Ruling that a state statute violated federal Medicaid law, a federal district court granted a preliminary injunction preventing Connecticut from denying Medicaid benefits to an applicant seeking to disregard his spouse’s assets using the doctrine of spousal refusal.  Fortmann v. Starkowski(D. Ct., No 3:10cv1562 (JBA), Sept. 28, 2011).

Bernhard Fortmann, a nursing home resident, applied for Medicaid benefits effective July 1, 2010.  In his application, Mr. Fortmann claimed that his spouse refused to support him, and therefore her assets should be disregarded for purposes of determining his eligibility.  The Connecticut Department of Social Services denied Mr. Fortmann’s application, citing Connecticut General Statute Sec. 17b-285, a law that permits Medicaid applicants to exempt spousal assets from an eligibility determination only if the community spouse cannot be located or the spouse cannot provide the required information about his or her assets.

Mr. Fortmann filed a civil rights lawsuit claiming that the state statute conflicted with federal law, and he requested a preliminary injunction barring the state from denying his benefits.  Mr. Fortmann argued that, according to federal law, his application should be approved so long as he assigned his support rights to the state, regardless of whether his spouse could be located.  After a magistrate judge granted Mr. Fortmann a preliminary injunction “to the extent that it would preserve the status quo,” both parties filed objections. Mr. Fortmann claimed that preserving the status quo meant that he would not receive benefits (which would adversely affect his health) until a final ruling, and the state claimed a right to limit spousal refusal.

The U.S. District Court for the District of Connecticut modified the magistrate’s decision and ruled that the state “may not deny [Mr. Fortmann’s] Medicaid eligibility on account of the resources of [his] wife.”  The court found that Mr. Fortmann’s lawsuit is likely to succeed on its merits because “[i]t is not possible therefore for defendant, or plaintiff as a Medicaid applicant, to adhere to the limitations in § 17b-285 and also obey the federal mandate for assignments where medical assistance is sought.”

The decision is annexed here – Fortmann v. Starkowski

(Case Summary Provided Courtesy of the ElderLaw Answers website)

UPDATED ON AUGUST 8, 2013 – Despite the earlier grant of a preliminary injunction to Mr. Fortmann, a Connecticut Medicaid applicant, the state requested summary judgment, and Mr. Fortmann died while waiting for the final decision. The U.S. District Court for the District of Connecticut granted the state’s summary judgment, holding that the applicant’s use of spousal refusal was not valid because the state law regarding the assignment of support to the state is not preempted by federal law and the applicant’s spouse was able to be located and provide information about her assets. Fortmann v. Starkowski (U.S. Dist. Ct., D. Conn., 3:10CV1562 (JBA), July 31, 2013).