Attorney Christopher R. Bray's Legal Cases

Medicaid and medicare

Matter of TH, Fair Hearing No. 7742418J

Jul 16, 2018

OUTCOME: Successful in obtaining increase in Community Spouse Resource Allowance and amending the date of eligibility to June 1 resulting in a refund of amounts paid by CS for the months of June, July and August

Applicant's spouse paid privately for nursing home for the months of June - August. Met with attorneys who applied for Medicaid in September. Initial decision was disqualified due to excess resources ... until November. Fair Hearing was requested for purposes of obtaining an increased resource allowance and challenging the eligibility date of September 1. Successful in obtaining increase in community spouse resource allowance to include a retroactive award resulting in a refund for three months of nursing home payments already made by the Applicant to the Applicant's spouse.

Medicaid and medicare

Matter of RV, FH#7378581Z

Jan 11, 2017

OUTCOME: Finding that uncompensated transfers made by Applicant were made for a purpose other than to qualify for Medicaid and must be disregarded; DSS penalty period of 2.34 months reduced to zero months

On review of Application made for Medicaid, Madison County DSS makes determination that $21,653.23 transferred by Applicant to his grandchildren during the applicable "lookback" period was "uncompensat ... ed" and assessed a penalty of 2.34 months of ineligibility. Applicant provided evidence at fair hearing that the transfers were not done for the purpose of qualifying for Medicaid and must be disregarded. Evidence included proof of payment for college expenses only at a time when Applicant was not anticipating nursing home stay. Full case is available at http://otda.ny.gov/fair%20hearing%20images/2017-1/Redacted_7378581Z.pdf

Medicaid and medicare

Matter of PL, FH#7020792Q

May 01, 2015

OUTCOME: Finding that uncompensated transfers made by Applicant were made for a purpose other than to qualify for Medicaid and must be disregarded; DSS penalty period of 5.587 months reduced to zero months

On review of Application made for Medicaid, Oneida County DSS makes determination that $60,500.00 transferred by Applicant to her children during the applicable "lookback" period was "uncompensated" an ... d assessed a penalty of 5.587 months of ineligibility. Applicant provided evidence at fair hearing that the transfers were not done for the purpose of qualifying for Medicaid and must be disregarded. Evidence included evidence of a long established pattern of gift giving of relatively small amounts (mostly $1,000 transfers). Full case is available at http://otda.ny.gov/fair%20hearing%20images/2015-9/Redacted_7020792Q.pdf.

Medicaid and medicare

Matter of AO, FH#6799465J

Aug 06, 2014

OUTCOME: Reversed DSS position to count homestead as an available resource; reduction of assessed penalty period from 8.65 months to 2.9 months

Otsego DSS denies Application for Medicaid and disregards "intent to return home" to homestead arguing 1. homestead was not Applicant's residence prior to SNF admission; 2. homestead was not habitable ... and 3. Applicant subsequently listed the property for sale and therefore Applicant could not return there. Further DSS calculates uncompensated transfer for difference in "assessed value" of property and amount received at arm's length sale of property. Further DSS treated amounts transferred to friend/POA as uncompensated and assessed a penalty period of 8.65 months. At hearing evidence was presented to express Applicant's strong intent to return to her homestead; evidence was presented with reference to the sale of real property and evidence was presented as to the value received by the Applicant in exchange for amounts transferred by her to her friend/POA. Full case is available at http://otda.ny.gov/fair%20hearing%20images/2015-2/Redacted_6799465J.pdf. Otsego County requested reconsideration from Office of Temporary and Disability Assistance and the Chief Hearing Officer issued a letter decision affirming the findings at Fair Hearing

Medicaid and medicare

Matter of AS, FH#5515265P

Aug 09, 2010

OUTCOME: DSS determination reversed, penalty period eliminated

Fair Hearing requested to challenge DSS denial of Medicaid for "uncompensated transfers" made within the lookback period. DSS assessed a penalty period of 30+ months of disqualification for Medicaid. ... Appellant argued that transfers were made exclusively for purpose other than to qualify for Medicaid. Case established criteria to be followed in determining whether such transfers should be disregarded.

Christopher R. Bray's Legal Cases (5)

Matter of TH, Fair Hearing No. 7742418J

Matter of RV, FH#7378581Z

Matter of PL, FH#7020792Q

Matter of AO, FH#6799465J

Matter of AS, FH#5515265P