A New Jersey appeals court ruled that payments to the spouse of a Medicaid recipient from an annuity purchased with the spouse’s “resource allowance” were properly considered “income” to the spouse under the Medicaid rules. J.G. v. Division of Medical Assistance and Health Services J.G., who was married to M.G. for 67 years, suffered from Alzheimer’s.. read more →

In a 2 to 1 precedential decision by the United States Court of Appeals for the Third Circuit reversing an earlier federal district court judgment, the court ruled that “short-term annuities” purchased by applicants for nursing home Medicaid cannot be treated as an “available resource” that prevent Medicaid eligibility. Zahner v. Secretary, Pennsylvania Department of Human.. read more →

Two years ago, in 2013, a federal judge in New Jersey granted a preliminary injunction to Elizabeth Flamini, a Medicaid applicant who successfully sued for an injunction preventing the State of New Jersey from counting an annuity owned by Mrs. Flamini’s husband Angelo as an available resource in determining Medicaid eligibility. Flamini v. Velez  ,.. read more →

(In Zahner v. Mackereth (U.S. Dist. Ct., W.D. PA, Jan. 16, 2014), a federal district court ruled that long-term annuities, that is, annuities with payment terms of 5-years or more, purchased by Medicaid applicants were not transfers for less than fair market value and, therefore, were not subject to a penalty period, but that shorter-term annuities.. read more →

In Brill v. Velez (U.S. Dist. Ct., D. N.J., No. 1:13-cv-05643 (NLH/AMD), June 27, 2014), a federal district judge ruled that an applicant’s claim against the State of New Jersey for denying Medicaid benefits based upon the purchase of an annuity survived a motion to dismiss even though the State reversed the denial because the applicant.. read more →

A federal district court in New Jersey ruled that a Medicaid applicant was not entitled to a preliminary injunction to prevent the State from counting her annuity as an available resource. Matrangolo v. Velez (U.S. Dist. Ct., D. N.J., No. 13-6289 (MAS) (LHG), May 30, 2014). Plaintiff Marie Matrangolo, an 88-year-old woman who has been a.. read more →

The annual roundup of the top 10 11 elder law decisions from across the country for 2013 as prepared by staff at the ElderLawAnswers website is reproduced below. Almost all the cases hinged on the interpretation of state or federal Medicaid law.  Those purchasing annuities or transferring property in exchange for a promissory note did.. read more →

For the first time, the Division of Medical Assistance and Health Services (DMAHS), New Jersey’s  Medicaid agency, held that an applicant for nursing home Medicaid was eligible for benefits despite the fact that she made a substantial gift within the look-back period and owned an $80,000 annuity. M.W. v. Division of Medical Assistance and Health.. read more →

A federal district court in Western Pennsylvania held that the purchases of single premium immediate annuities with short payment terms by applicants for Medicaid constitute improper transfers of assets even if the annuities otherwise comply with the federal Medicaid laws in all respects. Zahner v. Mackereth, Civil No. 11-306 (W.D. PA, January 16, 2014). This.. read more →

As the U.S. Court of Appeals, 2nd Circuit, held in Lopes v. Dep’t of Social Services, 696 F.3d 180 (2d Cir. 2012) and the U.S. Court of Appeals, 3rd Circuit, held in James v. Richman, 547 F.3d 214 (3d Cir. 2008) when resolving the same issue, the U.S. Court of Appeals, 8th Circuit, has now.. read more →

A federal district court judge in New Jersey granted a Medicaid applicant’s motion for a preliminary injunction, thereby enjoining the State from counting an annuity owned by her husband as an available resource in determining her eligibility for Medicaid. Flamini v. Velez, Civil No. 1:12-cv-07304 (D.N.J. July 19, 2013) Elizabeth Flamini entered a skilled nursing.. read more →

A federal district court in New Jersey holds that an annuity purchased by the spouse of a Medicaid applicant with the couple’s countable resources which exceeded the resource limit under Medicaid is not a transfer for less than fair market value for purposes of Medicaid eligibility. Carlini v. Velez (U.S. Dist. Ct., D.N.J., No. 12-7290 (JEI/KMW),.. read more →

