A New Jersey appeals court rules that a Medicaid applicant needed to appeal within 20 days even though the appeal notice was mailed to the Medicaid applicant instead of the applicant's designated representative. V.S. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-3452-16T4, May 14, 2018).
V.S. named his son, S.S., as his agent under a power of attorney and then entered a nursing home suffering from dementia and other ailments. S.S. designated the nursing home as V.S.'s representative for Medicaid purposes. The nursing home submitted a Medicaid application on V.S.'s behalf. The state requested additional information from V.S., and V.S.'s representative responded. The state notified V.S. that it was imposing a penalty period due to improper transfers and V.S. had 20 days to appeal.
Seven months later, S.S. requested a hearing, arguing that V.S. transferred less than the state claimed. The state denied the request as untimely. V.S. appealed, arguing that the penalty period notice was improper because it was addressed to V.S. instead of to the designated representative.
The New Jersey Superior Court, Appellate Division, affirms, holding that V.S. had notice of the need to appeal within 20 days, so the appeal is untimely. According to the court, the state sent all communications to the same address and V.S.'s representative had ongoing communications with the state over several months on V.S.'s behalf without any problem.
For the full text of this decision, go to: https://www.judiciary.state.nj.us/attorneys/assets/opinions/appellate/unpublished/a3452-16.pdf?cacheID=IUb3fQA
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