Baker v. Brown

CourtDistrict Court, W.D. Oklahoma
DecidedAugust 13, 2020
Docket5:19-cv-00479
StatusUnknown

This text of Baker v. Brown (Baker v. Brown) is published on Counsel Stack Legal Research, covering District Court, W.D. Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Baker v. Brown, (W.D. Okla. 2020).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF OKLAHOMA

PAUL BAKER, Personal Representative ) of the Estate of Lois Isabelle Matti, ) deceased; ) NELTA ROSE, by and ) through IVAN D. ROSE, next of friend ) and attorney-in-fact; and ) IDABELLE SCHNOEBELEN, by and ) through MICHAEL SCOTT MILLER ) and SHAWN TREY MILLER, next of ) friends and attorneys-in-fact, ) ) ) Plaintiff, ) ) ) v. ) Case No. CIV-19-479-R ) JUSTIN BROWN, Director of Oklahoma ) Department of Human Services (OKDHS), ) in his official capacity; and ) KEVIN CORBETT, Director of Oklahoma ) Health Care Authority (OKHCA), ) in his official capacity1 ) ) ) Defendants. )

ORDER

Before the Court are the parties’ cross-motions for summary judgment, Doc. Nos. 28, 31. Each party has responded in opposition to the other’s motion. Doc. Nos. 38, 39.

1 Plaintiffs initially filed this case against Ed Lake, Director of OKDHS and Becky Pasternik-Ikard, Director of OKDHCA. Those directors have since been succeeded by Justin Brown, and Kevin Corbett, respectively. In accordance with Federal Rule of Civil Procedure 25(d), Directors Brown and Corbett were automatically substituted as the proper Defendants herein.

Defendants have replied, Doc. No. 41; Plaintiffs have not. Defendants have also provided the Court with supplemental authority in support of their motion, Doc. No. 46, to which Plaintiffs have responded, Doc. No. 47. Defendants further move for oral argument, Doc.

No. 42, to which Plaintiffs object, Doc. No. 44. Upon review, the Court grants Defendants’ Motion for Summary Judgment, denies Plaintiffs’ Motion for Summary Judgment, and denies Defendants’ Motion for Oral Argument. I. Background On May 28, 2019, Plaintiffs Lois Matti, Nelta Rose, and Idabelle Schnoebelen filed

suit alleging that OKDHS Director Justin Brown and OKDHCA Director Kevin Corbett discontinued their Medicaid benefits in violation of federal law.2 Doc. No. 1. Below, the Court recites the undisputed material facts surrounding the cancellation of each Plaintiff’s Medicaid benefits in turn. Lois Matti, now deceased, was an elderly resident of Kingfisher County, Oklahoma,

who, with the help of her son and attorney-in-fact, Paul Baker, applied for Medicaid services in Oklahoma on May 26, 2015. Doc. No. 28, ¶ 2; Doc. No. 31, ¶¶ 7–9. Prior to filing her application, Ms. Matti took certain steps to reduce her available resources. On April 2, 2015 and May 18, 2015, Ms. Matti transferred assets to Mr. Baker in exchange for two promissory notes in the amounts of $144,000.00 and $37,000.00, totaling $181,000.00.

Doc. No. 28, ¶ 1; Doc. No. 31, ¶¶ 12–13. Thereafter, on June 3, 2016, OKDHS approved Ms. Matti’s Medicaid application. Doc. No. 28, ¶ 5; Doc. No. 31, ¶ 14.

2 The OKDHCA is the agency responsible for administering Medicaid programs in Oklahoma and it has designated the OKDHS responsible for making certain eligibility determinations. 63 O.S. § 5009(B); 42 C.F.R. § 431.10. In 2016, 2017, and 2018, Mr. Baker transferred money to Ms. Matti as payment on the two 2015 notes. After each of Mr. Baker’s payments, Ms. Matti transferred the money back to Mr. Baker in exchange for a new promissory note. Doc. No. 28, ¶¶ 3–4, 7–8, 10–

