In re Estate of Vollmann
296 Neb. 659
| Neb. | 2017Background
- Herman M. Vollmann, a Medicaid recipient (age 78), died in 2014; DHHS filed a claim against his estate for $22,978.35 for services paid while he resided in nursing facilities.
- DHHS payments to two facilities were calculated using Nebraska’s Medicaid per diem rates minus Vollmann’s share of cost.
- Personal representative Cathy Densberger disallowed the claim; DHHS petitioned for allowance and moved for summary judgment.
- County court granted DHHS’s summary judgment; Densberger appealed, arguing DHHS could not recover room-and-board and other nonmedical nursing-facility expenses.
- Central legal question: does “medical assistance” (and thus estate recovery under state and federal law) include routine nursing facility costs such as room, dietary, and administrative expenses?
Issues
| Issue | Plaintiff's Argument (Densberger) | Defendant's Argument (DHHS) | Held |
|---|---|---|---|
| Whether “medical assistance” recoverable from estate includes room & board and other nonmedical nursing-facility costs | §68‑919 and federal recovery provisions should not allow recovery for nonmedical expenses; only traditional medical services qualify | Federal and state definitions of “medical assistance” and “nursing facility services” include routine room, dietary, and related costs; state may recover total amount paid | Court held recovery authorized: nursing facility services include room and board, so DHHS may recover those sums |
| Whether §1396p(b)(1) limits recovery to only traditional medical treatments (nursing, hospital, prescriptions) | Argues §1396p contemplates only traditional medical services, not room/dietary | §1396p expressly authorizes recovery of nursing facility services; nursing facility services necessarily include room/dietary under federal/state definitions | Court rejected plaintiff’s narrower reading and affirmed statutory/regulatory scope |
| Whether recovering these amounts is inequitable or constitutes undue hardship warranting waiver | Recovery (71% of net estate) is unconscionable and effectively takes whole estate | Recovery is statutory; waivers exist but no statutory/regulatory undue-hardship grounds were shown here | Court found no undue-hardship basis in the record and affirmed DHHS’s claim |
| Whether summary judgment was improper because facts about whether expenses were “medical” remain disputed | Affidavit asserted most expenses were nonmedical, creating a factual issue | Whether those expenses qualify as “medical assistance” is a question of law; no material factual dispute bars summary judgment | Court held the legal question permits summary judgment; affirmed judgment for DHHS |
Key Cases Cited
- Arkansas Dept. of Health and Human Servs. v. Ahlborn, 547 U.S. 268 (U.S. 2006) (discusses allocation of third-party recoveries between recipient and state)
- West Virginia v. U.S. Dept. Health and Human Servs., 289 F.3d 281 (4th Cir. 2002) (explains federal crediting of recovered estate funds between state and federal share)
- Smalley v. Nebraska Dept. of Health & Human Servs., 283 Neb. 544 (Neb. 2012) (addresses Nebraska administration of Medicaid and related statutory framework)
- Cisneros v. Graham, 294 Neb. 83 (Neb. 2016) (statutory construction principles for in pari materia statutes)
- Merie B. on behalf of Brayden O. v. State, 290 Neb. 919 (Neb. 2015) (agency regulations have effect of statutory law)
- Edwards v. Hy‑Vee, 294 Neb. 237 (Neb. 2016) (states’ obligations when participating in Medicaid)
- Stewart v. Nebraska Dept. of Rev., 294 Neb. 1010 (Neb. 2016) (plain-meaning rule of statutory interpretation)