Reversing a decision by the Medicaid agency, a New Jersey appeals court holds that a Medicaid applicant’s sister’s credible testimony is enough to prove that the applicant’s transfers to her were to pay for his living expenses and were not transfers for the purposes of qualifying for Medicaid. J.F. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-3856-19, June 15, 2022).
J.F. lived with his sister, M.Q.L., and transferred $69,800 to her over a five-year period. J.F. applied for Medicaid, but the Medicaid agency imposed a penalty for transferring assets for less than market value within five years of applying for Medicaid.
J.F. appealed, and the administrative law judge (ALJ) determined that M.Q.L. was a credible witness. M.Q.L. testified that the money J.F. paid her was for J.F.’s cost of living, including $1,000 a month for rent. The Medicaid agency rejected the ALJ’s findings, claiming that because M.Q.L had not provided income tax returns showing rental income or documents reflecting expenses paid on J.F.’s behalf, she did not rebut the presumption that the assets were transferred for the purposes of establishing Medicaid eligibility. J.F. appealed to court.
The New Jersey Superior Court, Appellate Division, reverses, holding that “M.Q.L.’s credible statements amply and sufficiently rebutted the statutory presumption” that the assets were transferred to qualify for Medicaid.
The court notes that it was up to the ALJ to determine M.Q.L’s credibility and his findings were supported by the record. According to the court, “M.Q.L. provided shelter, food, some personal care, and transportation for her brother,” and the fact that M.Q.L. and J.F. had an oral lease “did not make it invalid, particularly given the familial relationship between the parties.”
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