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., 3^rd 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

A Massachusetts appeals court rules that the state may impose a second penalty period based on the same transfers of assets after one of the transfers was cured and the applicant reapplied for benefits before the first penalty period was over. Burt v. Director of the Office of Medicaid (Mass. Ct. App., No. 13-P-1853, May 29, 2015).

Catherine Harrington made two separate transfers of assets—one for $45,000 and one for $134,834. She applied for Medicaid benefits in December 2006. Based on the transfers, the state imposed a penalty period until December 2008. More than 60 days after Ms. Harrington was notified about the penalty period, her niece returned the $45,000 transfer. In June 2008, Ms. Harrington filed a second application for benefits. The state imposed a new penalty period, running from March 2008 until July 2009, for the $134,834 transfer that occurred before the first application.

Ms. Harrington appealed, arguing that her penalty period should have begun in December 2006 and that it was impermissible for the state to impose a new penalty period for the same transfer she was already penalized for. Under Massachusetts regulations, because the transfer was cured more than 60 days after the notice about the penalty period, Ms. Harrington had to reapply for benefits. The state argued its regulation requires it to review a new application in its entirety and make a new determination about when the applicant is “otherwise eligible.” The trial court affirmed the state’s decision, and Ms. Harrington appealed.

The Massachusetts Court of Appeals affirms, holding that the state’s imposition of the second penalty period does not violate state or federal law. According to the court, “nothing in the plain language of the regulations requires that the start date for the recalculated penalty period be the same day that the prior penalty period began.” The court rules that an applicant does not become “otherwise eligible” at a time when nursing home services are being paid for and that Ms. Harrington was paying for services until March 2008.

In a nursing home’s lawsuit against a former nursing home resident for unjust enrichment, an Ohio appeals court rules that although notice of the trial court’s hearing was initially sent to the wrong address for her attorney, the resident received proper notice because the court placed the hearing on its docket. Gibsonburg Health, LLC v. Miniet (Ohio Ct. App., 6^th Dist., No. S-14-023, May 15, 2015).

Elena Miniet moved to a nursing home in 2008. In August 2012, she lost her Medicaid benefits and did not pay the nursing home from October 2012 through November 2013, when she was discharged. The nursing home sued Ms. Miniet for unjust enrichment and breach of contract, among other things. Ms. Miniet filed a motion to dismiss. The trial court denied the motion, and set a hearing date on the court docket. Because the court did not have the right address for Ms. Miniet’s attorney, her attorney did not receive notice of the hearing until six days before it was scheduled.

At the hearing, the trial court found in favor of the nursing home, ruling that Ms. Miniet had been unjustly enriched and ordering her to pay $13,837 in damages. Ms. Miniet appealed, arguing she did not receive due process because her attorney did not receive proper notice of the hearing.

The Ohio Court of Appeals affirms, holding that Ms. Miniet received “adequate notice to satisfy [her] right to due process under the facts of this case” because “date of the hearing had been on the court’s docket for over a month before [Ms. Miniet’s] counsel received actual notice.”

For the full text of this decision, go to: http://www.supremecourt.ohio.gov/rod/docs/pdf/6/2015/2015-Ohio-1863.pdf