April 21, 2014

Transfer of assets and Medicaid ineligibility.

Practice point:  An individual will not be ineligible for Medicaid as a result of a transfer of assets if it is determined that the denial of eligibility will result in an undue hardship. An undue hardship occurs where the institutionalized individual is otherwise eligible for Medicaid, is unable to obtain appropriate medical care without the provision of Medicaid, and is unable to have the transferred assets returned, pursuant to18 NYCRR 360-4.4.

Student note:  In reviewing a Medicaid eligibility determination made after a fair hearing, the court must review the record, as a whole, to determine if the agency's decisions are supported by substantial evidence and are not affected by an error of law. "Substantial evidence" is such relevant proof as a reasonable mind may accept as adequate to support a conclusion or ultimate fact.

Case: Matter of Tarrytown Hall Care Ctr. v. McGuire, NY Slip Op 02600 (2d Dept. 2014).

Here is the decision.

Tomorrow's issue: A summary judgment motion in a medical malpractice action.