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I recently reviewed a Missouri Circuit Court of Appeals decision involving four community spouse and their purchases of post-Deficit Reduction Act of 2005 Medicaid Compliant Annuities as a means of spending down for Missouri's Medicaid program, MO HealthNet.  The decision in the matter of J.P. et al v. Missouri State Family Support Division is dated April 20^th, 2010.

The Missouri case revolved around Missouri legislature that was adopted in July 2007.  Prior to the 2007 amendment, when determining Medicaid eligibility the Missouri State Family Support Division ("the Division") treated Medicaid Compliant Annuities which paid income to a community spouse as excluded from a calculation of resources available to the institutionalized spouse - assuming all other annuity requirements were met.  In November 2007 the Division amended the legislature to exclude the income stream from a Medicaid Compliant Annuity as a resource only if the income was paid to the institutionalized spouse.

The Division's application of the legislature was clearly in violation of existing federal Medicaid eligibility rules.  Consequently, the four cases progressed to the Missouri Western District Court of Appeals ("the Western District").

The Western District ruled in the couples' favor, stating that the Division's policy violated federal law.  The decision heavily relied on the James, Weatherbee and Vieth opinions from other states that preceded Missouri in this matter.

To review the Western District's decision regarding the aforementioned case click here.