Lassoing A Loophole


If you think fighting City Hall is tough, how about Washington bureaucracy? Vivian Regina Pronin, a counselor and geriatric care manager from Hastings-On-Hudson, Westchester, refused to give up after being told by lawyers, Jewish groups and lawmakers that her fight with Medicaid was just about impossible to win. But a year after she began her campaign, Pronin achieved victory: not only for her parents but also for all Holocaust survivors.

The only child of Holocaust survivors, Pronin discovered to her dismay that although Holocaust reparations are generally excluded when calculating Medicaid eligibility, there was a loophole in the regulations that had cost her parents more than $7,000.

It all started in June 1996 when Proninís father entered a nursing home. His income was such that he qualified for institutional Medicaid. Under the law, he was not allowed to have more than $3,550 in savings in order for his nursing home bill to be paid by Medicaid.

Under the old rule, his wife could keep about $85,000 in savings and $2,049 a month in income while her husband was on Medicaid in the nursing home. Any income greater than $2,049 had to be turned over to the government. In calculating the income figure, Medicaid included German and Austrian reparations, according to Manhattan elder law attorney Daniel Fish. At the time, Proninís mother was receiving $650, and Proninís father was getting between $800 and $900 a month in reparations.

"The sea change is that Medicaid now agrees that the same rules that apply to the nursing home patient now apply to his spouse: that the reparations do not count either as income or savings," said Fish.

He said he did not know how many people this affected but that it was "very common in my practice."

Although the Medicaid change became effective in New York State on Sept. 2, 1997, Fish said he believed it was little known and that there are "case workers within Medicaid who are not aware of it and who continue to count reparations as income or savings. There are also attorneys in the field who are not aware of it because it has not been published in any specialized publications."

Pronin said her successful battle "can be an inspiration to individuals frustrated in negotiating the health care system and may act as a precedent for future treatment of Holocaust reparations from other countries by our government bureaucracies."