Andrianova v. Indiana Family & Social Services Administration

799 N.E.2d 5, 2003 Ind. App. LEXIS 2160, 2003 WL 22723487
CourtIndiana Court of Appeals
DecidedNovember 20, 2003
Docket29A05-0301-CV-49
StatusPublished
Cited by25 cases

This text of 799 N.E.2d 5 (Andrianova v. Indiana Family & Social Services Administration) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Andrianova v. Indiana Family & Social Services Administration, 799 N.E.2d 5, 2003 Ind. App. LEXIS 2160, 2003 WL 22723487 (Ind. Ct. App. 2003).

Opinion

OPINION

FRIEDLANDER, Judge.

Maria Andrianova appeals a determination by the Indiana Family and Social Services Administration (FSSA) that she is not entitled to full benefits under Indiana's Medicaid for the Aged program. 1

We affirm.

The undisputed facts are that Andriano-va was born in Russia and lived there most of her life. She entered the United States on November 25, 1994, on a visitor's visa and moved into her daughter's home. In the summer of 1995, Andrianova began experiencing symptoms of a serious illness. She had no medical insurance or means to pay for medical treatment in the United States. Therefore, she returned to Russia on February 25, 1995, to obtain medical treatment. In Russia, Andrianova was diagnosed with uterine cancer. She was hospitalized, underwent surgery, and received radiation treatments from November 15 until December 30, 1995. After she was discharged from the hospital, Andria-nova applied for another visa in order to return to the United States. She applied multiple times before she ultimately was able to obtain a visa. In the meanwhile, Andrianova underwent chemotherapy in 1996 from April 4 through April 25, July 18 through August 8, and October 30 through November 21. On October 17, 1996, Andrianova was approved for a new visa and she returned to the United States on December 11, 1996. In May, 1998, Andrianova onee again experienced symptoms associated with cancer. In July of that year, she returned to Russia for follow-up medical treatment. She returned to the United States on August 15, 1998, and has remained in this country since that time.

*7 On February 22, 2000, Andrianova was granted Lawful Permanent Resident (LPR) status by the Immigration and Naturalization Service (the INS). She filed an application for Medicaid on July 18, 2000, and attained the age of sixty-five one week later, on July 25, 2000. On July 31, 2000, an administrative law judge (ALJ) approved Andrianova for emergency assistance only and denied her request for full Medicaid benefits. She appealed that determination to the FSSA, which affirmed the ALJ's decision. Andrianova appealed the FSSA's decision to the Hamilton Superior Court. The court reversed the FPSSA's ruling that "lawful permanent resident status prior to August 22, 1996 is required to exempt an immigrant from the provisions of [Personal Responsibility and Work Opportunity Reconciliation Act of 1996, or} PRWORAL,J" Appellant's Appendix at 33, and remanded for further proceedings. On remand, the ALJ received additional evidence and again denied full Medicaid benefits, this time on the basis that Andrianova had not maintained continuous presence in the United States for five years, with the relevant period commencing to run when she initially entered the United States and continuing through the time that she obtained permanent legal resident status. The FSSA affirmed that ruling and Andrianova again sought judicial review. This time, the trial court affirmed the denial of benefits. Andrianova appeals that ruling. 2

When reviewing the decision of an administrative ageney, we are bound by the same standard of review as the trial court. Huffman v. Indiana Dept. of Envtl. Mgmt., 788 N.E.2d 505 (Ind.Ct.App.2003). We will reverse an administrative decision only if it is "(1) arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law; (2) contrary to a constitutional right, power, privilege, or immunity; (3) in excess of statutory jurisdiction, authority, or limitations, or short of statutory right; (4) without observance of procedure required by law; or (5) unsupported by substantial evidence." Id. at 507; see Ind.Code Ann. § 4-21.5-5-14(d) (West 2002). We are free to resolve any legal questions that arise from the agency's decision. We are not bound by its interpretation of the law because the law is the province of the judiciary. Huffman v. Indiana Dept. of Envtl. Mgmt., 788 N.E.2d 505. Nevertheless, we "pay due deference to the interpretation of a statute by the administrative agency that is charged with its enforcement in light of its expertise in its given area." Metro. Sch. Dist. of Southwest Allen County v. Allen County, 753 N.E.2d 59, 63 (Ind.Ct.App.2001).

When reviewing an administrative agency's decision, the trial court may not try the facts de novo or supplant the agency's judgment with its own. S & S Enters., Inc. v. Marion County Bd. of Zoning Appeals, 788 N.E.2d 485 (Ind.Ct.App.2003), trans. denied; see also Metro. Sch. Dist. of Southwest Allen County v. Allen County, 753 N.E.2d at 62 (review is not "de novo in the sense of a complete retrial of the issues involved. Rather, [the court] must go no further than to examine the propriety of the ageney's facts as the agency found them and the propriety of the agency's order in light of the facts found") (quoting Taylor v. Ind. Family & Soc. Servs., 699 N.E.2d 1186, 1189 (Ind.Ct.App.1998)). Neither the trial court nor this court may reweigh the evidence or reassess witness credibility. Id. Rather, reviewing courts must acéept the facts as *8 found by the agency factfinder. Id. The party seeking judicial review bears the burden of demonstrating that the agency's action is invalid. I.C. § 4-21.5-5-14(a); Metro. Sch. Dist. of Southwest Allen County v. Allen County, 753 N.E.2d 59.

We begin with a brief overview of the Medicaid program, which was established in 1965 as Title XIX of the Social Security Act, 79 Stat. 843. Its purpose is to provide medical assistance to needy individuals whose income and available resources are insufficient to meet the costs of necessary medical care and services. 42 U.S.C. § 1396; Sullivan v. Day, 681 N.E.2d 713 (Ind.1997). It operates through a combined scheme of federal and state statutory and regulatory authority. See 42 U.S.C. § 1396a; Ind.Code Ann. § 12-15 1-1 (West, PREMISE through 2003); Sanders v. State Family & Soc. Svcs,. Admin., 696 N.E.2d 69 (Ind.Ct.App.1998). States are free to decide whether to participate in the Medicaid program and receive federal assistance. After having opted in to the cost-sharing program, however, states must thereafter comply with the requirements imposed by the Medicaid Act and by the Secretary of Health and Human Services. Indiana State Bd. of Pub. Welfare v. Tioga Pines Living Ctr., Inc.,

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799 N.E.2d 5, 2003 Ind. App. LEXIS 2160, 2003 WL 22723487, Counsel Stack Legal Research, https://law.counselstack.com/opinion/andrianova-v-indiana-family-social-services-administration-indctapp-2003.