Medicare, Medicaid, Social Service Law, nursing home, indigent
In this case note, Leonard J. Morreale, Jr. analyzes Peninsula General Nursing Home v. Sugarman, 57 App. Div. 2d 268, 394 N.Y.S.2d 644 (1st Dep't 1977). Jacob Stupler, an alleged indigent, was enrolled in the federal Medicare program which reimbursed the petitioner, Peninsula General Nursing Home, for the cost of medical care and services rendered to him. When federal benefits were terminated, petitioner promptly applied for Medicaid coverage on behalf of Mr. Stupler pursuant to the New York State Medical Assistance for Needy Persons Plan. The Social Services Department of the City of New York denied the application because Mr. Stupler had sold his house less than one year before the date of his application for aid. Social Services Law § 366(1)(e) provides that a transfer of property within one year of the date of application for aid creates a presumption that the transfer was for the purpose of qualifying for aid. This presumption would render an applicant ineligible. The nursing home requested a hearing before the Department of Social Services to challenge the denial of the aid application. The Department denied this request, ruling that the Social Services Law allows only the recipient of aid or his family to obtain review. The trial court ruled that Social Services Law section 366 and the regulations thereunder do not afford the petitioner due process and are therefore unconstitutional. It enjoined the Commissioner of Social Services from enforcing the provisions of the statute without giving the petitioner an opportunity for a hearing on the denial of public assistance to its patient. The appellate division affirmed, ruling that the petitioner should obtain the hearing it requested.
Leonard J. Morreale, Jr.,
Case Note: Constitutional Law - Fair Hearing - A Provider of Services Has a Right to Challenge a Determination of Medicaid Benefits for its Patients,
6 Fordham Urb. L.J. 147
Available at: https://ir.lawnet.fordham.edu/ulj/vol6/iss1/7