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In a recent case out of Ohio, a Medicaid applicant was denied benefits because she owned two pieces of land valued over her resource limit. Despite being unable to sell the property, an Ohio appeals court affirmed the ruling. Let’s delve into Cowan v. Ohio Dept. Jobs & Family Servs.
The Medicaid Application, Denial, and Appeals
After entering Carespring, a nursing facility, in September 2017, Mary Cowan needed assistance covering her care costs, so she applied for Medicaid benefits. She granted Carespring the authority to apply on her behalf and take any necessary action to secure her eligibility, including pursuing legal action.
Unfortunately, the Ohio Department of Job and Family Services (ODJFS) denied her application due to assets exceeding the resource limit. Cowan owned two parcels of land totaling $6,000, which exceeded her asset limitation of $2,000. She appealed, arguing the property should not count toward her resources because she was unable to find a buyer and was therefore unable to liquidate the assets. This argument was based on a federal SSI regulation that asserts property that cannot be liquidated is not considered a resource.
After the state denied her appeal, Ms. Cowan appealed to court, where the appeal was dismissed. The basis of this decision was that the nursing home hired her attorney, which meant the facility was acting on her behalf and, thus, lacked standing to present the appeal. In an alternative decision, the trial court ruled Ms. Cowan had excess resources, which she then appealed.
Watch Now: Overcoming Denials and Fair Hearing Support
Ruling from the Ohio Court of Appeals, First District
Ultimately, the Ohio Court of Appeals, First District, affirmed the decision that Ms. Cowan’s Medicaid application was properly denied due to excess resources. Additionally, it held that the federal SSI regulation does not apply to this case since Ms. Cowan retained the legal authority to sell the property despite being unable to do so. However, it rejected the court’s decision on standing. That is, even though Carespring hired the attorney, the facility was not listed as a party to the appeal, and Ms. Cowan’s standing should not have been questioned.
In the end, Ms. Cowan decided to give the property away in order to achieve Medicaid eligibility.
A Case for Undue Hardship?
Since the value of the land was relatively low, Ms. Cowan likely had a penalty period of just a month (or less) before she could begin receiving Medicaid benefits. Additionally, Ms. Cowan was already residing in the facility, so she was receiving the care she needed as well as food, shelter, and other necessities. Under different circumstances, such as a case involving a higher-value resource or an individual who is not getting proper care, the attorney may be able to pursue an undue hardship waiver to surpass the penalty period and achieve immediate eligibility for benefits.
If you have a Medicaid planning case that requires a fair hearing or a trial due to a product purchased through our office, our in-house attorneys are ready to help. Whether you need expert testimony, litigation support, or advice for preparing the case, contact us.
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