the account principal. This should be done before the Medicaid application is filed.

Don’t cash out and transfer the retirement account without a really good reason that would be advised by the experienced elder law attorney you are working with. Cashing out will trigger significant consequences, such as tax liability, loss of creditor protection, and loss of a source of exempt funds that could be tapped into in the event you needed more than your allowable resource limit. Therefore, you should never do that unless you have reviewed the repercussions with an elder law attorney and financial advisor, and it is still advisable for your unique situation.

Conclusion

Retirement accounts are not automatically qualifying or disqualifying for Medicaid—but how they’re handled can make or break eligibility. Getting the right legal advice early allows families to preserve assets and avoid costly mistakes.

If you’re planning ahead or facing an urgent Medicaid need, consulting an experienced New York elder law attorney is the most effective way to navigate retirement account issues and implement a tailored strategy.

Need Help?

We assist clients across Nassau County and the greater New York area with Medicaid planning, Medicaid asset protection, and long-term care planning. Contact us today to schedule a consultation and start planning with confidence.

What is the difference between a Durable Power of Attorney and a Non-Durable Power of Attorney?

A Power of Attorney is a document that allows someone to give authority to an individual that they choose to manage their legal and financial affairs on their behalf. The authority can be very specific to only certain transactions, standard to include the powers outlined in the statutory form, or it can be very broad and include provisions dealing with more complex matters such as trust planning, tax planning, and long-term care asset protection.

The key difference between a durable and non-durable power of attorney lies in what happens when the person who granted the power (the "principal") becomes incapacitated or mentally incompetent. A durable power of attorney remains in effect when the principal becomes incapacitated. A nondurable power of attorney is no longer in effect if the principal becomes incapacitated.

When signing a power of attorney for a limited transaction, such as representing you in the sale of real estate or assisting you with managing an investment, it is possible that you only want the individual to have authority while you have capacity and can call the shots. In this case, a “non-durable” power of attorney would serve your purpose. In the event you become incapacitated, your agent will no longer have authority to act on your behalf. 

However, if you are signing a power of attorney as part of your estate planning, to make sure that if you become incapacitated, the individual you appoint will have authority to act on your behalf, your power of attorney must be a “durable” power of attorney.

Durable Power of Attorney:

• Remains effective even if the principal becomes incapacitated or mentally incompetent
• Contains specific language stating it will survive the principal's incapacity (often called a "durability clause")
• Continues until the principal's death or until formally revoked while the principal is still competent
• Most commonly used for estate planning and long-term care planning purposes
• Essential for situations where someone may need ongoing financial or healthcare decision-making assistance

Non-Durable Power of Attorney:

• Automatically terminates if the principal becomes incapacitated or mentally incompetent
• Only remains valid while the principal maintains mental capacity
• Becomes void precisely when the principal would most need someone to act on their behalf
• Useful for specific, temporary situations when the principal is traveling or temporarily unavailable
• Not useful for long-term care planning or estate planning purposes

Practical Implications: The durability feature is crucial for estate planning because incapacity is often when families most need someone to manage financial affairs, make healthcare decisions, or handle legal matters. Without a durable power of attorney, families may need to go through expensive and time-consuming guardianship or conservatorship court proceedings to gain authority to act for an incapacitated loved one.

It is critical to note that even if your power of attorney is “durable,” it is still critical that your power of attorney include provisions that you may require in the future. A basic statutory power of attorney does not have provisions that would allow your agent to protect your assets or income in the event you needed Medicaid long-term care, or provisions that would allow your agent to perform tax planning to minimize estate taxes. You must be sure to consult with an elder law attorney to make sure that the necessary provisions are included to maximize the planning strategies that your agent may need to perform on your behalf in the event you become incapacitated and need long-term care.

For these reasons, it is important to seek the assistance of an elder law attorney to prepare a durable power of attorney for you as one of the foundational documents you will need for a comprehensive estate plan.

Contact us today at 516-466-WILL (9455) and we will be happy to help you with your estate plan.

If you already have a 529 education savings plan as part of your family's financial strategy, there are important estate planning considerations that often go overlooked. As families face potential long-term care needs and Medicaid planning becomes a reality, understanding how your 529 account fits into this picture is crucial. Additionally, many 529 account owners fail to address what happens to these accounts upon their death, potentially subjecting their families to unnecessary probate proceedings.

