In Part I of this blog, I discussed a case law in New Jersey that addressed a challenge to the postponement of a penalty period of ineligibility by the New Jersey Department of Human Services.
When does a penalty begin when a transfer of assets, property and/or money is made by a Medicaid applicant? In the case of a transfer of assets, the start of the penalty date is the first day of a month during or after which assets have been transferred for less than fair market value, or the date on which the individual is eligible for medical assistance and would otherwise be receiving an institutional level care at a nursing home or assisted living residence, but for the application of the penalty period.
In order to qualify for “medical assistance under Medicaid”, New Jersey is legally required to consider only the such income and resources available to the applicant. Under New Jersey’s Medically Needy program, an individual becomes eligible for medical assistance when his/her resources do not exceed $6,000. As defined under this program, a “resource” is “any real or personal property which is owned by the applicant (or those persons whose resources are deemed available to him/her and which could be converted to cash to be used for his/her support and maintenance”. In order to be considered for eligibility, a resource must be “available”, i.e., “the person has the right, authority, or power to liquidate real or personal property, or his or her share of it.
The main issue in this case was whether the state of New Jersey through its Medical Assistance and Health Services Division which administers the Medicaid program could postpone the Plaintiff becoming eligible for benefits because of her uncompensated transfers. The Plaintiff argued that New Jersey was improperly postponing the penalty period and that the penalty period of ineligibility should have begun much earlier.
In Part III of this series, I will discuss the outcome of this case.
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