A federal court in New Jersey rules that a nursing home resident’s lawsuit challenging the state Medicaid agency’s interpretation of the caregiver exemption from the transfer of asset rules is moot because ultimately the agency withdrew its admittedly erroneous interpretation and awarded the benefits that were sought. Nieves v. Connolly (U.S. Dist. Ct., N.J., Civ. No. 16-1594 (WHW), Aug. 17, 2016).
Andres Nieves, Sr. suffered a stroke in 2002 that left him unable to perform his activities of daily living without assistance. For a time, Mr. Nieves was able to remain at home living with his son who provided him with care and assistance, including through the hiring of private caregivers and taking time off work. The home had originally been purchased by Mr. Nieves and the son jointly, but Mr. Nieves conveyed his interest to the son outright in 2011.
In 2015, Mr. Nieves was admitted to a nursing home and applied for Medicaid long-term care benefits. In the application he sought to have his son qualified as a “caregiver child” under federal Medicaid law so as to exempt the transfer of the residence from the transfer of assets penalty. The county agency approved Mr. Nieves’ request for long-term care benefits but imposed a transfer penalty of 954 days for the transfer of his interest in the home. In emails, an employee of the agency asserted that Mr. Nieves’ son was not entitled to the caregiver child exemption because he was not unemployed during the two years prior to Mr. Nieves’ institutionalization and because he was not Mr. Nieves’ sole care provider.
Mr. Nieves filed suit in federal district court and sought to enjoin the agency from interpreting the caregiver exemption to require the caregiver child to be unemployed for two years or to be the sole care provider. However, before the court could address the merits of the complaint, the agency informed Mr. Nieves that its employee’s prior interpretation of the caregiver exemption was erroneous, retroactively reversed its earlier decision to deny the caregiver exemption and eliminated the penalty period on Mr. Nieves’ receipt of benefits. The agency then filed a motion to dismiss for lack of subject matter jurisdiction, asserting that because Mr. Nieves had received the benefits he sought and the erroneous interpretation of the caregiver exception had been rescinded, there was no controversy and the case was moot. Mr. Nieves objected to dismissal on the grounds that the agency could continue to interpret the caregiver exemption erroneously in other cases and thus the issue could evade review.
The U.S. District Court, District of New Jersey, dismisses Mr. Nieves’ lawsuit as being moot. The court concludes that in light of the agency’s decision to award Mr. Nieves the benefits he sought and its express disavowal of the allegedly unlawful interpretation of the caregiver exemption, "[t]here is no 'reasonable expectation that the same complaining party,' Plaintiff Nieves, will be subject to the same allegedly unlawful denial ofbenefits again."
For the full text of this opinion, go to: https://scholar.google.com/scholar_case?case=5306930012484442156&hl=en&as_sdt=6&as_vis=1&oi=scholarr
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