12; Doc. No. 31, ¶¶ 17–23. After discovering these transactions, OKDHS issued a “Notice of Closure” discontinuing Ms. Matti’s Medicaid benefits. Doc. No. 28, ¶ 14; Doc. No. 31, ¶ 25. OKDHS found that the payments on the two 2015 notes were invalid and as a result, the 2015 notes were in default such that the amounts due under the notes were counted as available resources above the Medicaid limit. Doc. No. 28, ¶ 15. Alternatively, it

categorized the later notes as improper deferrals of the 2015 note payments and counted the notes as available resources above the Medicaid limit. Id. As a final rationale, it determined that the later notes were not bona fide and thus were countable as available resources above the Medicaid limit. Id. Ms. Matti appealed the decision, and an administrative hearing was held wherein the Administrative Law Judge affirmed

OKDHS’s determination. Doc. No. 31, ¶ 26–30.3 Thereafter, on May 28, 2019, Ms. Matti further appealed the decision to OKDHS’s Director. Id. ¶ 32. The parties have not indicated whether the Director has completed his final review.

3 Plaintiffs deny the facts asserted by Defendants relating to the ALJ’s decision on appeal, including those in paragraphs 26 to 30. Doc. No. 38, p. 6. Plaintiffs contend that all facts related to the ALJ’s decision should be disregarded because the OKDHS’s administrative process is under judicial review in The Estate of Schultz v. Lake, et al., No. 19-CIV-00217-JD (W.D. Okla. 2020). Since the filing of Plaintiffs’ response, the Court has dismissed The Estate of Schultz on jurisdictional grounds. See id. at Doc. Nos. 34, 35. In accordance with Federal Rule of Civil Procedure 56(e)(2), the Court considers Defendants’ assertion of facts regarding OKDHS’s administrative process— those found in paragraphs 26 to 32, 69 to 74, and 90 to 96—undisputed for purposes of Defendants’ motion because Plaintiffs fail to otherwise properly address those facts. Plaintiff Nelta Rose is a 92-year old resident of Woods County, Oklahoma, who, with the help of her son and attorney-in-fact, Ivan Rose, applied for Medicaid services in Oklahoma on March 2, 2017. Doc. No. 28, ¶ 17; Doc. No. 31, ¶¶ 53, 58. Like Ms. Matti,

Ms. Rose took certain steps to reduce her available resources prior to filing her application. In 2017, Ms. Rose transferred assets to Jean Rose—her daughter-in-law, Ivan Rose’s wife—in exchange for two promissory notes in the amounts of $267,650.00 and $36,365.00, totaling $304,015.20. Doc. No. 28, ¶ 16; Doc. No. 31, ¶¶ 55, 61. On October 17, 2017, OKDHS approved Ms. Rose’s application. Doc. No. 28, ¶ 18; Doc. No. 31, ¶ 62.

In 2018, OKDHS asked for verification that Ms. Rose received the first payment of $66,508.75 due on the 2017 notes. Doc. No. 28, ¶ 19. Ms. Rose provided evidence that Jean Rose fulfilled her 2018 payment obligations of $66,508.75 by paying certain personal and nursing home expenses for Ms. Rose, totaling $28,900.81, and by depositing the remainder—$37,607.94—into Ms. Rose’s bank account. Doc. No. 28, ¶ 20; Doc. No. 31,

¶ 63–64. OKDHS then requested confirmation that the $37,607.94, which was presumably in Ms. Rose’s possession, had been spent down.4 In response, Ms. Rose notified OKDHS that on February 28, 2018 she transferred $37,700.00 back to Jean Rose in exchange for a promissory note. Doc. No. 28, ¶ 21; Doc. No. 31, ¶ 66. OKDHS followed up with a “Notice of Closure” discontinuing Ms. Rose’s Medicaid benefits. Doc. No. 28, ¶ 23; Doc. No. 31,

¶ 67. Like in Ms. Matti’s case, OKDHS found that Ms. Rose had available resources over the Medicaid limit based upon three rationales. First, it construed the 2018 promissory note

4 A “spend down” occurs when a Medicaid beneficiary deducts funds spent toward medical care from those otherwise considered available for purposes of determining Medicaid eligibility. transaction to be an invalid payment of the 2017 notes. Doc. No. 28, ¶ 24. Alternatively, it construed the 2018 note to be a deferral of the payments due on the 2017 notes. Id. Lastly, it found that the 2018 promissory note was not bona fide. Id. Ms. Rose appealed the

decision, and an administrative hearing was held wherein the Administrative Law Judge affirmed OKDHS’s determination. Doc. No. 31, ¶ 68–74.

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