Morenz v. Wilson-Coker

321 F. Supp. 2d 398, 2004 U.S. Dist. LEXIS 10749
District Court, D. Connecticut·Decided June 10, 2004·No. CIV.A. 3:04CV216SRU·Published·Cited by 4 cases

Opinion

RULING ON CROSS-MOTIONS FOR SUMMARY JUDGMENT

UNDERHILL, District Judge.

Robert and Clara Morenz (collectively “the Morenzes”) brought this action seeking injunctive and declaratory relief against the Commissioner of the Connecticut Department of Social Services, Patricia Wilson-Coker (“Wilson-Coker”). The principal issue raised by this case is whether Robert Morenz’s eligibility for Medicaid must be determined without regard to the financial resources of his community spouse, pursuant to 42 U.S.C. *400 § 1396r-5(c)(3)(A). 1 Both sides have moved for summary judgment on a stipulated factual record. For the reasons stated below, the Morenzes’ motion for summary judgment (doc. # 16) is GRANTED and Wilson-Coker’s motion for summary judgment (doc. # 24) is DENIED.

I.Facts

Robert Morenz, is 82 years old and a resident of Wilton Meadows Nursing Home in Wilton, Connecticut. For purposes of Medicaid, he is an “institutionalized spouse.” His wife, Clara Morenz, is 77 years old and lives at the family home in Wilton, Connecticut. For purposes of Medicaid, she is a “community spouse.” In January 2004, Mr. Morenz filed an application for Medicaid benefits with the Department of Social Services (“DSS”). Under the DSS Uniform Policy Manual (“UPM”), DSS will deem the assets of the community spouse to the institutional spouse when calculating financial eligibility under Medicaid, absent “undue hardship.” UPM § 4025.67(B)(2). The Morenzes acknowledge that their circumstances do not fall within the definition of “undue hardship” as DSS defines that term, because the assets of the community spouse are not unavailable as a result of circumstances beyond the control of the institutionalized spouse. UPM § 4025.68(A)(2).

In support of Mr. Morenz’s Medicaid application, however, Mrs. Morenz also filed: (1) a written assignment of Mr. Mor-enz’s support rights to the State of Connecticut, and (2) a document entitled “Spousal Refusal Statement,” in which Mrs. Morenz disclaimed any intention to provide her husband with financial assistance. In 2003, institutionalized spouses could qualify for Medicaid if their community spouse maintained assets (called a Community Spouse Resource Allocation or “CSRA”) of not more than $90,660. In the 36 months prior to November 1, 2003, the first date for which Mr. Morenz sought Medicaid coverage, Mr. Morenz transferred title to $323,131.10 in assets to his wife using a durable power of attorney Mr. Morenz had executed on December 1, 2000. Mr. Morenz’s care at Wilton Meadows costs $9,145 per 31-day month. After Medicare Part B deductions, Mr. Morenz currently earns $1,530/month from Social Security. Mr. Morenz’s application for Medicaid was denied on March 1, 2004 on the basis of excess resources.

II. Procedural History

On February 25, 2004, the Morenzes moved for a temporary restraining order and preliminary injunction to require Wilson-Coker and the DSS to use only Mr. Morenz’s remaining assets when computing his eligibility for Medicaid. That motion was denied without prejudice in favor of proceeding to a prompt summary judgment hearing. Both the Morenzes and Wilson-Coker now move for summary judgment.

III. Standard of Review for Summary Judgment

Under Rule 56(c) of the Federal Rules of Civil Procedure, summary judgment is appropriate “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Fed.R.Civ.P. 56; Celotex v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986) (citation omitted). The *401 burden is on the moving party to establish that there are no genuine issues of material fact. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 256, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).

The burden on the moving party “may be discharged by ‘showing’ ... that there is an absence of evidence to support the non-moving party’s case.” Celotex, 477 U.S. at 325, 106 S.Ct. 2548. Once this burden has been met, “the burden shifts to the non-moving party to raise triable issues of fact.” Larson v. Prudential Insurance Company of America, 151 F.Supp.2d 167, 171 (D.Conn.2001). If the non-moving party then fails “to make a showing sufficient to establish the existence of an element essential to that party’s case, and on which that party will bear the burden of proof at trial,” summary judgment should be granted. Celotex, 477 U.S. at 322, 106 S.Ct. 2548.

IV. Discussion

Medicaid is a collaborative state and federal program designed to provide for individuals who cannot otherwise cover the costs of their medical expenses. States may choose whether or not to participate in the Medicaid program, but having agreed to participate, states “must comply with federal statutes and regulations.” Lewis v. Thompson, 252 F.3d 567, 569 (2d Cir.2001). The State of Connecticut has opted to participate in the Medicaid program, allocating responsibility for administration of the program to DSS. Conn. Gen. Stat. § 17b-260. DSS regulations are promulgated through the UPM.

The federal “spousal impoverishment” provision governs which resources are considered when determining Medicaid eligibility for couples like the Morenzes. This provision was enacted pursuant to the Medicare Catastrophic Coverage Act of 1988 (“MCCA”), codified at 42 U.S.C. § 1396r~5. The MCCA attempted to redress a number of existing problems in the original Medicaid program. Among other reforms, the new legislation sought to end the “pauperization” of the community spouse “by assuring that the community spouse has a sufficient — but not excessive — amount of income and resources available to her while her spouse is in a nursing home at Medicaid expense.” H.R.Rep. No. 100-105(11), at 65 (1987), reprinted in 1988 U.S.C.C.A.N. 857, 888.

In order to meet these goals, the MCCA established a series of steps used to determine the Medicaid eligibility of an institutionalized spouse. See Wisconsin Department of Health v. Blumer, 534 U.S. 473, 482, 122 S.Ct. 962, 151 L.Ed.2d 935 (2002). First, as a rule, assets of both spouses are calculated together to determine Medicaid eligibility. 42 U.S.C. § 1396r-5(c)(1)(A)(i).

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Morenz v. Wilson-Coker, 321 F. Supp. 2d 398, 2004 U.S. Dist. LEXIS 10749 (D. Conn. 2004).

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