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The National Council on Aging published an article titled Get the Facts on Elder Abuse. Using graphics to identify signs and symptoms of different forms of abuse, it describes different forms of abuse and provides resources/links you can use to get help. Of course, the first thing you should always do if you suspect abuse […]
The federal Patient Self-Determination Act, passed in 1990 and effective on December 1, 1991, requires most health care providers to provide information regarding health care advance directives. The purpose of the legislation was to enhance patient choice. It applies to Medicare providers through 42 U.S. Code § 1395cc(f) and Medicaid providers through 42 U.S. Code […]
HUD provides capital advances to finance the construction, rehabilitation or acquisition with or without rehabilitation of structures that will serve as supportive housing for very low-income elderly persons, including the frail elderly, and provides rent subsidies for the projects to help make them affordable. The Section 202 program helps expand the supply of affordable housing […]
Greene appealed denial of his application for Medicaid. The denial was affirmed by an administrative law judge. After review, the Commissioner adopted the findings of fact of the ALJ. The Commissioner addressed Greene’s specific arguments by explicitly noting the underlying evidence in the record supporting the ALJ’s decision and citing two cases: Atkinson v. Ledbetter […]
In Cruver v. Mitchell, Medicaid had paid many of Mitchell’s expenses until shortly before the hearing. Appellants, however, had decided to stop her benefits and “just pay for [the expenses] out of pocket,” using money from Mitchell’s bank accounts. Appellants explained that they removed their mother from the Medicaid program so that the State would […]
The undisputed record shows that in April 2004, Gladowski qualified for Medicaid assistance to pay for nursing home care, but the Department of Community Health delayed her benefits until September 2006 on the ground that Gladowski improperly transferred assets to qualify for Medicaid coverage. Gladowski appealed the decision to an administrative law judge (ALJ), who […]
White, a British citizen and a legal permanent resident of the United States entered the United States in 1991.She was issued a green card and resided in the U.S. continuously. When she applied for Medicaid, she was denied eligibility because she had not resided in the U.S. cotinuously for five years as provided for in […]
The Georgia Supreme Court granted certiorari to consider whether the Court of Appeals properly interpreted 42 USC § 1396p with respect to whether a Medicaid applicant’s purchase of an annuity was subject to an asset transfer penalty. In this case, the Georgia Department of Human Services, Family and Children Services (“DFCS”) granted appellee Jerry L. […]
Corrine Barber died on June 22, 2005. Her Will left the bulk of her estate to her youngest child, Alecia Holmes (fathered by Adams). When Alecia offered the Will for probate, Corrine’s four older children (fathered by Barber) filed a caveat. They contended the Will was invalid due to undue influence. The probate court granted […]
In November 2002, Mrs. Medder’s husband died. Her husband left her real estate and personal property in his Will. In May, 2003, Mrs. Medders filed a renunciation and disclaimer “renouncing” the gift in her husband’s Will. Less than three years after the renunciation, Mrs. Medders applied for Medicaid. When Mrs. Medders applied for Medicaid, the […]
Richard J. Medalie, brought suit under the Medicare Secondary Payer statute (the “MSP”) against the drug companies that developed, manufactured, and marketed the drug Baycol. Following its decision in Stalley v. Catholic Health Initiatives, Nos. 06-3884, 06-4121, 2007 U.S. App. LEXIS 27331, 2007 WL 4165751 (8th Cir. Nov. 27, 2007), the Court held that an MSP […]
Margie Mary Anderson started receiving Medicaid benefits on January 1, 1994. She died on February 21, 2004. Prior to Ms. Anderson’s death, benefits in the amount of $99,345.81 were paid to her medical providers on her behalf by the Tennessee Bureau of TennCare. In June, October and November of 2003, TennCare sent letters to Henkel’s […]
Mary Virginia Jones Henkel started receiving Medicaid benefits on July 1, 1991. She died on February 19, 2003. In March of 2003, her Conservator sent the Tennessee Bureau of TennCare a copy of the final accounting for Henkel’s conservatorship. TennCare responded by sending a printout of medical services paid by the State to the conservator, […]
Margretta K. Brice died leaving two children, Janice B. Stout and Stephen Curtice Brice. After Margretta died in 2005, Stephen filed a petition to probate her Will in solemn form. Stephen and Janice were the only beneficiaries. With the petition, Stephen filed an acknowledgment of service and assent to probate instanter executed by Janice. The […]
