Blog: News & Insights

Did you know that there is a way for low-income community spouses of Medicaid applicants to hold onto extra assets? We have had the opportunity in an array of cases over the years to obtain greater protection for such spouses. Ordinarily, the combined available marital assets must be “spent down” to a certain level before an application for Medicaid can be filed to pay for the...

E. R. vs DMAHS and Department of Health and Senior Services OAL docket no. HMARP 09910-09, Final Agency Decision dated April 12, 2010. In this case, attorney Lauren S. Marinaro secured a  Post-Eligibility Medical Expense Income Deduction (PEME) for her client per 42 USC 1396a(r)(1)(A) to pay off the Medicaid recipient’s outstanding pre-eligibility assisted living health care...

P.K. vs Union County Board of Social Services and DMAHS OAL docket no. HMA7069-09N, Final Agency Decision issued March 4, 2010 Immediate, nonassignable, irrevocable IRA annuity, purchased by the community spouse during the spend-down period, naming the State of New Jersey as the 1st remainder beneficiary to the extent of Medicaid benefits paid for the institutionalized spouse, is not an...

Duffy vs Velez, (U.S. District Court) Case no. 3:09-cv-05539-AET-LHG. This was an  action filed under the Americans with Disabilities Act (the A.D.A.), (Westlaw citation is Duffy v. Velez, 2010 WL 503037, (D.N.J.,2010)) seeking an accommodation for the plaintiff, specifically,  waiver of the income cap in the Global Options Medicaid Program so that Mr. Duffy could reside in assisted living...

Estate of M.M. vs Division of Medical Assistance & Health Services & Union County Board of Social Services, OAL docket no. HMA 13911-08 Final Agency Decision May 2009 adopting the ALJ Initial Decision, reverses County Board’s action that penalized pre-eligibility transfers of assets and that denied eligibility on the basis that the Medicaid applicant wasn’t a resident of New Jersey at...

J.P. v. Division of Medical Assistance and Health Services, 392 N.J.Super. 295, 920 A.2d 707 (N.J.Super.A.D.,2007). After a supplemental needs trust was created for a physically disabled wife and husband was ordered in divorce decree to pay $1550 per month in alimony to trust, county board of social services notified wife that the alimony would be considered income, for Medicaid purposes, to...

W.T. v. Division of Medical Assistance and Health Services, 391 N.J.Super. 25, 916 A.2d 1066 (N.J.Super.A.D.,2007). Appeal was taken from final agency decision of the Department of Human Services Division of Medical Assistance and Health Services (DMAHS) upholding the assessment of a transfer penalty delaying the effective date of institutionalized applicant’s participation in Medicaid...

38-4-3076 I/M/O Estate of Denner, Chancery Div.–Union Cy. (Lyons, P.J.Ch.) (8 pp.) (Unpublished decision dated Feb. 28, 2006, Released Mar. 1, 2006.) The plaintiff  submitted three unsigned alternative documents which she claimed should be probated as writings intended to be a Will under the revised probate code, instead of the earlier Will that was probated by the defendant: (1) an...

P.C. v.  Division of Medical Assistance and Health Services and Union County Board of Social Services, Docket No.  A-1005-02T3 (N.J. App.  Div., March 17, 2004) (unpublished). Medicaid applicant was issued a transfer penalty for failing to seek her “elective share” of her deceased spouse’s estate.  Applicant and spouse had been living separately for over 18 months due to applicant’s choice to...

Avery v. Union County Division of Social Services, Docket No. A-2408-01T2 (N.J. App. Div., May 15, 2003) (unpublished). Medicaid applicant denied eligibility due to “available resource” of the working spouse consisting of her employer-based 401k plan.  This ERISA plan restricted early withdrawal to distinct emergency situations, including payment of “medical care” which is defined in the IRS...