Understanding Your 529 Plan Structure

A 529 plan is a tax-advantaged savings account designed for future education costs. As the account owner, you maintain complete control over the funds, including investment decisions, withdrawal timing, and beneficiary designations. This control structure has significant implications for both Medicaid planning and estate administration that many families don't fully understand.

The key distinction in 529 planning is between the account owner (you) and the beneficiary (typically your child or grandchild). This separation creates unique opportunities and considerations when planning for long-term care needs and estate administration.

Medicaid Planning Implications

One of the most critical considerations for 529 account owners is how these assets affect Medicaid eligibility for long-term care. The treatment of 529 accounts in Medicaid planning depends on several factors that require careful analysis.

As the account owner, the 529 assets are generally considered your resources for Medicaid purposes, which could impact your eligibility for benefits. However, the specific treatment can vary by state, and there are potential planning strategies that may help protect these education funds while preserving Medicaid eligibility.

For beneficiaries of 529 accounts, the assets typically don't count toward their Medicaid resource limits since they don't own or control the funds. This distinction is particularly important for families with special needs beneficiaries who may require government benefits throughout their lives. The account owner's retention of control prevents the funds from disqualifying the beneficiary from crucial benefits.

However, distributions from 529 accounts can affect Medicaid eligibility. When funds are withdrawn and used for the beneficiary's expenses, this could potentially impact their benefit calculations. Understanding the timing and structure of distributions is essential for families navigating both education funding and benefit preservation.

The Critical Importance of Successor Custodians

Many 529 account owners overlook one of the most important aspects of their account setup: naming a successor custodian. This oversight can create significant problems for families after the account owner's death.

Without a named successor custodian, your 529 account may become subject to probate proceedings when you die. This means the court will need to determine who has authority to manage the account, potentially causing delays in accessing education funds when your family needs them most. Probate proceedings also increase administrative costs and create public records of your family's financial affairs.

Most 529 plans allow you to designate a successor custodian directly through your account documents. This person will automatically gain control of the account upon your death, allowing for seamless management and distribution of education funds. The successor custodian should be someone you trust to make decisions in your beneficiary's best interests and who understands the family's educational goals.

When selecting a successor custodian, consider their financial sophistication, proximity to the beneficiary, and long-term stability. You may also want to name a secondary successor in case your first choice is unable to serve when needed.

Ongoing Account Management Considerations

If you're facing potential long-term care needs, review your 529 account strategy with qualified professionals. Depending on your state's Medicaid rules and your family situation, there may be opportunities to restructure ownership or adjust beneficiaries to better align with your overall care planning strategy.

Consider whether changing the account beneficiary might benefit your family's overall educational goals. The ability to change beneficiaries within the same family provides flexibility that can be valuable in long-term care planning scenarios.

Regular review of your successor custodian designation is also essential. Life changes such as divorce, death, or relationship changes may require updates to ensure the right person will manage these important education funds.

Integration with Your Overall Estate Plan

Your 529 accounts should be coordinated with your broader estate planning documents. Ensure your attorney understands how these accounts fit into your overall plan, particularly if you're implementing Medicaid planning strategies or special needs planning for beneficiaries.

The flexibility of 529 accounts can be both an asset and a complication in estate planning. While the account owner's control provides valuable planning opportunities, it also requires careful coordination with other estate planning tools to avoid unintended consequences.

Moving Forward

If you own 529 accounts, don't let these important considerations fall through the cracks. The intersection of education funding, Medicaid planning, and estate administration requires careful attention to ensure your family's needs are met both now and in the future.

Work with experienced estate planning professionals who understand both Medicaid rules and 529 account structures. They can help you navigate the complexities of long-term care planning while preserving your family's educational goals and ensuring proper account succession planning.

Contact us and we will be happy to help.

On April 29, 2025, the New York State Assembly passed the Medical Aid in Dying Act by a vote of 81-67 after nearly five hours of emotional debate. This legislation allows mentally competent, terminally ill adults with six months or less to live to obtain a prescription for lethal medication. If enacted, New York would become the 11th state to legalize medically assisted death, joining states that already have similar programs.

