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Monday, July 18, 2005

Medicaid

The U.S. Court of Appeals for the Second Circuit affirms a district court ruling upholding the right of a Connecticut nursing home resident applying for Medicaid to assign support rights to the state and of his wife to exercise her right of spousal refusal. Morenz v. Wilson-Coker (2nd Cir., No. 04-4107-cv, July 14, 2005).

Robert Morenz, a Connecticut nursing home resident, applied for Medicaid coverage on November 1, 2003. In support of Mr. Morenz's application, his wife, Clara, also filed a written assignment of Mr. Morenz's support rights to the State of Connecticut, and a document entitled "Spousal Refusal Statement," in which Mrs. Morenz disclaimed any intention to provide her husband with financial assistance. In the 36 months prior to applying for Medicaid, Mr. Morenz had transferred title to $323,131 in assets to Mrs. Morenz using a durable power of attorney her husband had executed. Mr. Morenz's application for Medicaid was denied on the basis of excess resources. Both the Morenzes and Patricia Wilson-Coker, Commissioner of the Connecticut Department of Social Services, moved for summary judgment.

Ms. Wilson-Coker argued that Connecticut law grants acceptance of spousal support rights only when the community spouse cannot or will not provide eligibility information. She further claimed that Mrs. Morenz's power of attorney did not authorize the assignment, and that Mrs. Morenz violated her fiduciary duty to her spouse by assigning support rights. Finally, Ms. Wilson-Coker contended that permitting Medicaid eligibility in cases like those of the Morenzes would undermine the intent of the program.

The U.S. District Court for the District of Connecticut rejected these arguments and enjoined Ms. Wilson-Coker from denying Mr. Morenz's Medicaid application. Morenz v. Wilson-Coker, 321 F. Supp. 2d 398 (D. Conn. 2004). The court also ordered that Mr. Morenz's eligibility become effective three months prior to the court's decision. Ms. Wilson-Coker appealed, arguing in addition that the district court's order as to the effective date of Mr. Morenz's eligibility violated the Eleventh Amendment.

The United States Court of Appeals, Second Circuit, affirms. "[A]s the district court noted," the court writes, "the language of the [federal Medicaid] statute could not be less ambiguous. A community spouse's resources cannot be included in making an institutionalized spouse's initial eligibility determination if the institutionalized spouse has assigned support rights to the state or undue hardship is present." [emphasis in original] The court also rules that the district court correctly held that neither the statute nor Connecticut's own published regulations support Ms. Wilson-Coker's interpretation of the assignment statute. Finally, the court rules that the district court's order does not run afoul of the Eleventh Amendment.

 

 
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