A Connecticut appeals court holds that the state Medicaid agency’s decision to impose an ineligibility period on an applicant’s benefits must be reversed because the agency failed to make a final decision within 90 days of the applicant’s request for review, as required by law. Handel v. Commissioner of Social Services (Conn. App. Ct., No. AC 39372, July 17, 2018).
After Heather Handel’s father, Robert Wojciechowski, was admitted to a long-term care facility in August 2013, she assisted him with applying to Connecticut’s Department of Social Services for Medicaid benefits. Later, Ms. Handel was appointed as her father’s conservatrix and in that capacity she sought to liquidate his assets to bring them into compliance with Medicaid’s asset limits. By June 2014, all assets except two had been liquidated – an insurance plan and an IRA – and with the probate court’s permission, those were liquidated in early June 2014.
The agency granted Mr. Wojciechowski’s application for benefits beginning on June 1, 2014, but denied benefits for March, April and May of 2014, concluding that the IRA and insurance funds were available to him during that time. On September 17, 2014, Ms. Handel requested administrative review of the decision, asserting that the agency had erred in finding the IRA and insurance plan to be available assets. Ms. Handel filed one request for a continuance on October 16, 2014, and a review hearing was eventually held on November 10, 2014. The hearing officer’s decision upholding the benefit denial was issued on February 20, 2015.
Ms. Handel appealed the decision to a state trial court, again asserting that the agency made a mistake in finding that the IRA and insurance plan were assets available to her father and also asserting that because the agency failed to make a final decision within 90 days of the request for a review of its decision, the denial of benefits was impermissible as a matter of law. The trial court affirmed the agency’s decision and Ms. Handel appealed.
The Appellate Court of Connecticut agrees with Ms. Handel and reverses the trial court’s decision, holding that Medicaid regulations require the agency’s final decision to be made within 90 days of the request for a review unless the delay is attributable to the applicant. Here, the agency’s final decision was entered on the 127th day after the request for the review to be rescheduled was made on October 16, 2014, and as such the decision was untimely and impermissibly rendered. The appellate court remands the case to the trial court with instructions to render judgment sustaining Ms. Handel’s appeal.
For the full text of this decision, go to: https://www.jud.ct.gov/external/supapp/Cases/AROap/AP183/183AP358.pdf
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