DHA Case No. FCP 193270 (Wis. Div. Hearings and Appeals June 14, 2019) (DHS) ↓ Download the original decision In this case, the petitioner was receiving Family Care and owed monthly room and board to an assisted living facility. Due to an anomaly, the check for December was never delivered, resulting in it being reissued […] Read more
Fair Hearing Decisions
DHA Case No. FCP 197076 (Wis. Div. Hearings and Appeals Feb. 28, 2020) (DHS) ↓ Download the original decision In this case, the petitioner had a life estate in two properties, one in California and one in Wisconsin. Both were rented. But Dane County DHS did not reduce the petitioner’s cost share to allow her […] Read more
DHA Case No. MED 67/53178 (Wis. Div. Hearings and Appeals Feb. 28, 2003) (DHS) ↓ Download the original decision In this case, a Medicaid recipient failed to report a divestment that occurred after her initial application was approved and benefits had started. The ALJ held that, despite the failure to report, the overpayment of benefits […] Read more
DHA Case No. MDV-36/46674 (Wis. Div. Hearings and Appeals Nov. 21, 2000) (DHS) ↓ Download the original decision When a person, or another acting on the person’s behalf, acts to transfer property such as a life estate without receiving fair market value in return, it is a divestment. But what if the transfer happens automatically, […] Read more
DHA Case No. MDV 172290 (Wis. Div. Hearings and Appeals June 3, 2016) (DHS) ↓ Download the original decision A divestment can only be cured by returning the entire value of the resource divested. But what if there have been multiple resources divested? Must all cumulative divestments be returned, or can you cure one divestment at a […] Read more
DHA Case No. MDV 197185 (Wis. Div. Hearings and Appeals Mar. 2, 2020) (DHS) ↓ Download the original decision The petitioner’s husband bought an annuity with a term beyond his life expectancy, which is usually a divestment. The ALJ agreed with the argument, however, that the annuity was bought without the intent to qualify for […] Read more
DHA Case No. FCP 177326 (Wis. Div. Hearings and Appeals Feb. 24, 2017) (DHS) ↓ Download the original decision This case supports backdating Family Care eligibility when there is a delay in enrollment due to agency error. “Although there is no retroactive enrollment in the Family Care program, enrollment as of the date established in […] Read more
DHA Case No. MGE 174654 (Wis. Div. Hearings and Appeals July 27, 2016) (DHS) ↓ Download the original decision In this case, the county required a full five years of financial documentation because “there were a few discrepancies” in the initial documents provided. The applicant complied with more than 600 pages of documentation, plus authorizations […] Read more
DHA Case No. MRA 167179 (Wis. Div. Hearings and Appeals Dec. 11, 2015) (DHS) ↓ Download the original decision This decision contains the classic “name on the check” rule. If income is paid only to the name of the community spouse, it is not countable as income to the institutionalized spouse—even if the income is […] Read more
DHA Case No. MDV 155403 (Wis. Div. Hearings and Appeals Apr. 30, 2014) (DHS) ↓ Download the original decision This decision finds that the exception to divestment for transferring the residence to a caretaker child does not apply when the applicant resides in an assisted living facility for even a short period of time before being approved […] Read more
DHA Case No. MDV 45/86382 (Wis. Div. Hearings and Appeals Nov. 19, 2007) (DHS) ↓ Download the original decision This decision finds that transferring a remainder interest in the residence to an adult caretaker daughter was not a divestment. The petitioner met the requirements for the exception to divestment in the Medicaid Eligibility Handbook. ALJ […] Read more