Can Community Spouses ‘Just Say No:’?<\/b><\/p>\n
Connecticut Doctrine of Spousal Refusal Narrowed by U.S. District Court<\/b><\/p>\n
Often, a Medicaid applicant needing nursing home care will have a spouse who is able to continue living at home in the community (\u201cCommunity Spouse\u201d).\u00a0 There are strict income and asset guidelines regarding Medicaid eligibility when there is a community spouse.\u00a0 These guidelines prevent couples with significant assets from making one spouse eligible for Medicaid.\u00a0 However, federal Medicaid law has been interpreted to create an opportunity for the Community Spouse to keep all of his or her assets simply by refusing to pay the nursing home bills of the institutionalized spouse.<\/p>\n
The federal provision is known as “just say no” or the spousal refusal doctrine.\u00a0 Under this doctrine, if a spouse refuses to contribute his or her income or resources to pay the nursing home bill of the spouse applying for Medicaid, the ill spouse may still be able to qualify for Medicaid.\u00a0 The ill spouse must properly “assign” the right of support to the state.\u00a0 Once there has been a valid assignment of support rights, the Medicaid agency is required to determine the eligibility of the nursing home spouse based solely on the applicant’s own assets. \u00a0The assets of the Community Spouse must be disregarded when making this eligibility determination. \u00a0When such a situation occurs, the Medicaid agency can begin a legal proceeding to force the Community Spouse to pay the state back for the care of the institutionalized spouse.\u00a0 \u00a0This process does not always happen because of the burden such a proceeding puts on the agency.<\/p>\n
The spousal refusal doctrine has only been adopted by two states, New York and Florida. \u00a0In 2005 a U.S. Court of Appeals in Connecticut upheld the right of spousal refusal in a case called\u00a0Morenz v. Wilson-Coker<\/i>. \u00a0This decision allowed citizens of Connecticut to also take advantage of this doctrine.<\/p>\n
The Connecticut legislature responded to the\u00a0Morenz\u00a0<\/i>decision by revising the Connecticut General Statutes to prevent the use of the spousal refusal doctrine. \u00a0Before\u00a0Morenz<\/i>, the statute stated that an assignment of support rights to the state was valid “provided the spouse of such person is unwilling or unable to provide the information necessary to determine eligibility for Medicaid.” Conn. Gen. Stat. \u00a7 17b-285 (2005).\u00a0 The revised statute allows assignment of support rights only if:<\/p>\n
(1) the assets of the institutionalized person or person in need of institutionalized care do not exceed the Medicaid program asset limit; and<\/p>\n
(2) the institutionalized person or person in need of institutionalized care cannot locate the community spouse; or the community spouse is unable to provide information regarding his or her own assets.<\/p>\n
The statutory change made in response to\u00a0Morenz<\/i>, if valid, significantly limits the ability of Connecticut residents to take advantage of the spousal refusal doctrine. \u00a0This became a pivotal issue in the case of\u00a0Fortmann v. Starkowski<\/i>, a spousal refusal case brought following the statutory revision.\u00a0 The husband assigned his rights of support to the state and was then determined to qualify for Medicaid.\u00a0 As a result, none of the assets he had previously transferred to his wife were used to pay the nursing home bill.<\/p>\n
Assigning the right of support to the state essentially puts the burden of obtaining payment for nursing homes care onto the state.\u00a0 At issue in the\u00a0Fortmann\u00a0<\/i>case was whether the limitations on assignment of support rights in the Connecticut law conflicted with the federal provision, in which case the state law would be invalidated.<\/p>\n
The court’s final decision in\u00a0Fortmann<\/i>\u00a0determined that Connecticut’s revised statute was valid.\u00a0 Consequently, Connecticut residents can no longer use the spousal refusal doctrine if the community spouse’s location is known and he or she can provide information about his or her assets.\u00a0 The court interpreted the federal law as giving states the power to define for themselves what constitutes a valid assignment of support by a Medicaid applicant.\u00a0 Therefore, Connecticut could freely determine that a valid assignment could only occur when a spouse’s location was unknown or the spouse could not provide required information about his or her assets.<\/p>\n
For help protecting the assets of a Community Spouse or handling other Medicaid planning issues, please call our office at 888-882-8778 to schedule a consultation.<\/p>\n
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Can Community Spouses ‘Just Say No:’? Connecticut Doctrine of Spousal Refusal Narrowed by U.S. District Court Often, a Medicaid applicant needing nursing home care will have a spouse who is […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2679","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\n