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. […]

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 […]

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, […]

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), […]

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 […]

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 […]

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