Appellants' Medicaid benefits under the New Jersey FamilyCare Aged, Blind, and Disabled (ABD) Program were terminated by the Department of Human Services, Division of Medical Assistance and Health Services (the Division). Prior to termination, appellants applied for benefits under another Medicaid Program, the Specified Low-Income Medicare Beneficiaries (SLMB) Program, but the Division rejected their application. Although appellants qualified for the SLMB Program, they were advised their application could not be processed until the ABD Program benefits were terminated. Because State Medicaid agencies are required under federal regulations to assess beneficiaries' eligibility for other Medicaid programs before terminating benefits, the court held that the Division was required to conduct an ex parte pre-termination review, and, based on appellants' undisputed eligibility, transition them from the ABD Program to the SLMB Program with no gap in coverage. As a result, the court reversed the Division's final agency decision and remanded for further proceedings.