The bill includes safeguards such as evaluations by two doctors to confirm the patient's capacity to choose and a formal written request signed by two unrelated witnesses. Despite its progress, the bill faces uncertain prospects in the Senate, and Governor Kathy Hochul has not yet taken a public stance on the issue.

As with any deeply personal and ethically complex legislation, the Medical Aid in Dying Act has sparked a wide range of reactions. Supporters emphasize autonomy and compassion, while opponents raise concerns about potential abuse and moral implications. Below are some of the key arguments on both sides to provide a fuller understanding of the law’s potential impact.

Pros of the Medical Aid in Dying Act

1. Respecting Patient Autonomy

The act empowers terminally ill individuals to make decisions about their own end-of-life care, allowing them to choose a peaceful and dignified death.

2. Providing Relief from Suffering

For patients experiencing unbearable pain and suffering, this law offers an option to end their lives on their own terms, potentially alleviating prolonged agony. ​

3. Aligning with Public Opinion

A recent poll found that over 70% of New Yorkers support the Medical Aid in Dying Act, indicating strong public backing for the legislation. ​City & State New York

4. Safeguards Against Abuse

The bill includes multiple safeguards, such as requiring two physicians to confirm the patient's diagnosis and mental capacity, and a mandatory mental health evaluation if necessary. ​

Cons of the Medical Aid in Dying Act

1. Potential for Coercion

Opponents argue that the law could pressure vulnerable individuals, particularly those with disabilities, into choosing assisted death due to societal or familial pressures. ​

2. Ethical Concerns

Some religious and ethical groups contend that the act undermines the sanctity of life and could lead to a slippery slope, potentially expanding to non-terminal conditions.

3. Impact on Medical Professionals

Healthcare providers who oppose the practice on moral or religious grounds may face dilemmas, despite provisions for immunity from liability for those who refuse to participate. ​

4. Implementation Challenges

The law's success depends on effective implementation, including ensuring that all safeguards are rigorously followed, which could pose challenges in practice.​

The passage of the Medical Aid in Dying Act in the New York State Assembly marks a significant step in the ongoing debate over end-of-life choices. While the act offers a compassionate option for terminally ill individuals seeking control over their final days, it also raises important ethical, moral, and practical considerations. As the legislation moves forward, it will be crucial to balance patient autonomy with robust safeguards to ensure that the law is implemented responsibly and equitably.

At its core, this legislation is about how we honor the final chapter of life—balancing medical reality with personal dignity. Whether one supports or opposes the Medical Aid in Dying Act, the conversation it has sparked invites all of us to think more deeply about compassion, choice, and how we care for one another at the most vulnerable moments. These are not easy questions, but they are profoundly important ones.

Creating a trust as part of your estate plan could have many benefits. But those benefits can be completely missed if you don’t title your assets properly and they don’t end up in the trust! A crucial aspect of trust planning that cannot be overlooked is funding your trust.

Establishing a trust can have a variety of benefits. They may include avoiding probate, protecting assets, providing for a beneficiary with special needs, minimizing estate tax, or protecting an inheritance. However, while it is critical to include the right language in the trust document to achieve your objectives, it is equally critical to make sure the right assets end up in the trust.

We are currently assisting a lovely client through an estate administration process that could have been avoided. Her deceased mother had created a trust (with another law firm) but never followed through with properly funding her trust As a result, when our client sought our help to “administer the trust,” we found that upon review of the mother’s assets, there was nothing actually held in the trust.

If the trust had been properly funded, and the assets outside the trust had all been designated with named beneficiaries, the entire estate would have been readily available for distribution to the appropriate parties. Instead, our client did not have immediate access to her mother’s assets and had to petition the Surrogates Court to be appointed as the Estate Administrator, in order to collect and distribute the assets.

This court administration process caused legal expense and delay that could have been avoided. Additionally, by going through the court-supervised estate administration, the assets were now exposed to potential claims from creditors. If the mother had been receiving Medicaid benefits, the estate assets could have also been subject to Medicaid estate recovery, further reducing the inheritance for the intended beneficiaries. All of these issues could have been prevented if the mother’s trust had been properly funded during her lifetime.

A critical part of the estate planning process is not only creating the documents, but reviewing each asset and updating either the ownership or beneficiary designations to make sure the process is as smooth and economical as possible after lifetime.

Contact us to review your estate plan and ensure the smooth administration of your estate. We are happy to help you with this process.

