The NH Supreme court has struck down a Health and Human Services hearing officer’s decision in the Appeal of Emily Huff, and sent the case back to HHS for further proceedings.
In the administrative case, a hearings officer had upheld a HHS decision finding Emily ineligible for Medicaid due to her special needs trust, ruling that such trusts are income for purposes of Medicaid eligibility. The court found that the hearing officer had ruled without sufficient information about the state’s Medicaid eligibility plan in effect in 1972, which the state could not find during the proceedings. Under an option the federal government offered to states back then (the 209B option), states were allowed to use more restrictive criteria than SSI eligibility when determining Medicaid eligibility, and were then obligated to provide Medicaid benefits to those who qualified in NH as medically needy in 1972.
This decision does not settle the matter of whether special needs trusts should be counted as income for Medicaid eligibility, but rather directs the case back to HHS to further address the matter by locating and abiding by the 1972 plan or addressing federal law obligations related to the state’s rules absent the plan. The court found that the hearing officer could not render a decision based solely on state law, rules, and procedures, but must also assure compliance with federal law.
The DRC served as an amicus curiae (friend of the court) in this case.
The Decision can be found here: http://www.courts.state.nh.us/supreme/opinions/2006/huff135.pdf