The Long-Term Care Medicaid application process details the financial history of the applicant. There are limitations on assets and income. Applicants who enter the application process with excess assets are required to show by substantial evidence how they achieved financial qualification.
By definition, the client’s duty of full disclosure and honesty in fact are implicit in this process. They are the bedrock of the Elder Law Attorney-Client relationship. The client knows what their financial history is. When a lawyer submits the Medicaid application, they are vouching for the truth of the facts in the application. The Medicaid office assumes that the Attorney made a full investigation of the facts asserted. The Medicaid office makes a decision to approve or disapprove the application based on this assumption.
When a client lies, misleads, or fails to disclose pertinent financial facts, the client is committing fraud at several levels.[1] The first is that the client has engaged the services of the Attorney to perpetuate their fraudulent scheme. The second is that financial misrepresentations in the application are made to induce Long-Term Care Medicaid to approve the application.
Fraudulent misrepresentations expose the client to serious sanctions. It is a crime to mislead the Medicaid office. Elder Law Attorneys have the right to terminate services when misrepresentations of the facts are made. This is the case even when ending the relationship will leave the client in a vulnerable position with respect to the case.
[1] Legal fraud is a knowing misrepresentation of the facts or the concealment of facts with the intent to induce another to act to his detriment. Equitable fraud is an innocent misrepresentation that another relies upon to his detriment.
