DHA Case No. MRA 213308 (Wis. Div. Hearings and Appeals Jul. 31, 2024) (DHS) ↓ Download PDF A Community Waivers member in Group B or B Plus may use spousal improverishment rules to give income to his or her spouse as an “institutionalized person,” but Group A members are excluded from that definition. In this […] Read more

DHA Case No. CWA 213191 (Wis. Div. Hearings and Appeals Jul. 15, 2024) (DHS) ↓ Download PDF Community Waivers members in Groups B and B Plus may use spousal improverishment rules to give income to their spouses, but Group A members may not. In this case, the petitioner was enrolled in Group B in 2019 […] Read more

DHA Case No. MRA 211198 (Wis. Div. of Hearings and Appeals March 28, 2024) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the community spouse was diagnosed […] Read more

DHA Case No. MRA 210683 (Wis. Div. of Hearings and Appeals January 8, 2024) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the community spouse had many […] Read more

DHA Case No. MED 36/47216 (Wis. Div. of Hearings and Appeals July 24, 2001) (DHS) ↓ Download PDF Wisconsin’s spousal impoverishment law provides that the income of an institutionalized spouse (including a participant in Community Waivers) is not considered available to the community spouse. In this case, DHS had changed its policy so that the […] Read more

DHA Case No. MGE 162960 (Wis. Div. of Hearings and Appeals March 6, 2015) (DHS) ↓ Download PDF In a spousal impoverishment case, any assets designated for burial purposes are exempt (as long as the amount is reasonable). In this case, the petitioner designated stocks and an insurance policy as burial funds on his November […] Read more

DHA Case No. MGE 210503 (Wis. Div. of Hearings and Appeals December 19, 2023) (DHS) ↓ Download PDF After enrollment in a long-term care Medicaid program, the institutionalized spouse must spend down or transfer resources to the community spouse to get below $2,000 by the first renewal. In this case, the petitioner failed to do […] Read more

DHA Case No. MGE 210600 (Wis. Div. of Hearings and Appeals December 22, 2023) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the CSIA was increased in […] Read more

DHA Case No. MGE 207780 (Wis. Div. of Hearings and Appeals July 14, 2023) (DHS) ↓ Download PDF A Medicaid applicant has an obligation to give the agency all relevant information. In this case, the petitioner applied in November 2022 and had an asset assessment as of that date, which presumably resulted in a $50,000 […] Read more

DHA Case No. MGE 209995 (Wis. Div. of Hearings and Appeals December 1, 2023) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the agency did not explain […] Read more

DHA Case No. MRA 208459 (Wis. Div. of Hearings and Appeals June 29, 2023) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the community spouse had income […] Read more

DHA Case No. FCP 173457 (Wis. Div. of Hearings and Appeals September 15, 2016) (DHS) ↓ Download PDF The Medicaid Eligibility Handbook used to direct that the snapshot date for a spousal asset assessment was the “date of the first request for Community Waivers.” In this case, the petitioner was determined functionally eligible on August […] Read more

DHA Case No. MGE 207580 (Wis. Div. of Hearings and Appeals April 14, 2023) (DHS) ↓ Download PDF An institutionalized spouse may allocate income to the community spouse up to a certain amount, and an ALJ may increase that if the petitioner shows “exceptional circumstances resulting in financial duress.” In this case, the petitioner appealed […] Read more

DHA Case No. MGE 207300 (Wis. Div. of Hearings and Appeals February 28, 2023) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the community spouse had earned […] Read more