Ketchum Estate v. Department of Health and Human Services
314 Mich. App. 485
| Mich. Ct. App. | 2016Background
- Estate of Wilma Francis Ketchum challenged DHHS’s authority to recover Medicaid long-term-care costs from the decedent’s estate.
- Ketchum received Medicaid long-term care services Nov 2010–Aug 2013; she died Aug 1, 2013.
- DHHS denied a hardship waiver request; owner sought administrative hearing; petition denied at both agency and director levels.
- Circuit court reversed DHHS decision; this Court granted leave to appeal limited to whether MCL 400.112g(3)(e)(i) creates a statutory hardship exemption.
- Court holds that state plan may include additional permissible provisions; but the hardship waiver is temporary and may expire when the qualifying condition (home of modest value) no longer exists; here the home had been sold, converting to cash.
- Court reverses and remands for entry of summary disposition in favor of DHHS
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does MCL 400.112g(3)(e)(i) create a statutory hardship exemption? | Ketchum argues the 50% home-value threshold mandated a waiver. | DHHS argues (Keyes) that (3)(e) requires federal approval and does not bind grant of a waiver. | No, the statute’s text allows state-plan provisions beyond (i); but the waiver’s existence is contingent on criteria including home value. |
| Can DHHS rely on state-plan provisions added beyond (i)-(iii) to deny hardship when a home is sold? | Hardship defined by statute includes 50% threshold; BAM 120 misapplies timeline. | State plan may include temporal rules; hardship waivers are temporary and expire when conditions cease. | Yes; the state plan may include temporal provisions and a hardship expires when the qualifying home-value condition ceases. |
Key Cases Cited
- In re Keyes Estate, 310 Mich App 266 (2015) (agency must seek federal approval; not dispositive on whether other hardship rules bind)
- West Virginia v. Thompson, 475 F3d 204 (4th Cir. 2007) (means test informed by federal interpretation; informs hardship evaluation)
- Detroit Edison Co v Dep’t of Treasury, 498 Mich 28 (2015) (agency deference within statutory framework; broad DCH authority)
- Pohutski v City of Allen Park, 465 Mich 675 (2002) (statutory interpretation requires discerning legislative intent)