DHA Case No. MDV-37/88496 (Wis. Div. of Hearings and Appeals May 16, 2008) (DHS)  ↓ Download PDF 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 of the […] Read more

DHA Case No. MRA 135337 (Wis. Div. of Hearings and Appeals Feb. 10, 2012) (DHS)  ↓ Download PDF The Medicaid Eligibility Handbook contains two apparently conflicting rules. On the one hand, revocable annuities are counted as available assets. On the other hand, the retirement accounts of a community spouse are exempt. In this case, the […] Read more

DHA Case No. MRA-70/110322 (Wis. Div. of Hearings and Appeals May 19, 2010) (DHS)  ↓ Download PDF 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 like $110,000. […] Read more

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

DHA Case No. MDV 146580 (Wis. Div. of Hearings and Appeals April 23, 2013) (DHS)  ↓ Download PDF 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 the payments […] Read more

DHA Case No. MGE 148648 (Wis. Div. of Hearings and Appeals Sep. 4, 2013) (DHS)  ↓ Download PDF 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 well-known fact […] Read more

DHA Case No. MGE 170367 (Wis. Div. of Hearings and Appeals March 2, 2016) (DHS)  ↓ Download PDF This decision discussed two issues at some length. First, whether payments to the petitioner’s daughter were divestments; and second, whether the petitioner’s former home, now rented at fair market value, was countable. On the first issue, the […] Read more

DHA Case No. MGE 185074 (Wis. Div. Hearings and Appeals March 14, 2018) (DHS)  ↓ Download PDF 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 would exempt […] Read more

DHA Case No. MDV 195771 (Wis. Div. Hearings and Appeals January 9, 2020) (DHS)  ↓ Download PDF In this case, the petitioner’s son bought her multi-family residential property, which had also been her home. A bank evaluation estimated the property’s fair market value at $225,000, and the tax assessment bill estimated it at $236,500. The […] Read more

DHA Case No. MED 67/53178 (Wis. Div. Hearings and Appeals Feb. 28, 2003) (DHS)  ↓ Download PDF In this case, a Medicaid recipient failed to report a divestment that occurred after her initial application was approved and benefits had started. The ALJ held that, despite the failure to report, the overpayment of benefits was not […] Read more

DHA Case No. MDV-36/46674 (Wis. Div. Hearings and Appeals Nov. 21, 2000) (DHS)  ↓ Download PDF 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, because of […] Read more

DHA Case No. MDV 197185 (Wis. Div. Hearings and Appeals Mar. 2, 2020) (DHS)  ↓ Download PDF 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 Medicaid, warranting […] Read more

DHA Case No. MGE 174654 (Wis. Div. Hearings and Appeals July 27, 2016) (DHS)  ↓ Download PDF 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 for the […] Read more

DHA Case No. MRA 167179 (Wis. Div. Hearings and Appeals Dec. 11, 2015) (DHS)  ↓ Download PDF This decision contains the classic “name on the check” rule. If income is paid only to the name of the community spouse, it is not countable as income to the institutionalized spouse—even if the income is from an […] Read more