After John Lopes was admitted to a nursing home, his wife, Amelia, purchased a irrevocable, nontransferable, single premium annuity for $166,878.99 from The Hartford Life Insurance Company. The annuity contract provided for monthly payments of $2,340.83 over a period of approximately six years. In a letter, the annuity company confirmed that no part of the.. read more →

Medicaid is a joint federal and state program that provides a funding source to pay nursing home costs for elderly and disabled persons.  The Medicaid program was created under Title XIX of the Social Security Act of 1965, codified in the U.S. Code, Title 42, Section 1396 et seq.  New Jersey’s Medicaid regulations are found.. read more →

Here are my selections for the top ten (10) twelve (12) New Jersey elder law / public benefits / Medicaid cases decided in 2010: (1) R.C. v. Division of Medical Assistance and Health Services and Hudson County Board of Social Services, OAK DKT. NO. HMA 08047 – 10 (Hudson County, October 22, 2010): Judge Awards.. read more →

Ohio’s First District Court of Appeals has joined other state and federal courts across the country in ruling recently that Ohio improperly imposed a penalty period on a Medicaid applicant whose wife purchased an annuity during the look-back period. The Court held that Ohio’s regulations regarding the purchase of annuities are improperly restrictive, and are.. read more →

In Lopes v. Starkowski (U.S. Dist. Ct., Dist. Conn., No. 3:10-CV-307, August 11, 2010), the U.S. District Court for the District of Connecticut held that the State of Connecticut cannot treat the income stream from an annuity as an available asset for the purposes of Medicaid eligibility. After John Lopes was admitted to a nursing.. read more →

Following is an exchange posted on a electronic bulletin board devoted to the discussion of issues involving pension and compensation claims submitted to the Department of Veterans Affairs (VA): Question: My client applied for pension benefits from the VA. The client was deemed medically qualified for VA Aid and Attendance benefits, but denied pension benefits.. read more →

As you know, the Supplemental Security Income (SSI) program, administered by the Social Security Administration (SSA), is a needs-based government benefit program which provides monthly cash assistance to aged, blind or disabled individuals who have limited income and resources. Individuals over age 65 automatically meet the “aged” requirement. Adults who assert eligibility as “blind” or.. read more →

Conceding defeat in the courts, the National Association of State Medicaid Directors (NASMD) has sent a letter to the Center for Medicare and Medicaid Services (CMS) requesting that the agency revisit its treatment of community spouse annuities. In the Omnibus Budget Reconciliation Act of 1993, Congress delegated the treatment of annuities in the Medicaid program.. read more →

As I had reported in a March 4, 2009 blog post, New Jersey Administrative Law Judge (“ALJ”) Walter M. Braswell, in E.F. v. Division of Medical Assistance and Health Services and the Union County Board of Social Services, OAL DKT. No. HMA-7536-08 (Union County, February 26, 2009), held that an annuity purchased by a community.. read more →

In Weatherbee v. Richman, 595 F. Supp. 2d 607 (W.D. Pa. 2009), the U.S. District Court for the Western District of Pennsylvania reversed the denial of Medicaid benefits to a nursing home resident (“institutionalized spouse”), holding that the income from an irrevocable, non-transferable, non-assignable, single premium, immediate annuity payable to the spouse of the nursing.. read more →

An Opinion and Order was entered on October 20, 2009 by Administrative Law Judge Joseph A. Paone, in the consolidated matter of the Estate of F.L. v. Division of Medical Assistance and Health Services and the Union County Board of Social Services, OAL Docket No. HMA 13756-08.  The ruling in the Estate of F.L. case.. read more →

In June 2009, plaintiff, Daisy Jeanne Prall, applied for nursing home Medicaid benefits with the Ocean County Board of Social Services. To be eligible for Medicaid, plaintiff and her spouse, Christopher Prall, cannot own resources which exceed $111,560; $109,560 is the community spouse resource allowance and $2,000 is the institutionalized spouse resource allowance. Although the.. read more →

As I blogged here, the New Jersey appellate court, in N.M. v. Division of Medical Assistance and Health Services, 405 N.J. Super. 353  (App. Div. 2009), certif. den., 199 N.J. 517 (2009), held that an annuity purchased for the sole benefit of the community spouse after the effective date of the Deficit Reduction Act of.. read more →