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.. read more →

In Sable v. Velez, applicants were denied Medicaid because of promissory notes owned by the applicants. Each note was properly signed, and contained a specified interest rate and repayment schedule.  Medicaid found the promissory notes to be countable after determining that the notes qualified as a “trust-like device.” In their suit in federal court under.. read more →

The Director of New Jersey Medicaid recently decided that, when a couple is institutionalized, the resources of the couple are not combined when determining Medicaid eligibility. Rather, the resources of each spouse must be considered separately.  Therefore, when only one spouse applies for Medicaid benefits and that spuse’s resources alone do not exceed the resource.. read more →

For most of her life, V.P. resided in her home with her adult son, R.P. V.P. suffered from many significant impairments, including spinal scoliosis and other degenerative diseases of the spine, hypertension, diabetes, gastroesophageal reflux disease, anxiety, and frequent urinary tract infections. As a result of her poor health, V.P. relied upon her son R.P… read more →

A New Jersey appeals court held that a Medicaid applicant who transferred money to her daughter and then a few months later received a life estate in her daughter’s home made a gift to the daughter rather than engage in a bona fide transaction involving the purchase of a life estate, resulting in the imposition.. read more →

Very often, family members provide assistance in caring for an aged or disabled loved one.  The assistance is often provided at great personal and financial sacrifice by the family member involved in care-giving. One way to alleviate the financial sacrifice experienced by the care-giver to some extent is by utilizing a Personal Services Contract (“PSC”)… read more →

In an unpublished, per curiam decision, a New Jersey appeals court ruled that a grant of funds awarded by a state agency which were held by an elderly Medicaid recipient in a bank account for the benefit of her disabled grandson are not countable resources that would affect her Medicaid eligibility. I.M. v. Division of.. read more →

A New Jersey appeals court upheld the imposition of a penalty period on a nursing home resident’s receipt of Medicaid benefits, holding that the resident failed to rebut the presumption that a court-ordered payment made to the resident’s adult children for previously uncompensated services provided under a power of attorney was not a valid payment.. read more →

A New Jersey appeals court ruled that the penalty period for a Medicaid applicant who transferred funds to her son could not begin until she became financially eligible for Medicaid, which occurred only after the son used all the transferred assets to pay the cost of the applicant’s care. S.S. v. Division of Medical Assistance.. read more →

A recent amendment to Section 369 of the Social Services law expands the list of assets which are considered to be in an individual’s “estate,” against which Medicaid could make a claim for recovery, to also include jointly held property, retained life estates, interests in trusts and any other property in which the individual has.. read more →

A New Jersey appeals court ruled that a nursing home resident who transferred the majority of her assets to her son during the look-back period was ineligible for nursing home Medicaid benefits when she failed to prove the transfer was done exclusively for a purpose other than to qualify for Medicaid. A.M. v. Division of.. read more →

(The following is part of a discussion, taken from a listserv, or electronic bulletin board, concerning benefits available for veterans, their dependents and survivors from the Department of Veterans Affairs.) Question: I have a client who has applied for Aid and Attendance Benefits (A&A) from the Department of Veterans Affairs (VA). The client is moving.. read more →

    Here are my selections for the top ten (10) New Jersey cases involving Special Needs Trusts / Disability Planning decided in 2009 and 2010. For those cases I previously blogged about,  a link to the blog post as well as the case is included below. (1)     Special Needs Trust Can Be Established Only.. read more →

A self-settled special needs trust is exempt from being counted as a “resource,” for purposes of determining eligibility for public benefits, pursuant to section (d)(4)(a) of 42 U.S.C. §1396p. (For this reason, this type of trust is sometimes referred to as a “(d)(4)(a) trust.”) Pursuant to this federal law, as amended on August 10, 1993.. 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 →

My law firm recently was successful on appeal in overturning the denial of Medicaid eligibility for an incapacitated client residing in a nursing home. In R.C. v. Division or Medical Assistance and Health Services and Hudson County Board of Social Services, OAK DKT. NO. HMA 08047 – 10 (Hudson County, October 22, 2010), R.C., through.. read more →

Lawyers who regularly deal with elderly and disabled clients like I do often confront the issue of client capacity. Under our professional rules, a lawyer may represent a client who has less than full capacity, although a lawyer is precluded from representing a client who lacks capacity. The issue confronting the lawyer involves properly assessing.. 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 →

As many readers know, Medicaid applicants are subject to the imposition of a penalty, or a period of ineligibility for Medicaid, when gifts, called “transfers for less than fair market value” in the regulations, are made at any time during the five year period prior to the date on which the Medicaid application is filed,.. 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 →

A New Jersey administrative law judge (ALJ) recently held, contrary to a court order awarding wages for services rendered, that a payment to the adult children of a Medicaid applicant for services rendered under a power of attorney was properly considered to be a gift by the State’s Division of Medical Assistance and Health Service.. read more →

Soon after the passage of the Deficit Reduction Act of 2005 (DRA), New Jersey’s Division of Medical Assistance and Health Services, the State Medicaid agency, took the position that the penalty period, or period of ineligibility for Medicaid, resulting from transfers made during the look-back period by applicants for home or community – based services.. read more →

A New Jersey appeals court recently held that a life care contract between a nursing home resident and her daughter, in which the resident paid her daughter a lump sum for the future provision of personal care services, is not a transfer for fair market value for the purposes of Medicaid eligibility. E.S. v. Division.. read more →

Heriberto Pumarejo transferred the ownership of his home to his son, Herbert Pumarejo, Jr., for one dollar. About two years later, Mr. Pumarejo became a patient at the Arnold Walter Nursing Home. Kathryn Pumarejo, Herbert’s wife and the resident’s representative, signed an agreement in which she agreed to pay all nursing home bills that were.. read more →