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1
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OPINION
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EXTRACTED KEY WORDS
TRUST SOCIAL SERVICES PAID SOCIAL SERVICES LAW RECOVER CORRECTLY PAID COURT PAYMENTS ELIGIBILITY DECEDENT DETERMINATION TRUSTEE STATUTES APPELLATE DIVISION COUNTY JUDSON DEFENDANTS MISREPRESENTATION FRAUD SUPREME COURT MATTER ASSISTANCE REVERSE DEATH INCORRECTLY PAID REGARD USC NY2D OVERPAYMENT |
94 N.Y.2d 110 (1999).
November 18, 1999
(99 NY Int. 0148)
Decided November 18, 1999
_________________________________________________________________
This opinion is uncorrected and subject to revision before publication
in the New York Reports.
_________________________________________________________________
WESLEY, J.:
WESLEY, J.:
Plaintiff, Commissioner of the Department of Social Services for
Columbia County, seeks to recover Medicaid benefits paid to decedent
Marion F. Judson, the named beneficiary of a self-settled, irrevocable
trust. The parties acknowledge that had the Department included the
trust principal in its eligibility determination, decedent would not
have been eligible for Medicaid benefits. Defendants contend, however,
that because the Department made an administrative error that was not
due to misrepresentation or fraud, the benefits should be deemed
"correctly paid" to decedent within the meaning of Social Services Law
§ 369(2)(b)(i) and are therefore not recoverable. We disagree, reverse
the order of the Appellate Division andreinstate the order of Supreme
Court.
I.
Marion Judson resided in a nursing home from May 1, 1989 until her
death on December 26, 1995. She initially was admitted as a
private-pay resident. On May 1, 1991 one of her sons submitted an
application for Medicaid benefits on her behalf to the Columbia County
Department of Social Services. The application disclosed that Judson
was the named beneficiary of a self-settled, irrevocable trust; a copy
of the trust instrument was provided. The trust instrument stipulated
that the trustee was to pay decedent the trust income and gave the
trustee discretion to apply "all or such part of the principal of this
trust * * * for the support, care and maintenance of (decedent) during
(her) lifetime." The initial application was denied.
A second application, submitted on September 4, 1991, also contained
the trust information. This time, the Department determined that
Judson was eligible for Medicaid benefits. The Department included the
trust income in determining her eligibility for Medicaid, but did not
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