Austin v. Indiana Family & Social Services Administration
2011 Ind. App. LEXIS 713
| Ind. Ct. App. | 2011Background
- Austin transferred $35,500 to her nephew James Mack and wife Julianne Mack in November 2007 before applying for Medicaid nursing home benefits.
- Payment preceded two Medicaid applications and fell within the look-back period for transfer penalties.
- The Macks used the funds to finance an addition to their home and anticipated ongoing services under a Lifetime Care Agreement.
- The Agreement obligated the Macks to provide extensive personal services to Austin for life, with compensation set at $35,500 despite an estimated value of $41,236.
- The Medicaid agency determined the Agreement did not constitute fair market value, and imposed a transfer penalty delaying Austin's benefits for seven months.
- The trial court and Indiana Court of Appeals affirmed, ruling the transfer penalty appropriate given the lack of FMV/adequate consideration and the potential windfall to the caregiver.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the transfer penalty was valid for the transfer | Austin | FSSA | Affirmed |
Key Cases Cited
- Reed v. Missouri Dept. of Social Services, Family Support Division, 193 S.W.3d 839 (Mo.Ct.App. 2006) (FMV assessment depends on services provided; fact-specific)
- E.S. v. Division of Medical Assistance & Health Services, 412 N.J. Super. 340, 990 A.2d 701 (N.J. Super. Ct. App. Div. 2010) (Life-care contracts often fail FMV; windfall concerns emphasized)
- Brewton v. State Dep't of Health & Hosps., 956 So.2d 15 (La.Ct.App. 2007) (Personal care contracts may constitute FMV under certain circumstances)