Medicaid Agency Must Adopt Probate Court Order of Support Made Prior to Application

A Connecticut trial court rules that a probate court’s order of support to a community spouse issued prior to a Medicaid application has clear priority over the state Medicaid agency’s subsequent calculation of the applicant’s minimum monthly maintenance needs allowance (MMMNA).  Valliere v. Bremby (Conn. Super. Ct., No. HHBCV156027650S, Nov. 25, 2015) (unpublished).

Marjorie Valliere entered a nursing home on November 24, 2012. Nearly four months later, her daughter and conservator applied to the probate court for an order of spousal support for Ms. Valliere’s husband, Paul Valliere, who lived in the community.  On June 25, 2013, the probate court ordered that Ms. Valliere’s total net income of $1,170.33 be paid to Mr. Valliere as monthly support. On July 13, 2013, Ms. Valliere applied to the Connecticut Department of Social Services for Medicaid assistance.  The Department granted benefits but calculated her MMMNA and found that rather than providing her husband with a community spouse allowance (CSA) she was required to contribute $898.45 from her income toward her cost of care. After the determination was upheld at a fair hearing, Mr. Valliere and his daughter appealed to court, arguing that the Department erred in applying the MMMNA calculation rather than adopting the probate court order.

The Superior Court of Connecticut reverses the Department’s decision. The court rules that where a court order is issued before a Medicaid application, “both the statutory scheme and the department’s policy manual provide for the mandatory adoption of and deference to [the] prior court order setting the CSA in lieu of the MMMNA calculation standard.”  The court finds that the Department’s claim that it may ignore the court order because it is the sole state agency tasked with administering the Medicaid program to be “an absurd and untenable position.”

For the full text of this decision, click here.

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