The following is a recent New Jersey Superior Court decision regarding funds held in an inaccessible account.
A New Jersey appeals court reverses the suspension of Medicaid benefits to a nursing home resident, concluding that the agency improperly counted funds being withheld by the beneficiary's bank. A.D. v. Division of Medical Assistance and Health Services and Bergen County Board of Social Services (N.J. Super. Ct. App. Div., No. A-1053-09T1, Nov. 23, 2010).
A.D., an 80-year-old retired physician, entered a nursing home in late 2004 and began receiving Medicaid nursing home benefits. Subsequently, the county agency learned that she owned two Keogh accounts at Citibank worth $22,000 and found her ineligible to receive benefits for two and a half years. (A.D. had not known of the accounts, which apparently were set up by a former employer.)
A.D. challenged the benefits suspension, asserting that Citibank's obstructionism and failure to release the funds had made them inaccessible and not countable as an available resource for Medicaid eligibility purposes. A final agency decision upheld the suspension, concluding that although Citibank was responsible for two years of delays in releasing the funds, at all times the accounts had been available to A.D. and includable in the Medicaid eligibility determination. Relying on I.L. v. N.J. Dept. of Human Services, A.D. appealed, asserting that the agency erred by failing to distinguish between available resources and accessible resources.
The Superior Court of New Jersey, Appellate Division, reverses. The court holds that Citibank's recalcitrance and failure to release the funds when asked made the funds inaccessible to A.D. and thus uncountable as a resource to her in the eligibility determination.
