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Page 3 of 4 § 10:71-2.1 Definitions Chapter Notes Case Notes Notice of denial of Medicaid to the authorized agent who submitted the application on behalf of the proposed recipient was valid. N.J.A.C. 10:71-8.3, which authorized such notice to the applicant, was not contrary to federal Medicaid regulations and no denial of due process existed when the notice of denial was sent to the applicant. ESTATE OF V.M. v. DIVISION OF MED. ASSISTANCE & HEALTH SERVS. & BERGEN COUNTY BD. OF SOC. SERVS., 385 N.J. Super. 165, 896 A.2d 503, 2006 N.J. Super. LEXIS 116 (2006). Elderly woman was not denied due process when the notices regarding the denial of her applications for Medicaid benefits were sent to her daughter and/or son-in-law, who had actually filed the various applications, instead of the elderly woman herself. N.J.A.C. 10:71-8.3 authorized sending a notice of denial to the applicant, which included a recipient's authorized agent, and the State of New Jersey's Medicaid plan was approved by the federal government and was not contrary to the federal Medicaid regulations. ESTATE OF V.M. v. DIVISION OF MED. ASSISTANCE & HEALTH SERVS. & BERGEN COUNTY BD. OF SOC. SERVS., 385 N.J. Super. 165, 896 A.2d 503, 2006 N.J. Super. LEXIS 116 (2006). ALJ rejected an agency determination denying Medicaid benefits to an applicant, which denial was based on the agency's finding that the applicant had failed to provide required verifications. The evidence tended to show that the applicant's representative in fact provided most of the requested documents prior to the deadline and timely requested clarification of some of the requested items, which clarification was not timely provided. Nor was the agency's claim that the documents should have been included in tabbed volumes sufficient to justify the agency's denial. S.I.K. v. Passaic Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 03882-17, 2017 N.J. AGEN LEXIS 703, Initial Decision (September 8, 2017). Medicaid applicant who signed a contract agreeing to pay all expenses of residing in a nursing home for a guaranteed two year period was not entitled to have the asset transfer-related penalty period run while she was in private pay status. Her claim of financial eligibility was a sham designed to have a Medicaid bed waiting for her when her assets ran out. Further, the facility would not accept payments from Medicaid until the applicant had been a resident of the facility for two years. Because the application for Medicaid benefits was premature, the county social services board acted properly in denying it. B.K. v. Monmouth Cnty. Div. of Social Servs. et al, OAL DKT. NO. HMA 18569-16, 2017 N.J. AGEN LEXIS 224, Initial Decision (April 24, 2017). County social services board erred in denying an application for Medicaid for a claimed failure to provide required verifications because some of the items that the board claimed had not been provided in response to its original notification in fact had not been requested and the board failed to respond to a request by the applicant for a reasonable extension of the deadline to allow other materials to be submitted. S.I.K. v. Passaic Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 11596-16, 2016 N.J. AGEN LEXIS 1013, Initial Decision (December 5, 2016). County social services board did not err in denying an application for Medicaid for the applicant's failure to provide required verifications because it had granted two extensions to the applicant to allow her to provide missing information and the applicant's ongoing failure to provide needed information afforded grounds for denial of the application. S.C. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 11683-16, 2016 N.J. AGEN LEXIS 1014, Initial Decision (November 30, 2016). Denial of Medicaid eligibility under N.J.A.C. 10:71-2.1 was reversed and a reassessment of the case ordered. The Division of Medical Assistance and Health Services and the Passaic County Board of Social Services (agency) failed to provide notification of documents needed for eligibility approval to the applicant's husband, who took care of her affairs after she was admitted to a nursing home due to the her dementia, and instead sent those letters to the nursing home, which did not forward them. The agency failed to comply with the administrative law judge's letter ordering it to provide a specific list of remaining documents needed for Medicaid eligibility to the husband. N.L.