Medicaid: No transfer penalty where transfer reimbursed third party for advancing expenses

No Penalty Where Transfer Reimbursed Third Party for Paying Applicant’s Expenses. Petitioner was admitted to a nursing home on May 7, 2008 and remained there until her death on July 24, 2008. Petitioner filed an application for Medicaid on July 3, 2008, seeking retroactive coverage. The application was denied after DFCS discovered a $22,668.56 transfer on June 19, 2008, as well as another transfer of $4,500. However, the evidence at the fair hearing showed the recipient had spent more than forty thousand of her own funds paying for Petitioner’s care. The ALJ found there was no transfer for less than fair market value and reverse the decision. Even if the transfer was deemed “a transfer to a relative or others for care provided for free in the past” under Section 2342 and, therefore, without consideration, the evidence proved that reimbursement of payments made to third parties was for compensation. Further, O.C.G.A. § 11-3-303(a) provides that transfer of an interest (e.g., bank draft) may be for value if transferred as payment of, or as security for, an antecedent claim. Under O.C.G.A. § 11-3-303 (b), such a transfer is for consideration. Thus, Petitioner rebutted the presumption that the transfers were for less than fair market value. (Homel v. Department).

OSAH-Richmond-Woodard-11-2008.pdf (November 7, 2008).