DHA Case No. MDV 40/44764 (Wis. Div. Hearings and Appeals 2001) (DHS) ↓ Download PDF It is generally a divestment to sell real estate for less than its fair market value. In this case, the petitioner sold her duplex on the market for $72,500, less than its tax-assessed value of $95,900. ALJ Joseph Nowick concluded […] Read more

DHA Case No. MDV 70/74428 (Wis. Div. Hearings and Appeals Apr. 18, 2006) (DHS) ↓ Download PDF One exception to the usual divestment rule is if the transfer was not made for the purpose of becoming eligible for Medicaid. In this case, the petitioner’s POA transferred three pieces of real estate to family members before […] Read more

DHA Case No. MDV 45/81748 (Wis. Div. Hearings and Appeals Feb. 26, 2007) (DHS) ↓ Download PDF A certified appraisal generally considers a home’s condition when estimating its fair market value. In this case, the petitioner sold her home to her son for $80,000. About one year earlier, an appraisal done for refinancing estimated the […] Read more

DHA Case No. MDV 23/99503 (Wis. Div. Hearings and Appeals Jan. 26, 2009) (DHS) ↓ Download PDF Purchasing an annuity or promissory note with interest at less than the applicable federal rate is a divestment. In this case, the petitioner established a private annuity that met all other requirements but returned no interest. ALJ Kenneth […] Read more

DHA Case No. MDV 37/61571 (Wis. Div. Hearings and Appeals Apr. 7, 2004) (DHS) ↓ Download PDF Fair market value is an estimate of the amount an asset will sell for in an arms-length transaction on the open market. In this case, the petitioner sold three residential properties to his sons for their appraised value, […] Read more

DHA Case No. MDV 45/55210 (Wis. Div. Hearings and Appeals, 2003) (DHS) ↓ Download PDF It is generally a divestment for a community spouse to transfer assets for less than fair market value to anyone other than the institutionalized spouse. In this case, the community spouse’s interest in marital property was transferred by his revocable […] Read more

DHA Case No. MDV 13/106538 (Wis. Div. Hearings and Appeals Jan. 4, 2010) (DHS) ↓ Download PDF A transfer to an irrevocable trust is generally a divestment if the trust cannot make payments back to (or for the benefit of) the grantor under any circumstances, but a divestment can be cured if the full value […] Read more

DHA Case No. CWA 208558 RHG (Wis. Div. Hearings and Appeals Sep. 5, 2023) (DHS) (decision on rehearing) ↓ Download PDF Participants in IRIS may submit a budget amendment (BA) request to increase their budget to pay for an ongoing need not met within the current budget. In this case, the petitioner submitted a BA […] Read more

DHA Case No. CWA 208558 (Wis. Div. Hearings and Appeals Jul. 26, 2023) (DHS) ↓ Download PDF Participants in the IRIS program have certain rights to appeal that do not extend to providers. In this case, the petitioner appealed the denial of his budget amendment request to increase the rate paid to his supportive home […] Read more

DHA Case No. MGE 157892 (Wis. Div. of Hearings and Appeals July 30, 2014) (DHS) ↓ Download PDF County agencies may not over-verify; they may only require the verification needed to determine eligibility. In this case, the agency requested verification of an old family trust that had been depleted and the value of a Wispact […] Read more

DHA Case No. MED 70/82111 (Wis. Div. of Hearings and Appeals February 28, 2007) (DHS) ↓ Download PDF The asset limit for Institutional MA is $2,000. In this case, the petitioner misidentified a savings account as life insurance on her application. The county worker, who was “simply scanning the application” at the time, advised the […] Read more

DHA Case No. CWA 212224 (Wis. Div. of Hearings and Appeals July 3, 2024) (DHS) ↓ Download PDF Family Care enrollment may be backdated if agency error causes a delay in enrollment. In this case, the ADRC completed the functional screen on October 31 but did not notify IM of the referral until January 10. […] Read more

DHA Case No. CWA 211772 (Wis. Div. of Hearings and Appeals July 2, 2024) (DHS) ↓ Download PDF Late renewals can cause a gap in Community Waivers enrollment, though the Department has allowed for an expedited re-enrollment process to minimize this. In this case, however, the petitioner submitted his renewal timely on the due date […] Read more

DHA Case No. MGE 212813 (Wis. Div. of Hearings and Appeals June 28, 2024) (DHS) ↓ Download PDF Family Care enrollment may be backdated if agency error causes a delay in enrollment. In this case, the agency requested verification of a new funeral trust—which the petitioner had created but not reported during the pandemic—during a […] Read more