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Lopes v. Dept. of Social Services – Another Win

John Lopes was married, residing in a nursing home, and in need of assistance.  Amelia Lopes, John’s spouse residing in the community, purchased a Medicaid Compliant Annuity, and shortly thereafter made a Medicaid application on behalf of her husband.  The Connecticut Department of Social Services denied the application after determining that the payment stream Amelia was receiving was a resource that rendered John ineligible for Medicaid.

The matter progressed to the United States District Court for the District of Connecticut, under the argument that the payment stream was income that did not count against John’s eligibility in light of the annuity being non-assignable.  The district court granted summary judgment to the Lopeses, and Connecticut appealed.

The U.S. Court of Appeals for the Second Circuit upheld the district court ruling that the income stream from a Medicaid Compliant Annuity cannot be considered an available asset for the purposes of Medicaid eligibility.  Lopes v. Dept. of Social Services (2nd Cir., No. 10-3741-cv, Oct. 2, 2012).  The court further ruled that it was irrelevant that the Medicaid Compliant Annuity was purchased just prior to John’s Medicaid application.  Thankfully the U.S. Department of Health and Human Services lent their opinion in this case, affirming that the Lopeses position was consistent with Medicaid’s primary purpose of providing healthcare to the indigent and protecting community spouses from impoverishment.

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