Medicaid Applicant's Retirement Benefits May Be Counted as Available Income Despite Contrary Court Ruling

A New York trial court upheld a Medicaid agency's finding that an applicant's Social Security and pension benefits should be included in the applicant's available income even though the court had ruled in a guardianship proceeding that the benefits were unavailable for Medicaid eligibility purposes. Freedman v. Commissioner of the State of New York Dept. of Health (N.Y. Sup. Ct., Richmond Cty., No. 85037/13, March 6, 2014.

The court appointed Gay Lee Freedman as guardian of the person and property of her sister, Mary Backer. The court ordered that the funds in the guardianship account and any income the guardian received, including Social Security and pension benefits, would be "deemed" unavailable for purposes of Medicaid eligibility.

Ms. Freedman applied for Medicaid benefits on Ms. Backer's behalf. The state determined she was eligible subject to a net available income that included her Social Security and pension benefits. Ms. Freedman appealed, arguing her net available income should not include those benefits. After a hearing, the state upheld the decision, and Ms. Freedman appealed.

The New York Supreme Court, a trial court, affirmed the decision, holding that the court must show deference to the state's interpretation of its rules. According to the court, as long as the agency's decision is neither legally impermissible nor violates "the petitioner's constitutional rights and protections, the court is powerless to alter that determination on the strength of what...the court might do in a similar situation."

For the full text of this decision, click here.