Cook v. Robertson
320 Ga. App. 796
Ga. Ct. App.2013Background
- Georgia sought to determine if the asset transfer penalty for long-term care Medicaid transfers aligns with federal law on annuities.
- Four applicants (Bottesch, Shorey, Robertson, Glover) and their spouses purchased irrevocable annuities benefiting community spouses or the institutionalized spouses.
- DCH imposed an asset transfer penalty on each applicant for not naming Georgia as the remainder beneficiary on the annuities.
- OSAH initially favored no penalty for Bottesch/Shorey/Robertson but required designation for Medicaid eligibility; Glover was ultimately subjected to the penalty.
- Superior Court opinions varied, with Bottesch/Shorey/Robertson reversed in part, while Glover’s decision led to reversal of the agency’s ruling; the Court consolidated the four cases.
- The central issue is how 42 U.S.C. § 1396p(c) subsections (F) and (G) govern annuities and when the State need be named as remainder beneficiary, in light of other spousal protections.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Scope of the asset transfer penalty for annuities | Bottesch/Shorey/Robertson argue (F)/(G) protect community-spouse annuities; penalties improper without designation | DCH contends all annuities are subject to penalty unless specifically exempted by (G) | Glover exempted when annuity complies with (G); Bottesch/Shorey/Robertson subject to penalty for noncompliance with (F) |
| Plain-language interpretation of (F) and (G) vs CMS interpretation | CMS interpretation broadens (F) to apply to any annuity transactions | Agency interpretation should be given deference | Court rejects CMS view that both (F) and (G) must be met; plain reading favors exemption for compliant annuities |
| Effect of spousal-protection provisions on penalty | Combined spousal protections supersede the asset-transfer penalty | Spousal protections pertain to eligibility/CSRA, not the penalty | Spousal protections do not control the application of the asset-transfer penalty under (F)/(G); penalty can apply notwithstanding protections |
Key Cases Cited
- Pruitt Corp. v. Ga. Dept. of Community Health, 284 Ga. 158 (Ga. 2008) (judicial review scope; non-disputed facts; statutory/constitutional issues handled narrowly)
- Medders v. Ga. Dept. of Community Health, 292 Ga. App. 439 (Ga. App. 2008) (agency decision review; substantial rights; statutory interpretation)
- Chevron U.S.A. v. NRDC, 467 U.S. 837 (1984) (agency interpretations must defer unless plain language contradicts statute)
- Fast Sign Co. v. American Home Svcs., 291 Ga. 844 (Ga. 2012) (statutory interpretation guiding construction of plain language)
- Jenkins v. State, 265 Ga. 539 (Ga. 1995) (rule that specific statutes prevail over general ones)