Mackey v. Department of Human Services

808 N.W.2d 484, 289 Mich. App. 688
CourtMichigan Court of Appeals
DecidedSeptember 7, 2010
DocketDocket No. 288966
StatusPublished
Cited by28 cases

This text of 808 N.W.2d 484 (Mackey v. Department of Human Services) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mackey v. Department of Human Services, 808 N.W.2d 484, 289 Mich. App. 688 (Mich. Ct. App. 2010).

Opinion

Murray, P.J.

Respondent, the Department of Human Services (DHS), appeals on leave granted the circuit court order reversing the hearing referee’s decision that the DHS properly imposed a Medicaid benefit divest[690]*690ment penalty on petitioner, Elizabeth Marden.1 We conclude that the circuit court’s ruling was in error because the circumstances of petitioner’s investment in a closely held L.L.C. rendered the transaction a transfer for less than fair market value. Accordingly, the circuit court’s order is reversed.

I. FACTS AND PROCEEDINGS

The underlying facts are not in dispute. On November 29, 2005, petitioner and her husband applied for Medicaid, but they failed to disclose certain annuity contracts they held, which, had they been disclosed, would have rendered them ineligible for Medicaid benefits. On November 9, 2006, Mr. Marden died. Shortly thereafter, petitioner’s case was due for redetermination, but was closed when she failed to return the required form.

On January 11, 2007, petitioner again applied for Medicaid, but was denied eligibility the following June because she had too much money in her bank account. After her second application had been denied, petitioner received close to $100,000 in payouts as a result of her husband’s death. In preparation for submitting a third request for Medicaid benefits, petitioner’s daughter and attorney-in-fact, Betsy Mackey, formed the Marden Family L.L.C. Mackey was assigned, in her own name, 100 investment (nonvoting) units of the L.L.C. and all 100 voting units. Petitioner was assigned 111,460 investment units, for which she (through Mackey’s power of attorney) paid the L.L.C. $111,460. The same day, Mackey, as sole voting member of the L.L.C., acted to disallow any transfer of investment units during a [691]*691two-year holding period. Thus, under the L.L.C.’s operating agreement, petitioner could not sell, transfer, or liquidate her units for two years from the date of investment without a supermajority of the voting members. After two years, the agreement permitted sale of the units and guaranteed compounding two percent interest on the amount paid for the units from the date of purchase to the date of sale. During the two years, petitioner would not receive any payments from the L.L.C.

That September, petitioner again applied for Medicaid, including a retroactive application for the month of August (the month the L.L.C. was created). The DHS found that petitioner was eligible for Medicaid, but applied a divestment penalty,2 refusing to pay for long-term-care services for 18 months and 23 days. Petitioner appealed the DHS determination, and the hearing referee found that petitioner had not received fair market value for her money, and affirmed the decision of the DHS to apply the divestment penalty. Specifically, the hearing referee found that because petitioner’s investment within the five-year “look-back” period rendered an otherwise available cash asset unavailable for two years, the investment was for less than fair market value and a divestment penalty was appropriate. Additionally, the hearing referee rejected petitioner’s argument that the investment was a permissible conversion [692]*692of the annuity proceeds3 since the annuity was actually cashed out — and was thus available as a cash asset— before it was invested in the L.L.C.

Petitioner then appealed to the circuit court, which reversed the hearing referee, holding that petitioner’s purchase of the L.L.C. shares was not a divestment because she received fair market value for her money. In reaching this conclusion, the court initially observed that federal law permits certain annuity purchases and asset transfers for a spouse’s benefit in order to circumvent countable asset provisions and qualify for Medicaid long-term-care benefits,4 and noted that this was the third case wherein the DHS ruled that an applicant’s investment in a closely held L.L.C. guaranteeing compound interest after a set period of time was a divestment.5 As in the prior case it had decided, the court ruled that

the purchase of stock in the family limited liability company in this case was not, by definition, a “divestment” because the transfer was not “for less than fair market value.” In fact, the value of the asset did not change — the asset merely took another form — a form that legally made it unavailable and uncountable. Based on the authority cited herein, not only is the value of the stock not countable, but the income stream from that investment is also not countable.

[693]*693Accordingly, the court reversed the hearing referee’s decision and determined that petitioner was entitled to long-term-care benefits without a divestment penalty.

We granted the DHS’s application for leave to appeal, Marden v Dep’t of Human Servs, unpublished order of the Court of Appeals, entered March 18, 2009 (Docket No. 288966), and now reverse.

II. ANALYSIS

A. GENERAL MEDICAID BACKGROUND

In 1965, Congress enacted Title XIX of the Social Security Act, commonly known as the Medicaid act. See 42 USC 1396 et seq. This statute created a cooperative program in which the federal government reimburses state governments for a portion of the costs to provide medical assistance to low-income individuals. Cook v Dep’t of Social Servs, 225 Mich App 318, 320; 570 NW2d 684 (1997). Participation in Medicaid is essentially need-based, with states setting specific eligibility requirements in compliance with broad mandates imposed by federal statutes and regulations.6 Id.; see also Atkins v Rivera, 477 US 154, 156-157; 106 S Ct 2456; 91 L Ed 2d 131 (1986), Nat’l Bank of Detroit v Dep’t of Social Servs, 240 Mich App 348, 354-355; 614 NW2d 655 (2000), and Gillmore v Illinois Dep’t of Human Servs, 218 Ill 2d 302, 305; 843 NE2d 336 (2006).

Like many federal programs, since its inception the cost of providing Medicaid benefits has continued to skyrocket. The act, with all of its complicated rules and regulations, has also become a legal quagmire that has resulted in the use of several “loopholes” taken advan[694]*694tage of by wealthier individuals to obtain government-paid long-term care they otherwise could afford. The Florida District Court of Appeal accurately described this situation, and Congress’s attempt to curb such practices:

After the Medicaid program was enacted, a field of legal counseling arose involving asset protection for future disability. The practice of “Medicaid Estate Planning,” whereby “individuals shelter or divest their assets to qualify for Medicaid without first depleting their life savings,” is a legal practice that involves utilization of the complex rules of Medicaid eligibility, arguably comparable to the way one uses the Internal Revenue Code to his or her advantage in preparing taxes. See generally Kristin A. Reich, Note, Long-Term Care Financing Crisis — Recent Federal and State Efforts to Deter Asset Transfers as a Means to Gain Medicaid Eligibility, 74 N.D. L.Rev. 383 (1998). Serious concern then arose over the widespread divestiture of assets by mostly wealthy individuals so that those persons could become eligible for Medicaid benefits. Id.; see also Rainey v.

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Bluebook (online)
808 N.W.2d 484, 289 Mich. App. 688, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mackey-v-department-of-human-services-michctapp-2010.