A tort plaintiff sought to fund his special needs trust without first repaying the Medicaid lien. Citing Norwest, the Court concluded that 1396p(d)(4) does not alter Medicaid’s right to recover on its lien prior to funding a special needs trust. The recipient’s rights against the third-party tortfeasor were assigned when he applied for and received […]
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A 51 year old nursing home resident assigned her Social Security Disability check to a special needs trust. She then argued that the SSD payment was not subject to Medicaid’s co-pay requirement. The Department rejected her argument, requiring that she pay her SSD (less her personal needs allowance) toward the cost of nursing home care. […]
Carl Bergman had an annuity account which he transferred to his wife after he was admitted to a nursing home. After Lucille, his wife, was diagnosed with cancer, she gifted those assets to their children. Following Lucille’s death, the State filed an estate recovery claim in Lucille’s estate relating to payments made for Carl’s care. […]
Prior to his death, Harold Ullmer was on Medicaid. At his death, Harold and his wife, Agnes, owned their home in joint tenancy. Agnes continued to reside in the home. The State recorded a notice of lis pendens against the property, and filed a petition seeking to impose a lien in the amount of $144,475.76 […]
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 […]
Seeking to increase the Community Spouse Resource Allowance (CSRA), the Staffords conveyed their home to a trust. After Mr. Stafford was institutionalized, the trust conveyed the home to Mrs. Stafford. The purpose of the transaction was to make the home countable during the resource assessment, thereby increasing the value of the marital assets; in Idaho […]
Robert and Josephine James were married when Robert went to the nursing home. A resource assessment was done and Medicaid determined they had $278,343 in available resources. To reduce their assets, Josephine purchased a $250,000 single premium immediate irrevocable annuity from General Electric Assurance Company. She then purchased a new vehicle for $8,550 and filed […]
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 […]
