Resource limit firm; debt not a factor. Petitioner’s application for benefits was denied twice because the Petitioner’s agent was unable to secure information requested by the caseworker. Petitioner’s agent was not able to gain control over the resources until a conservatorship was approved in February, 2008. As of March 1, 2008, Petitioner had $23,453.89 in […]
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In M.K. v. Division of Medical Assistance, Superior Court of New Jersey, Appellate Division (2016), the Division imposed a period of ineligibility for benefits because she transferred ownership of her home to her daughter, J.K., for less than fair-market value within sixty months of entering a nursing home facility (the look-back period). The applicant argued […]
An applicant filed three Medicaid applications from February 7 through November 26, and all of them were denied for failure to submit necessary financial verification. A fair hearing was conducted on November 26, 2018 where the ALJ gave the applicant additional time to supply verification. Once that verification was supplied, on May 14, 2019, the […]
In a Memorandum decision, the Supreme Court of New York, Appellate Division, Fourth Department, held that a nursing home may bring a plenary action in its own right against the agency designated to declare Medicaid eligibility. A transfer of resources penalty of 11.74 months had been imposed and the nursing home sought a declaratory judgment […]
In Maryland Department of Health and Mental Hygiene v. Centers for Medicare and Medicaid Services, 542 F.3d 424 (2008), the State of Maryland petitioned for review of a final decision of the Centers for Medicare & Medicaid Services (CMS) disapproving an amendment to the Maryland State Medicaid Plan (SMP). Maryland’s SMP would have eliminated deductions […]
In Timm v. Mont. Dep’t of Pub. HHS, 2008 MT 126 (2008), Linda Timm entered the nursing home in July 2002. The Timm family applied for Medicaid on November 1, 2002 reporting, among other resources, the Community Spouse’s one-third interest in J & R Transportation, Inc., worth roughly $20,150. The Department completed its first resource […]
On July 1, 2021, the Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise billing […]
