R.S. VS. DIVISION OF MEDICAL ASSISTANCE AND
HEALTH SERVICES AND UNION COUNTY BOARD OF SOCIAL
SERVICES
A-5798-11T1
In this appeal, we address an institutionalized
Medicaid recipient's ability to shelter income for his non-
institutionalized spouse. Here, the institutionalized
petitioner appeals from a final agency decision of the
Division of Medical Assistance and Health Services
(Division) finding that the community spouse monthly income
allowance (CSMIA) for his wife, D.S., should be calculated
in accordance with 42 U.S.C.A. § 1396r-5(e)(2)(B) and
N.J.A.C. 10:71-5.7(e), rather than pursuant to a Family
Part separate maintenance order, which gave petitioner's
spouse substantially more money per month than the amount
calculated according to the CSMIA. Following our review,
we conclude the Division, when determining the
institutionalized spouse's obligation for his nursing home
care, is not bound to abide by the terms of the separate
maintenance order, entered in a non-contested proceeding,
without notice to the Division, because the Order was
designed to circumvent the regulations governing the
CSMIA. We affirm the Division's decision.
01/23/14
HEALTH SERVICES AND UNION COUNTY BOARD OF SOCIAL
SERVICES
A-5798-11T1
In this appeal, we address an institutionalized
Medicaid recipient's ability to shelter income for his non-
institutionalized spouse. Here, the institutionalized
petitioner appeals from a final agency decision of the
Division of Medical Assistance and Health Services
(Division) finding that the community spouse monthly income
allowance (CSMIA) for his wife, D.S., should be calculated
in accordance with 42 U.S.C.A. § 1396r-5(e)(2)(B) and
N.J.A.C. 10:71-5.7(e), rather than pursuant to a Family
Part separate maintenance order, which gave petitioner's
spouse substantially more money per month than the amount
calculated according to the CSMIA. Following our review,
we conclude the Division, when determining the
institutionalized spouse's obligation for his nursing home
care, is not bound to abide by the terms of the separate
maintenance order, entered in a non-contested proceeding,
without notice to the Division, because the Order was
designed to circumvent the regulations governing the
CSMIA. We affirm the Division's decision.
01/23/14