n 2003, Frankie Walker created an irrevocable trust. After her death, her husband, Van Anda, sought to set aside the trust and transfers into the trust, arguing they were the product of undue influence. The trust, as drafted had the effect of leaving virtually all of Frankie’s estate to her sister, Mollie Lewis. Frankie, then […]
Porter Morrison Ryan was survived by her daughter, Mary Frances Tuttle and other relatives. After Porter died in 2003, Tuttle asked the court to probate a Will executed in 1956. The other relatives objected, contending that the 1956 Will was revoked when Porter executed a new Will in 1999. Tuttle responded arguing that Porter was […]
In a “short” order, the District Court adopted the Report and Recommendation of the Magistrate finding that a medical malpractice settlement was not subject to any Medicare repayment or lien. It does not appear as though CMS was a party to the action. Thomas G. Golden of Bainbridge Island, Washington, represented the Plaintiff. Mr. Golden […]
Stalley brought a qui tam action against a group of skilled nursing facilities for failing to reimburse Medicare under the Medicare Secondary Payer Act (MSP). The action was removed and then the Defendants filed a motion to dismiss for lack of Article III standing. Because he was neither eligible for Medicare nor injured, the Court […]
Resident suffering from dementia was admitted to nursing facility. Husband signed admissions documents including two arbitration agreements. California law prohibits including the arbitration agreement in the admissions agreement so it was a separate document. Husband signed the arbitration agreement on a line labled “Legal Rep/Responsible Party/Agent.” Husband did not hold a power of attorney and […]
Lakeridge is an Ohio nursing home that participates in Medicare and Medicaid. When it was surveyed, it was found out of compliance with several provider requirements. It was fined a civil monetary penalty of $80,300. The fine was upheld and affirmed on appeal. Among the violations cited were “one violation of 42 C.F.R. § 483.25(h)(2), […]
The trial court’s order replacing a health care agent was affirmed. Resident, an 88 year old Alzheimer’s patient, was unmarried and had no children. He had named his neighbor as his health care agent. There was evidence that the agent had used a power of attorney to make substantial gifts to himself. Following admission to […]
A Tennessee case decided November 1, 2006, addresses estate recovery for married individuals. In In re Estate of Smith, Mr. and Mrs. Smith had been married for more than 60 years. Mrs. Smith suffered a series of strokes in 2001. She was then admitted to a nursing home in Madison, Tennessee. She predeceased her husband. […]
This is a motor vehicle case where Plaintiff cited Ahlborn, seeking to avoid reimbursing Medicaid. Decedent was injured in a collision on June 30, 2005 and died intestate on July 4, 2005 at age 85. A proposed settlement of $50,000 constituted the defendant’s insurance limits. All medical expenses associated with the collision were paid by […]
In this Medicaid case, the State appealed from a trial court decision. The trial court’s finding that the applicant was eligible for Medicaid was affirmed Reed entered Blanchette Place Care Center in July of 2003. In September, she and her daughter entered into a “personal care contract.” The contract required Reed’s daughter to perform duties […]
After Plaintiff filed suit, Defendant filed a motion to dismiss, compel arbitration and stay discovery. The magistrate entered a report and recommendation that the motion be denied. Before the magistrate the plaintiff raised enough evidence to question the nursing home resident’s capacity to enter into an arbitration agreement. The plaintiff also argued that because a […]
Plaintiff contested Medicare’s claim under the MSP statute. Initially counsel informed Medicaid by letter that there was no duty to reimburse Medicare due to the holding in Thompson v. Goetzmann, 315 F.3d 457 (5th Cir. 2002). Medicare responded that even if Goetzmann was relevant, it would not apply to beneficiaries residing outside the Fifth Circuit. […]
A jury trial was held to determine whether Mildred Hilton had testamentary capacity to execute a new Will. After the jury found she lacked capacity, the trial court determined that the verdict was incorrect and entered judgment notwithstanding the verdict. Alternatively, the judge also entered an order granting a new trial. Under Georgia law, a […]
Glover v. Liggett Group, Inc. Plaintiff brought a claim under 42 U.S.C. § 1395y(b)(3)(A) to recover funds for the Medicare program attributable to cigarette smoking. The trial court dismissed the claim. On appeal, the court found that “[u]ntil Defendants’ responsibility to pay for a Medicare beneficiary’s expenses has been demonstrated (for example, by a judgment), Defendants’ […]
CMS sought to impose a civil monetary penalty on the successor of a fined nursing home where the successor accepted assignment of the provider agreement rather than going through the certification process for a new provider agreement. This case includes a detailed discussion of the administrative process through which civil monetary penalties are imposed and […]
