Page 29

Page 7 of 14 § 10:71-2.2 Responsibilities in the application process demonstrate they either asked for or that there were exceptional circumstances warranting additional time to provide the requested verifications. J.B. v. DMAHS, OAL DKT. NO. HMA 9587-2016, 2016 N.J. AGEN LEXIS 1374, Final Administrative Determination (December 15, 2016). Failure on the part of the representative for a nursing home resident to submit required documentation despite the issuance of numerous extensions of the deadline afforded grounds for a denial of Medicaid eligibility. A.D. v. Cape May Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 10418-16, 2016 N.J. AGEN LEXIS 1236, Initial Decision (December 8, 2016). 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). Though the ALJ recognized that employee of a county social services board had mishandled the Medicaid application made by a husband on behalf of his institutionalized wife, the ALJ lacked the power to provide an "equitable" remedy because the wife was not Medicaid-eligible until the spend-down was completed. However, the ALJ encouraged the Commissioner to exercise any discretion possessed by the Commissioner's office in order to address the seemingly unfair result. A.S. v. DMAHS and Monmouth Cnty. Div. of Social Servs., OAL DKT. NO. HMA 13504-16, 2016 N.J. AGEN LEXIS 1015, Initial Decision (November 4, 2016). Applicant's challenge to an order denying Medicaid eligibility on findings that there was no verification of certain deductions from insurance policies failed because the social services board made clear requests for such information and the nursing home that was acting for the applicant failed to provide the requested information. J.B. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 09587-16, 2016 N.J. AGEN LEXIS 955, Initial Decision (November 3, 2016). Agency should not have denied a Medicaid application on a finding that required financial verifications were not provided but should have granted additional time to the applicant to obtain the requested documents because the applicant's representative made ongoing concerted efforts to obtain the requested documents and had promptly advised the agency of the difficulties that were being encountered by the representative in trying to obtain documents from a financial institution that had been acquired by another institution. W.S. v. DMAHS et al., OAL DKT. NO. HMA 11145-16, 2016 N.J. AGEN LEXIS 866, Initial Decision (October 21, 2016). Though the agency failed to promptly process an application for Medicaid Only nursing home benefits and failed to advise the applicant of the reason for delay, the failure of the agency to advise the applicant of what needed to occur for eligibility to be determined was not grounds for an eligibility date that was earlier than that granted by the agency because the applicant was not resource-eligible earlier than the date awarded. W.H. v. Monmouth Cnty. Div. of Social Servs., OAL DKT. NO. HMA 10917-16, 2016 N.J. AGEN LEXIS 862, Initial Decision (October 19, 2016). Application for Medicaid was properly denied because the applicant, despite receiving three deadline extensions, failed to provide documentation repeatedly requested by a county social services board. M.M. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 03870-16, 2016 N.J. AGEN LEXIS 820, Initial Decision (October 3, 2016). Medicaid recipient's benefits were properly terminated on findings that he did not demonstrate, as required, that he in fact was not the owner of an LLC in whose name a utility bill was received because the recipient had the