The deadline for companies existing before 2024 have until the end of the year to get in compliance with their obligations under the Corporate Transparency Act.

The federal law, known as The Corporate Transparency Act, was enacted in 2021 and went into effect as of January 1, 2024. Many companies active in the United States are now required to report information disclosing the identity of the individuals that own and control the companies.

New companies have 90 days from the registration or creation date to file, while companies existing before January 1, 2024 have a deadline of January 1, 2025 to file their report.

“Reporting entities” include corporations, limited liability companies, and any other entity that is formed by filing a document with the secretary of state or other government office. There are certain entities that either do not fall under these categories, or are exempt from reporting.

A trust does not fall under the category of a “reporting entity”, however, if a trust is a shareholder of a corporation or a member of an LLC, there will be reporting requirements.

If you have business ownership, it is important to become familiar with this law and be sure that you are in compliance before the end of this year.

Read More Here

For most people, receiving an inheritance is something to celebrate. However, for a nursing home resident on Medicaid, an inheritance may not be such welcome news.

What Is Medicaid?

Medicaid is a public assistance health insurance program for people who have limited means. For many older adults, or individuals with disabilities, Medicaid often serves to help cover the expensive costs of long-term care.

Medicaid eligibility requirements for long term care come with extremely strict income and resource limits. Because Medicaid is a federal program that is run separately by each individual state, the income and resource limits varies by state, and more specifically, by each Medicaid program. In many states, an individual may not have more than $2,000 in their name to qualify for the program. Generally, New York State has a limit of $31,175 (for 2024).

When applying for Medicaid long-term care benefits, the review process goes beyond just examining an applicant’s current assets. Medicaid also scrutinizes the applicant’s financial transactions for a period leading up to their application date. This review, known as the “lookback period,” typically spans 60 months and is designed to prevent individuals from qualifying for benefits by giving away or transferring assets for less than fair market value.

Interestingly, while New York State has established a 30-month lookback period for community-based long-term care (such as home care services) in 2020, the lookback has not yet been implemented to date. If Medicaid uncovers any uncompensated transfers during the lookback period, they will assess a penalty, potentially affecting the applicant’s eligibility for benefits.

The Medicaid program’s strict asset limits can turn an inheritance into a double-edged sword for recipients. While seemingly a windfall, an inheritance can actually jeopardize a recipient’s Medicaid benefits, potentially disrupting their care. Even worse, without proper planning, the inheritance itself might be consumed by high care costs. To avoid these negative outcomes, it’s crucial to engage in careful planning. This ensures that an inheritance enhances the recipient’s quality of life rather than undermining their Medicaid-funded care or disappearing into medical expenses.

Inheritance Money is Income in the Month Received

An inheritance counts as income in the month you receive it. You or whoever is representing you will have to inform the state Medicaid agency about the inheritance. If you receive an inheritance and the amount puts you over the income limits for your state, you will not be eligible for Medicaid benefits for that month. If you can properly spend down the money from an inheritance in the same month that you receive it or make a transfer of the money that is exempt from a lookback penalty, you will be eligible for Medicaid again the following month.

Preserving Your Inheritance

An elder law attorney can identify and advise you on your options to preserve your inheritance. The attorney will determine the rules for your specific state program and identify whether any exceptions to the lookback are available to you that will allow you to preserve some or all of the inheritance. If there are no exceptions applicable to your situation, the attorney still can advise you on the proper way to spend down the inheritance to gain some benefit from the inheritance while minimizing the reduction of Medicaid benefits. Further, there may be additional strategies that the attorney can identify to help you for maximum preservation of the inheritance.

Advance Planning is Best, If Not Too Late

If you have a loved one that may be receiving Medicaid benefits when you die, even unexpectedly, it is best for your estate plan to direct their inheritance to a Medicaid compliant special needs trusts. This would allow your loved one to benefit from their inheritance without jeopardizing either their Medicaid or the inheritance. An elder law attorney can help you with your estate planning.

Conclusion

The Medicaid program is, in and of itself, quite complicated. With different rules in every state, and changing requirements from year to year makes the task of navigating Medicaid even more daunting. Trying to navigate this yourself can result in avoidable loss to your benefits or your inheritance. Seek guidance from an experienced elder law attorney.

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