Jun 22

Medicaid Applicant Can Appeal Decision that Has Not Yet Been Enforced


An Ohio appeals court rules that a trial court improperly dismissed an appeal by a Medicaid applicant for lack of justiciability because the decision had not been enforced yet. Stolzenburg v. Ohio Dept. of Job & Family Servs. (Ohio Ct. App., 3rd Dist., No. 2-15-01, June 8, 2015).

Nursing home resident Larry Stolzenburg applied for Medicaid benefits. The Medicaid agency found that Mr. Stolzenburg had made an improper transfer and imposed a penalty period. Mr. Stolzenburg appealed the decision to the Ohio Department of Job and Family Services (ODJFS), and after a hearing, the ODJFS affirmed the decision.

Mr. Stolzenburg appealed the ODJFS’s decision to court (Mr. Stolzenburg died while the case was pending and his executor was substituted). The trial court dismissed the appeal for lack of justiciability, holding that ODJFS’s decision does not adversely affect Mr. Stolzenburg until the Ohio Department of Medicaid (ODM) takes action to enforce the state’s decision. The estate appealed.

The Ohio Court of Appeals reverses, holding that the case is justiciable. According to the court, “the possibility that parties might settle a case following a court’s judgment or that a prevailing party might not enforce a court’s judgment do not affect justiciability and the court’s ability to enter judgment in the first place.  Applying the common pleas court’s reasoning, no case would be justiciable . . . “

For the full text of this decision, go to: http://www.supremecourt.ohio.gov/rod/docs/pdf/3/2015/2015-Ohio-2212.pdf