loading…
loading…
loading…
Page 25 of 40 § 10:71-4.10 Transfer of assets utilized. C.R. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 15192-15, 2016 N.J. AGEN LEXIS 251, Initial Decision (May 10, 2016). Medicaid applicant did not rebut the presumption that transfers during the look-back period were made in contemplation of Medicaid. Since the applicant had been found to be totally and permanently disabled in 2003 and started receiving Social Security disability benefits at that time, it could not be said that he suffered a traumatic onset of a disability in 2012 that resulted in his needing to apply for Medicaid. M.W. v. DMAHS and Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 8394-2013, 2016 N.J. AGEN LEXIS 264, Final Administrative Determination (April 20, 2016). Eligibility penalty was properly imposed on an elderly man's application for skilled nursing home Medicaid benefits based on $ 247,104 in transfers during the look-back period. Though the applicant's representative claimed that the bulk of those payments was made to compensate a woman who provided care to the applicant, there was no evidence whatever that the recipient of those payments actually rendered services to the applicant and it thus was properly presumed that they were transfers for less than fair market value for the purpose of establishing Medicaid eligibility. A.M. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 17835-2015, 2016 N.J. AGEN LEXIS 200, Initial Decision (April 15, 2016). Use of funds belonging to an applicant for Medicaid to purchase an immediate, irrevocable, non-transferrable, actuarially sound annuity, which named the State of New Jersey as the first remainder beneficiary, did not provide a basis for the imposition of a transfer penalty by a county division of social services. Proceeds of the annuity were clearly intended to pay for the applicant's nursing home bills during the 536.25 day penalty period imposed on account of the applicant having made a gift to her children in the amount of $ 178,353.51. Because the annuity met the criteria in 42 U.S.C.S. § 1396p(c)(1), the funds used to purchase it were not countable as a resource for eligibility purposes. M.N. v. Hunterdon Cnty. Div. of Social Servs., OAL DKT. NO. HMA 00688-16, 2016 N.J. AGEN LEXIS 198, Initial Decision (April 14, 2016). Medicaid Only Institutional benefits were properly denied by a county board of social services to an elderly applicant on the ground that her countable resources exceeded the eligibility ceiling. Though the applicant's caregiver/daughter claimed that the execution by the applicant of a power of attorney giving the daughter total power over all of the applicant's affairs, including her financial affairs, combined with the purported existence of a signed deed to the applicant's house, was sufficient to render the property "inaccessible," the applicant remained the owner of the property and its value was such that she was ineligible for the program. E.C. v. Passaic Bd. of Social Servs., OAL DKT. NO. HMA 16475-15, 2016 N.J. AGEN LEXIS 121, Initial Decision (March 14, 2016). Applicant was properly denied Medicaid eligibility based on his failure to comply with regulations requiring applicants to produce documentation reflecting his finances over the prior five years. Since it ultimately appeared that the applicant's attorney in fact possessed the information that was needed to complete the application and because the agency had already granted several extensions to the regulatory deadline for submission of such documents, there was merit to the agency's claim that the only available recourse was against the attorney, not the agency. P.S. v. Ocean Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 17263-15, 2016 N.J. AGEN LEXIS 50, Initial Decision (February 8, 2016). Decision of County Board of Social Services imposing a 34 day transfer penalty on the Medicaid benefits to which an elderly nursing home resident was entitled was rejected by an ALJ because the fair market value of the rent, utilities, food and other expenses that the resident was receiving from her daughter, with whom she lived, completely accounted for the amounts that the resident had paid to her daughter. Because those amounts represented the FMV of what the resident was receiving, no transfer penalty should have been imposed. L.S. v. Morris Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 09660-15, 2016 N.J. AGEN LEXIS 48, Initial Decision (February 5, 2016). A 99-year old Medicaid applicant failed to rebut the presumption that transfers of her property with an FMV of $ 30,300 were made in an effort to qualify for Medicaid, and an order imposing a 97 day transfer penalty was