3.3.01 Penalty period

MDV 209022 (08/25/2023)
Missed deadlines scuttled a valid appeal of divestment, a cautionary tale

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 3.3.11 Undue hardship, 4 Program Administration, 4.7 Notices & fair hearings, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Beth Whitaker

DHA Case No. MDV 209022 (Wis. Div. of Hearings and Appeals August 25, 2023) (DHS) ↓ Download PDF An appeal of a divestment penalty must be filed within 45 days; an appeal of a hardship waiver denial must also be filed within 45 days. In this case, the agency imposed a divestment penalty when the […] Read more

MDV 210996 (12/27/2023)
Divestments during COVID PHE start penalty at first renewal, a cautionary tale

Tags: 1 Applications and Renewals, 1.2 Renewals, 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Beth Whitaker

DHA Case No. MDV 210996 (Wis. Div. of Hearings and Appeals December 27, 2023) (DHS) ↓ Download PDF The penalty period for divestments reported or discovered during the COVID-19 does not begin until “the member’s next renewal that occurs after April 1, 2023.” In this case, the petitioner sold her house in January 2023 and […] Read more

MDV 193440 (06/11/2019)
Land contract was divestment, but penalty could not be imposed due to agency error

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 3.3.18 Promissory notes – loans – land contracts – mortgages, 3.3.19 Making an asset unavailable, 4 Program Administration, 4.4 Overpayments, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Brian C. Schneider

DHA Case No. MDV 193440 (Wis. Div. of Hearings and Appeals June 11, 2019) (DHS) ↓ Download PDF A land contract must have a term within the lender’s life expectancy, provide for equal payments, and not allow cancellation on the death of the lender to avoid being considered a divestment. If it does not meet […] Read more

MDV 208757 (07/27/2023)
Undue hardship waiver filed late, not backdated

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 4 Program Administration, 4.5 Undue hardship, ALJ Beth Whitaker

DHA Case No. MDV 208757 (Wis. Div. of Hearings and Appeals July 27, 2023) (DHS) ↓ Download PDF To waive the entire divestment penalty, an undue hardship waiver request must be filed within 20 days of the undue hardship notice letter mailed by the agency. If filed later, the earliest effective date is the date […] Read more

MDV 198638 (06/29/2020)
Divestment penalty not started, petitioner failed to reapply

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 5 Subprograms, 5.05 Home and Community-Based Waivers Long-Term Care, 5.05.1 Family Care, ALJ Debra Bursinger

DHA Case No. MDV 198638 (Wis. Div. of Hearings and Appeals June 29, 2020) (DHS) ↓ Download PDF A divestment penalty for a Medicaid applicant begins on the date the person applies and is “otherwise eligible” but for the divestment; it begins for a member the first of the month after the member receives timely notice. In this case, […] Read more

MDV 200210 (01/21/2021)
Appeal too late to correct agency

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 4 Program Administration, 4.7 Notices & fair hearings, 5 Subprograms, 5.05 Home and Community-Based Waivers Long-Term Care, ALJ Debra Bursinger

DHA Case No. MDV 200210 (Wis. Div. of Hearings and Appeals January 21, 2021) (DHS) ↓ Download PDF An appeal must be filed within 45 days of an agency action for the ALJ to have jurisdiction to review it. In this case, the petitioner established an irrevocable trust, divested, and applied for Medicaid in May […] Read more

MGE 200475 (02/08/2021)
Miscalculated MCA delayed eligibility

Tags: 1 Applications and Renewals, 1.1 Applications, 1.1.5 Begin dates, 3 Financial Eligibility, 3.1 Income, 3.1.5 Unearned income, 3.2 Assets, 3.2.6 Liquid assets, 3.2.6.04 Annuities, 3.3 Divestment, 3.3.01 Penalty period, 3.3.17 Irrevocable annuities, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Peter McCombs

DHA Case No. MGE 200475 (Wis. Div. of Hearings and Appeals February 8, 2021) (DHS) ↓ Download PDF Eligibility for MA begins the first of the month in which the applicant meets all program requirements. In this case, the petitioner planned for a divestment penalty with a Medicaid-compliant annuity, but the final annuity payment occurred […] Read more

MDV 204093 (03/24/2022)
Divestment penalty start date: A cautionary tale

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.01 Penalty period, 5 Subprograms, 5.05 Home and Community-Based Waivers Long-Term Care, ALJ Kelly Cochrane

DHA Case No. MDV 204093 (Wis. Div. of Hearings and Appeals March 24, 2022) (DHS) ↓ Download PDF A divestment penalty does not start until the date a Community Waivers applicant requests a waiver program, meets the functional screen criteria, and meets all other Medicaid eligibility requirements. In this case, the petitioner—represented by a lawyer—divested […] Read more