A New Jersey appeals court upholds the state's denial of Medicaid benefits to an applicant because the applicant did not provide the necessary verifications, rejecting the administrative law judge's decision that the case must be decided on its merits. P.B. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-5405-15T2, Dec. 8, 2017).
P.B.'s daughter filed a Medicaid application on her behalf. The Medicaid agency requested additional information about P.B.'s bank accounts, life insurance, and housing. P.B.'s daughter did not provide this information, and the Medicaid agency denied P.B. benefits.
P.B.'s daughter appealed on P.B.'s behalf. After a hearing, the administrative law judge (ALJ) remanded the case to the Medicaid agency to work on getting the required information, ruling that the case must be decided on the merits unless P.B.'s daughter failed to cooperate without good cause. The state rejected the ALJ's decision and upheld the decision to deny benefits. P.B.'s daughter appealed to court, arguing that the Medicaid agency failed to assist her with the application.
The New Jersey Superior Court, Appellate Division, affirms the state's denial of Medicaid benefits. According to the court, P.B.'s daughter did not provide any evidence to show why she couldn't comply with the state's request for additional verifications, so the state properly denied P.B. benefits.
For the full text of this decision, go to: https://www.njcourts.gov/attorneys/assets/opinions/appellate/unpublished/a5405-15.pdf
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