Between April 2, 2018 and April 11, 2018, the New Jersey Superior Court, Appellate Division, issued six separate opinions involving Medicaid. While this is unusual, what is even more striking is that all six cases involve the same appellate court panel, and the same attorney representing each of the appellants. In these cases, the law.. read more →
After J.C. was admitted to a nursing facility, her son, S.C., submitted an application to the Camden County Board of Social Services for Medicaid benefits on her behalf. The county welfare board notified J.C. that she was eligible for long-term care benefits but her transfer of assets for less than full market value during the.. read more →
A.S.’s nephew and power of attorney designated Senior Planning Services (“SPS”) as A.S.’s authorized representative for establishing Medicaid eligibility. In SPS filed a Medicaid application, which was denied for excess resources on December 10, 2012. After SPS filed a request for a fair hearing but before the fair hearing was scheduled, A.S. died, and SPS.. read more →
There were three Medicaid applications filed on behalf of E.M. The first was filed in 2012 by his daughter, after his admission to a subacute care center. At the time, E.M. was suffering from dementia and was on a ventilator and feeding tube. This Medicaid application was denied for failure to provide documents to Medicaid,.. read more →
After A.S. entered a nursing home, her son T.S. applied for Medicaid benefits on her behalf, listing A.S.’s sister’s address on the application. In June 2013, because the necessary financial information was not provided, Medicaid notified T.S. that the application was dismissed, and that T.S. had a right to request a fair hearing. However, T.S… read more →
On February 1, 2016, a Medicaid application was filed on behalf of W.S. by Hammonton Center for Rehabilitation and Healthcare as his authorized representative. On June 21, 2016, the application was denied for failure to provide information necessary to make an eligibility determination. The information outstanding consisted of bank statements from an ING Direct account… read more →
Because K.K. was a legal permanent resident (LPR) of the United States before August 22, 1996, the Superior Court, Appellate Division, reversed a Medical denial based on the agency’s error in finding that the applicant “had not been a permanent resident for five years or more.” K.K. v. Division of Medical Assistance and Health Services,.. read more →
A.M. appealed a gift penalty imposed by the Medicaid agency based on a transfer of assets. The penalty was imposed based on $100,000 in distributions to beneficiaries of an irrevocable trust established by A.M. with her assets. A.M. asserted that the transfer penalty was inappropriate because she established the trust and transferred assets into the.. read more →
Below, in chronological order, is the annual roundup of the top 10 elder law decisions in the U.S. for the year just ended, as measured by the number of “unique page views” of the summary of each case found on the ElderLawAnswers website. ElderLawAnswers is a web-based resource available for those in the public seeking information on.. read more →
Although it is common practice to add the name of a family member to a bank account as a convenience, the existence of a “convenience” account can have negative results when that family member applies for Medicaid benefits. In F.J. v. Division of Medical Assistance and Health Services, the applicant’s daughter testified that she opened.. read more →
A New Jersey appeals court upheld the denial of Medicaid benefits to an applicant who failed to provide necessary verifications, rejecting the claim that the Medicaid agency’s failure to assist with the application prejudiced the applicant. P.B. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-5405-15T2, Dec. 8, 2017). P.B.’s daughter.. read more →
After being sued by Medicaid applicant in federal court, the Director of New Jersey Medicaid, who had previously denied benefits because the applicant transferred assets to a trust more than 5 years before, instead stated the application was denied because, under the terms of the trust, the trustee was permitted to pay the applicant’s rent… read more →
Contrary to the recent decision in the G.V. v. Division of Medical Assistance and Health Services case which held that assets transferred to an Income Only Trust more than 5 years before a Medicaid application was filed were still available, rendering the applicant ineligible for benefits, the M.K. v. Morris County Board of Social Services.. read more →
Lawsuit for Unpaid Bills by Nursing Home Against Resident’s Power of Attorney Dismissed, and Attorneys Fees Awarded
A Superior Court judge in Ocean County dismissed a lawsuit filed by a nursing home for unpaid bills against a power of attorney appointed by a former resident, and ordered the nursing home to pay legal fees incurred by the power of attorney, ruling that the law prohibited the nursing home from requiring the power.. read more →
After being denied Medicaid because of a $70,000 joint bank account she maintained with her son, the Medicaid applicant, S.M., appealed the case to An administrative hearing. S.M. argued that Medicaid had failed to consider that her son was the sole source of $60,000 of those bank funds. After the ALJ affirmed Medicaid’s denial, and.. read more →
A New Jersey appeals court held that a Medicaid application was properly denied when the applicant did not submit all the financial information and documents requested by the Medicaid agency. P.N. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-2025-15T2, July 28, 2017). P.N. resided in an assisted-living facility. Based.. read more →
On August 10, 2017, I presented at the 2017 Sophisticated Elder Law Program on Medicaid litigation strategies. I provided an overview of various strategies and tactics which have been used successfully in litigation involving Medicaid and other needs-based public benefits in state and federal courts and in administrative agencies. I prepared a paper and PowerPoint slides.. read more →
In this case, the Division of Medical Assistance and Health Services (DMAHS), New Jersey’s state Medicaid agency, affirmed the denial of a Medicaid application filed by Grace M. Vinci (G.V.) by the Monmouth County Division of Social Services (MCDSS) finding that G.V. had resources in excess of $2,000 available to her, namely, resources contained in.. read more →
New Jersey’s Division of Consumer Affairs (DCA) released a Consumer Brief on Medicaid Advisors/Application Assistors. Medicaid Advisors/Application Assistors are non-lawyers who provide limited services without payment or compensation in connection with Medicaid applications. According to the DCA Consumer Brief, the limited services which Medicaid Advisors/Application Assistors may perform include the following: providing information on insurance.. read more →
A U.S. district court denied a preliminary injunction to a Medicaid applicant who sued New Jersey to prevent the state from denying benefits based on her dead husband’s assets. Flade v. Connolly (U.S. Dist. Ct, D. N.J., No. 16-4407, Sept. 23, 2016). Plaintiff, Eileen Flade, was a nursing home resident. On April 12, 2016, plaintiff applied for.. read more →
In this case, the Court considered whether a Medicaid applicant received full and fair notice of the reasons for the agency’s decision to deny benefits prior to holding a hearing on the applicant’s appeal. E.W. v. Cape May County Board of Social Service, OAL Docket. No. HMA 14667-15 (OAL December 24, 2015) In 2012, E.W.,.. read more →
In a recent opinion, an appellate court in Minnesota held that county officials were not liable for incorrectly telling a Medicaid applicant that his estate would not be subject to a Medicaid lien because the applicant could have hired a lawyer to learn the correct information. Benigni v. St. Louis County (Minn. Ct. App., No. A15-1154, June.. read more →
The Committee on the Unauthorized Practice of Law, appointed by the Supreme Court of New Jersey, recently issued Opinion 53 in which the Court considered weather non-lawyers who assisted applicants and beneficiaries in applying for Medicaid benefits were engaged in the unauthorized practice of law. The Court identified the non-lawyers providing Medicaid assistance as “Medicaid.. read more →
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 →
The New York State Bar Association has issued a brochure to help consumers understand the benefits of utilizing an elder law attorney to assist (1) in the preparation of Medicaid applications and (2) in planning for yourself or a loved one to protect assets when seeking eligibility for public benefits based upon financial need. The.. read more →
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