Cook v. Glover
295 Ga. 495
| Ga. | 2014Background
- Jerry L. Glover, an 82‑year‑old nursing‑home resident, purchased an irrevocable, nonassignable, actuarially sound annuity shortly before applying for Medicaid.
- Georgia DFCS approved Glover’s Medicaid application but imposed a multi‑month transfer‑of‑asset penalty because Glover refused to name the State as the annuity’s remainder beneficiary per DCH Policy §2339.
- An ALJ reversed the penalty; DCH (on agency review) upheld it; the Superior Court affirmed DCH; the Court of Appeals reversed, holding the federal Medicaid statute unambiguous and that the penalty did not apply.
- The dispute centers on how to read 42 U.S.C. § 1396p(c)(1) — whether an annuity must meet both subsection (F) (state as remainder beneficiary) and (G) (irrevocable, actuarially sound, equal payments) to avoid penalty, or whether (G) alone can exclude an annuity from being an "asset."
- Georgia’s DCH followed CMS guidance requiring compliance with both (F) and (G); the Court of Appeals rejected deference to CMS and DCH, but the Georgia Supreme Court granted Chevron‑style deference and reversed the Court of Appeals, upholding the penalty.
Issues
| Issue | Glover's Argument | State's Argument (Cook/DCH) | Held |
|---|---|---|---|
| Whether an annuity that meets (c)(1)(G) but does not name the State per (c)(1)(F) is exempt from transfer penalty | (Glover) An actuarially sound, irrevocable annuity is removed from the definition of "assets" by (G), so (F)’s remainder‑beneficiary requirement does not apply | (State) CMS guidance and DCH policy require both (F) and (G); (F) must be satisfied for any annuity to avoid penalty | Held for State: statute ambiguous; reasonable agency interpretation requiring both (F) and (G) is entitled to deference; penalty upheld |
| Whether the federal statutory text is plain or ambiguous such that courts must independently resolve meaning without agency deference | (Glover) Text is plain: (G) excludes certain annuities from "assets," so no penalty | (State) Text is ambiguous about relationship between (F) and (G); agency guidance resolves ambiguity | Held: Text ambiguous; deference to agency interpretation appropriate |
| Whether Chevron deference (or comparable deference) applies to CMS opinion letter and DCH manual policy | (Glover) Agency guidance cannot override clear statute; Court of Appeals concluded statute was clear so no deference | (State) CMS and DCH interpretations are reasonable constructions of an ambiguous statute and entitled to Chevron‑style deference | Held: Georgia courts will accord Chevron‑style deference to reasonable agency interpretation here; DCH policy consistent with CMS is reasonable |
| Whether Court of Appeals erred by refusing to defer to CMS/DCH and by reversing the agency penalty | (Glover) Agency view is wrong as a matter of statutory construction | (State) Court of Appeals wrongly disregarded agency expertise on ambiguous Medicaid provisions | Held: Court of Appeals erred; reversal of superior court vacated; judgment reversed and agency decision upheld |
Key Cases Cited
- Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837 (agency interpretations of ambiguous statutes get deference)
- Christensen v. Harris County, 529 U.S. 576 (opinion letters and informal interpretations generally do not get full Chevron deference)
- Skidmore v. Swift & Co., 323 U.S. 134 (informal agency rulings entitled to respect to the extent they are persuasive)
- United States v. Mead Corp., 533 U.S. 218 (degree of deference depends on formality, expertise, persuasiveness)
- Nat'l Cable & Telecom Assn. v. Brand X Internet Svcs., 545 U.S. 967 (Chevron presumption that agencies may have primary interpretive authority)
- Hutcherson v. Ariz. Health Care Cost Containment Sys. Admin., 667 F.3d 1066 (9th Cir.) (applies CMS interpretation that both (F) and (G) must be satisfied)
- Pruitt Corp. v. Ga. Dept. of Community Health, 284 Ga. 158 (Ga. 2008) (discusses deference to agency interpretations in Medicaid context)