A community spouse purchased an actuarially sound single-premium irrevocable annuity for $250,000 for the purpose of spending down excess assets so her husband, a nursing home resident, would qualify for Medicaid. Pennsylvania denied eligibility, contending that the annuity was an available asset and that Medicaid eligibility could not be established until that asset was spent […]
A physician brought a qui tam action against two other physicians and several health care providers after a nurse showed him a progress note in a nursing home chart allegedly documenting a physician’s (Lachman’s) review of the chart. The problem was that the resident had died several weeks earlier. After seeing that record, the relator […]
In Arkansas Dept. Health and Human Services v. Ahlborn, 547 U.S. 268 (2006), Heidi Ahlborn suffered severe and permanent injuries at age 19 as a result of an automobile accident. She was left partially brain damaged and unable to complete her education. Medicaid determined she was eligible for benefits and paid providers $215,645.30 on her behalf. Later, […]
A personal injury victim tried to make an end-run around MSP by having payment go directly to the victim. The trial court approved the settlement structure, but it was appealed. The case was reversed since “Liberty Mutual exposes itself to paying off Tripp’s Medicare lien in the event Tripp herself does not. Leaving Liberty Mutual […]
Plaintiff’s daughter sued the nursing home after it asked EMTs to revive Doris Lee; Ms. Lee had a DNR. There were legal deformities and contradictions in three separate DNRs executed between 1996 and 2002. “The record was clear that Mrs. Lee had been under the care of several physicians and had several close calls with […]
Prior to filing suit, Plaintiff opened an estate for resident in Tallahatchie County. After the suit was filed, Defendants filed a motion to render appointment of the administrator void ab initio, contending the estate should have been filed in Leflore county. Plaintiffs then filed a petition for the appointment of an administrator in Leflore county […]
The wife was a personal representative of the husband’s estate. The husband was killed in a vehicle collision. Medicaid paid $168,691.58 in medical expenses and had an automatic lien. Medicaid filed its lien with the Court alleging a right to full payment. After the wrongful death action was brought, the case settled for $900,000, plus […]
Beverly Tutinas’s husband, Julian, was on Medicaid, but she was not. When Beverly died owning a home valued at $69,641.89 and a car worth $2,000, the State of Illinois filed a claim against Beverly’s estate, seeking to recover what Medicaid had invested in Julian’s care. The court found that, although the State clearly had a […]
When contrasted with Hines and Smith, a different result was reached where the legislature had re-written the property code. In 1993, Jack Willingham transferred certain real property to his son, reserving a life estate. In 1997, he applied for medical assistance from the state, which he received until his death in 2002. There, a 1995 […]
Effective January 1, 2021, Georgia HB 865 (Act 508), amended the Georgia Probate code. Now, if you prepare a written statement or list disposing of tangible personal property (a “who gets what” list), it can be incorporated into your will by reference. That means that if there is a dispute concerning tangible personal property, the […]
The Special Needs Alliance (SNA) is a national organization comprised of attorneys committed to the practice of disability and public benefits law. Individuals with disabilities, their families, and their advisors rely on the SNA to connect them with nearby attorneys who focus their practices in the disability law arena. The SNA is an invitation-only organization. […]
On July 5, 2016, in Doctors Hospital of Augusta v. Alicea, 299 Ga. 315 (2016), the Georgia Supreme Court affirmed lower court decisions denying a motion for summary judgment. In doing so, the Court interpreted the Georgia Advanced Directive Act, O.C.G.A. § 31-32-1 et seq., holding that it is the will of the patient or […]
Video: https://www.aging.senate.gov/hearings/watch?hearingid=3F196EE0-5056-A066-609D-66BD4C1DCB38 https://www.aging.senate.gov/hearings/fighting-elder-fraud-progress-made-work-to-be-done
If a Guardianship Petition moves forward, O.C.G.A. § 29-4-11(d) describes the required evaluation and how it works: (1) If the petition is not dismissed under subsection (b) of this Code section, the court shall appoint an evaluating physician who shall be a physician licensed to practice medicine under Chapter 34 of Title 43, a psychologist […]
Georgia has adopted the Uniform Adult Guardianship and Conservatorship Proceedings Jurisdiction Act. See O.C.G.A. § 29-11-1. et seq. That means, if you have a Georgia guardianship that needs to move to another state, or if you are in another state and you need to move a guardianship to Georgia, we have a procedure for making […]
