Medicaid Applicant's Authorized Representative Can Appeal Eligibility Determination

Reversing a lower court, an Ohio appeals court rules that a nursing home, as a Medicaid applicant's authorized representative, has standing to appeal the applicant's eligibility determination to court. Juanita Fowler Life Care Centers of America, Inc. v. Ohio Department of Job and Family Services (Ohio Ct. App. 8thDist., No. 106989, April 4, 2019).

Juanita Fowler was admitted to a nursing home and signed a designation of authorized representative form, authorizing the nursing home to take any action needed to ensure she received Medicaid benefits. The nursing home applied for Medicaid on Ms. Fowler's behalf. The state denied the application because Ms. Fowler owned three life insurance policies.

The nursing home appealed, and the state concluded that the life insurance policies were an available resources. The nursing home appealed to court. The trial court dismissed the appeal, holding that the nursing home as authorized representative did not have the authority to appeal. The nursing home appealed.

The Ohio Court of Appeals, Eighth Appellate District, reverses, holding that the court has jurisdiction to hear an appeal by the nursing home. According the court, under state law, an authorized representative stands in the shoes of the represented person, so the authorized representative does have standing appeal a Medicaid determination to the trial court.

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