Medicaid Applicant Who Was Still Receiving Care During Penalty Period Not Entitled to Hardship Waiver

A Pennsylvania appeals court rules that a Medicaid recipient is not entitled to an undue hardship waiver of a penalty period because she was still receiving care at a nursing home during the penalty period. Brenckman v. Department of Human Services (Pa. Comm. Ct., No. 443 C.D. 2018, Oct. 1, 2019).

Mary Lou Brenckman entered a nursing home. Ms. Brenckman's son's business was failing because he was spending time with her, so he withdrew money from her bank account to cover his living expenses. Once Ms. Brenckman's money ran out, she applied for Medicaid. The state imposed a penalty period due to the transfers to her son.

Ms. Brenckman appealed the penalty period, claiming that because she needed full-time care, denial of Medicaid benefits was an undue hardship. The state determined that there was no evidence that Ms. Brenckman was evicted or denied care, so there was no undue hardship. Ms. Brenckman appealed to court, arguing that the state's interpretation would require the nursing home to evict her in order to meet the definition of undue hardship.

The Pennsylvania Commonwealth Court affirms the denial of the undue hardship waiver, holding that because Ms. Brenckman was receiving the necessary care during the ineligibility period, she did not establish undue hardship. The court notes that the fact that the son spent Ms. Brenckman's money also counted against the hardship waiver.

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