institutional MA

DHA Case No. MDV-37/88496 (Wis. Div. of Hearings and Appeals May 16, 2008) (DHS) ↓ Download the original decision Promissory notes are commonly used to reduce countable resources for Medicaid eligibility. The rules require the note to have a repayment term within the applicant’s life expectancy, require equal payments with no balloon payment, prohibit cancellation […] Read more

DHA Case No. MRA 135337 (Wis. Div. of Hearings and Appeals Feb. 10, 2012) (DHS) ↓ Download the original decision This case was about an apparent conflict in the Medicaid Eligibility Handbook rules. On the one hand, revocable annuities are treated as available assets. On the other hand, the retirement accounts of a community spouse are exempt. […] Read more

DHA Case No. MRA-70/110322 (Wis. Div. of Hearings and Appeals May 19, 2010) (DHS) ↓ Download the original decision This case is an example of using the fair hearing process to increase the Community Spouse Resource Allowance (CSRA) beyond the normal limits. At the time of this case, the maximum CSRA would have been something […] Read more

DHA Case No. MGE 117071 (Wis. Div. of Hearings and Appeals Jul. 26, 2011) (DHS) ↓ Download the original decision This case is one example of a marital property avoiding the potential divestment when a community spouse (1) dies, (2) leaves property to someone other than the Medicaid recipient, and (3) the recipient fails to […] Read more

DHA Case No. MDV 146580 (Wis. Div. of Hearings and Appeals April 23, 2013) (DHS) ↓ Download the original decision In this divestment case, the petitioner divested $85,000 to relatives. Those same relatives afterward paid about $89,000 for the petitioner’s nursing home care. Despite this, the agency found only a partial cure, arguing that only […] Read more

DHA Case No. MGE 148648 (Wis. Div. of Hearings and Appeals Sep. 4, 2013) (DHS) ↓ Download the original decision In this straightforward case, the issue was simply whether paying a private-rate nursing home bill reduced the petitioner’s countable assets. Unsurprisingly, it did. It appears the issue came up because the county chafed against a […] Read more

Out-of-state home exempted

DHA Case No. MGE 185074 (Wis. Div. Hearings and Appeals March 14, 2018) (DHS) ↓ Download the original decision In this straightforward decision, the petitioner owned home property in Michigan but was admitted to a Wisconsin nursing home. Her Medicaid application was denied because the agency “did not receive timely verification of any circumstance that […] 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 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. 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. 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