Below, in chronological order, is our annual roundup of the top 10 elder law decisions for the past year, as measured by the number of readers of ElderLawAnswers' Weekly and Monthly e-letters who "clicked through" to the full story.

At least one of the cases, In Re: Estate of Perry, was argued by an ElderLawAnswers member firm, and another that just missed the Top 10 list involved another ElderLawAnswers firm).   Also involved in that case was star Medicaid litigator René H. Reixach, Jr., who had a busy year – two of his cases (Sable and Fortmann, below) made the Top 10 list and another came close (Behning).  As usual, our list does not include several cases involving attorney behavior, most particularly this unusual case in which the District of Columbia Court of Appeals suspended, rather than disbarred, an attorney who intentionally misappropriated a nursing home resident's funds in order to qualify the resident for Medicaid.

1. Medicaid Applicant's Penalty Period Does Not Begin Until Returned Assets Are Spent Down

The U.S. Court of Appeals, Third Circuit, rules that a New Jersey Medicaid applicant who transferred assets and then had some of the transfers returned cannot get credit toward her penalty period for the time before the transfers were returned that she was resource-eligible. Marino v. Velez (U.S. Ct. App., 3rd Cir., No. 10-2324, Jan. 10, 2011). To read the full summary, click here.

2. State Cannot Recover Assets That Were Transferred Before Medicaid Recipient Died

In a case pursued by ElderLawAnswers member attorney Peter C. Sisson, an Idaho district court rules that the state cannot recover assets from the estate of a Medicaid recipient's spouse that were transferred to the spouse before the Medicaid recipient died. In Re: Estate of Perry (Idaho Dist. Ct., 4th Dist., No. CV-IE-2009-05214, March 16, 2011). To read the full ummary, click here.

3. Federal Court Rules Ahlborn Does Not Bar Medicaid Recovery From Future Medical Expenses

A federal district court rules that a state Medicaid agency may recover the cost of a beneficiary's medical care from the portion of her personal injury settlement that was allocated to medical expenses, regardless of whether the funds were allocated to past or future medical care. Perez v. Henneberry (D. Colo., No. 09-cv-01681-WJM-MEH, April 26, 2011). To read the full summary, click here.

4. Court Upholds Nursing Home Resident's Eviction Prior to Resolution of Medicaid Appeal

A Kentucky appeals court holds that a nursing home may evict a resident for nonpayment despite a pending Medicaid appeal. King v. Butler Rest Home, Inc. (Ky. Ct. App., No. 2010-CA-001467-MR, June 17, 2011). To read the full summary, click here.

5. Payments to Caregivers of Dementia Patient Are Deductible Medical Expenses

The U.S. Tax Court rules that payments to caregivers of a dementia patient are deductible medical expenses, even though the caregivers were not licensed health care providers. Estate of Lillian Baral (U.S. Tax Ct., No. 3618-10, July 5, 2011). To read the full summary, click here.

6. Third Circuit Affirms That N.J. May Count Promissory Notes As Available Resources

In a long-running case that has bounced back and forth between two federal courts, the Third Circuit Court of Appeals rules that New Jersey's Medicaid agency may analyze promissory notes as trust-like devices and count the notes as available resources. Sable v. Velez (U.S. Ct. App., 3rd Cir., No. 10-4647, July 12, 2011). To read the full summary, click here.

7. Transfer of Medicaid Applicant's House to Son Falls Within Caregiver Child Exception

A New Jersey appeals court rules that the transfer of a Medicaid applicant's house to her caregiver son is not subject to a Medicaid penalty period because it falls within the caregiver child exception. V.P. v. Dept. of Human Services (N.J. Sup. Ct., App. Div., No. A-2362-09T1, Sept. 2, 2011). To read the full summary, click here.

8. U.S. Court Rules Connecticut Likely Cannot Refuse Spousal Refusal Doctrine

Ruling that a state statute violates federal Medicaid law, a federal district court grants a preliminary injunction preventing Connecticut from denying Medicaid benefits to an applicant seeking to disregard his spouse's assets using the doctrine of spousal refusal.  Fortmann v. Starkowski (D. Ct., No 3:10cv1562 (JBA), Sept. 28, 2011). To read the full summary, click here.

9. Medicaid Applicant's Transfer to Daughter Created Trust-Like Device

A federal district court rules that when a Medicaid applicant transferred money to her daughter with the intention that the daughter pay for her care during the resulting penalty period, she created a trust-like device, so the money is still an available resource. Pfeffer v. AHCCCS (U.S. Dist. Ct., D. Ariz., No. CV-11-0891-PHX-GMS, Sept. 29, 2011). To read the full summary, click here.

10. Irrevocable Trust Set Up by Medicaid Applicant's Children Is Available Asset

A Wisconsin appeals court rules that a Medicaid applicant who transferred funds to her children, who then put them in an irrevocable trust for her benefit, is ineligible for Medicaid because the trust is an available asset under state law, even though the transfer occurred 17 years before she applied for Medicaid. Hedlund v. Wisconsin Dept. of Health Services (Wis. Ct. App., No. 2010AP3070, Oct. 13, 2011). To read the full summary, click here.