A New Jersey appeals court rules that the state must give proper notice and the right to appeal to a deceased Medicaid applicant's designated representative. E.H. v. Division of Medical Assistance and Health Services (N.J. Sup. Ct., App., Div., No. A-4560-15T2, Nov. 3, 2017).
E.H. applied for Medicaid and named Future Care Consultants (FCC) as her designated representative. E.H. died while the application was pending. The state denied the application because E.H. did not provide her husband's bank records.
FCC requested a hearing, but the state requested a copy of the denial letter before doing anything else. FCC sent the requested document and contacted the state about the hearing. In an oral response to the FCC, the state refused to set a hearing unless the executor of E.H.'s estate signed the designated representative form. FCC appealed to court, arguing that FCC met the federal definition of a Medicaid applicant.
The New Jersey Superior Court, Appellate Division, reverses and remands, ruling that the state did not provide FCC with proper notice of its right to appeal. According to the court, the state's "oral decision, even if deemed a final decision, violated state and federal regulations requiring written notice and notice of a right to seek state agency or judicial review."
For the full text of this decision, go to: https://www.judiciary.state.nj.us/attorneys/assets/opinions/appellate/unpublished/a4560-15.pdf
Did you know that the ElderLawAnswers database now contains summaries of more than 2,000 fully searchable elder law decisions dating back to 1993? To search the database, click here.
Subscribe to the Knowledge Bank.
