In PR v. Division of Medical Assistance and Health Services (NJ. App. Div. 6/8/2023), the State was authorized to recover Medicaid benefits incorrectly paid. It was not, however, authorized to play fast and loose by withdrawing a waiver of a portion of its claim as part of the Commissioner’s review. Peter and Uma, an unmarried […]
The collateral estoppel (issue preclusion) rule is part of the finality doctrine along with Res Judicata (claim preclusion). It general prevents a party from re-litigating the same issue in a second court. In other words, you don’t get a second bite at the apple in another court simply because you were dissatisfied with the result […]
The SSI rules are a good beginning point because Medicaid cannot impose rules more restrictive than the SSI rules. SSI excludes burial funds up to the exemption limit which is currently $1,500 for the applicant and the applicant’s spouse. POMS SI 01130.410. Burial funds can be: revocable burial contracts; revocable burial trusts; other revocable burial […]
Obviously, if you follow the law, get a license and have the event officiated, you’re married. See O.C.G.A. § 19-3-1 (Requiring parties able to contract, an actual contract and consummation according to law). And with marriage goes the benefits and liabilities. Although not a traditional case, Justice Kennedy concluded Obergfell v. Hodges with the following […]
The following is a mishmash of information on various Elder Law, Special Needs Law, and Estate Planning issues. It also includes anything else we found interesting during the month of June, 2023. We will continue updating from time to time throughout the month. Last updated 6/8/2023. Keep in mind, you are using linked content at […]
In McGee v. State Dep’t of Health Care Servs., 2023 Ca. App. LEXIS 409 (Cal. Ct. App., 3d Dist. 5/24/2023), Diana McGee established a special needs trust under the provisions of 42 U.S.C. § 1396p(d)(4)(A). This followed a malpractice action and settlement. Dianna suffered from short bowel syndrome, which impaired her ability to care for […]
“In general, in order to maintain an action, a party “must establish standing to sue on the ground asserted, which requires showing an injury in fact that was caused by the breach of a duty owed by the defendants to the plaintiffs and that will be redressed by a favorable decision from the court.” Ames […]
In L.U. v. Division of Medical Assistance (N.J. Superior Court Docket A-2937-20, May 23, 2023), the Superior Court affirmed denial of L.U.’s request for a fair hearing. How, you ask? “I thought everyone had a right to a fair hearing!!! Well, apparently not. L.U. was an unrepresented Medicaid recipient. He appealed from a May 11, […]
In Henderson v. Dept. of Health and Human Services (May 18, 2023), a Medicaid applicant transferred significant resources, including the full value of her retirement account, to an irrevocable trust. When she applied for Medicaid during the 60 month look back period, the Medicaid agency found the resources were not countable, but imposed a transfer […]
The following Georgia Medicaid cases were litigated outside the context of an administrative hearing, or were appealed beyond that point. Of course, we are not representing there are no other published decisions on point. United Cerebral Palsy of Georgia v. Ga. Dep’t of Behavioral Health and Dev. Disabilities, 331 Ga. App. 616 (2015). A provider […]
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