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Wojchowski v. Novello

July 7, 2006

MICHAEL WOJCHOWSKI, SR., BY HIS ATTORNEY-IN-FACT, LUCY WOJCHOWSKI AND LUCY WOJCHOWSKI, PLAINTIFFS,
v.
ANTONIA NOVELLO, M.D., COMMISSIONER, NEW YORK STATE DEPARTMENT OF HEALTH, AND PATRICIA STEVENS, COMMISSIONER, MONROE COUNTY DEPARTMENT OF HUMAN AND HEALTH SERVICES, DEFENDANTS.



The opinion of the court was delivered by: Michael A. Telesca United States District Judge

ORDER

INTRODUCTION

Plaintiffs Michael Wojchowski, Sr., ("Mr. Wojchowski") by his attorney-in-fact, Lucy Wojchowski, and Lucy Wojchowski ("Mrs. Wojchowski") bring this action against defendants Antonia Novello, M.D., the Commissioner of the New York State Department of Health, and Patricia Stevens, the Commissioner of the Monroe County Department of Human and Health Services seeking injunctive and declaratory relief. Specifically, the plaintiffs seek an order directing the defendants to stop automatically allocating Social Security benefits received by Mr. Wojchowski, (who resides in a long-term healthcare facility) to his wife Lucy for purposes of determining her income. According to the plaintiffs, the act of automatically allocating Mr. Wojchowski's benefits to Mrs. Wojchowski violates the anti-alienation provision of the Social Security Act, (codified at 42 U.S.C. § 407(a)) which prohibits the assignment or transfer of rights to payment of social security benefits, and protects monies paid or payable to the recipient of social security benefits from execution, levy, attachment, garnishment, or "other legal process." 42 U.S.C. § 407(a). Plaintiffs contend that Mr. Wojchowski's benefits have been subjected to "other legal process" because the defendants have taken into account his benefits in determining the monthly income available to Mrs. Wojchowski for purposes of determining medicaid eligibility. Plaintiffs also allege that the defendants' allocation practice violates the income determination provisions of the Medicaid Catastrophic Coverage Act. 42 U.S.C. § 1396r-5.

Defendants deny plaintiff's allegations and move to dismiss plaintiff's complaint on grounds that because the allocation process neither takes or assigns Mr. Wojchowski's benefits, nor subjects his benefits to execution, levy, attachment, garnishment, or other legal process, defendants' attribution of Mr. Wojchowski's benefits to Mrs. Wojchowski for purposes of determining medicaid eligibility does not violate the anti-alienation provision of the Social Security Act. Defendants further contend that the allocation process does not violate the Medicaid Catastrophic Coverage Act.

For the reasons set forth below, I grant defendant's motion to dismiss plaintiffs' Complaint.

BACKGROUND

Plaintiffs Michael and Lucy Wojchowski are a married couple living in Monroe County, New York. At the time the Complaint was filed, Mr. Wojchowski was 85 years of age, and, for purposes of receiving necessary medical care, resided at the Hill Haven Nursing Home in the Town of Webster, New York. As such, Mr. Wojchowski is considered an "institutionalized" spouse for purposes of determining Medicaid eligibility. Mrs. Wojchowski continued to live in the couple's marital home, and under Medicaid regulations, is considered a non-institutionalized spouse or a "community spouse".

In late 2004 or early 2005, the plaintiffs filed an application with the defendants to receive Medicaid benefits to help cover the costs of Mr. Wojchowski's care. Prior to filing the application for benefits, Mrs. Wojchowski, pursuant to the Medicaid Catastrophic Coverage Act, declared that the couple's assets of approximately $575,000 were not "available" for Mr. Wojchowski's care, and therefore, Mr. Wojchowski would require assistance from the Medicaid program. On February 22, 2005, the plaintiffs received a notice indicating that Mr. Wojchowski was eligible for Medicaid assistance, but since Mrs. Wojchowski's assets were approximately $480,000 greater than the Medicaid's then-existing limit of $92,760.00, Mrs. Wojchowski could be subject to a support recovery claim against her by the defendants.

Plaintiff's objected to this determination, and requested an administrative hearing before an Administrative Law Judge ("ALJ") for purposes of determining the amount of assets that Mrs. Wojchowski would be allowed to retain for her own needs. Specifically, Mrs. Wojchowski argued that because she had very little monthly income, she needed the entire amount of the couple's assets to generate a sufficient monthly income upon which she could rely to meet her living expenses.

The ALJ, however, found that Mrs. Wojchowski had income of approximately $1,367.00 per month. In calculating Mrs. Wojchowski's monthly income, the ALJ allocated Mr. Wojchowski's Social Security benefits of approximately $976.00 per month as part of Mrs. Wojchowski's income. As a result, the ALJ found that because Mrs. Wojchowski had $1,367.00 in income per month, she did not need all of the couple's assets to generate sufficient income upon which she could live. Specifically, the ALJ determined that Mrs. Wojchowski could retain approximately $188,000 in assets. As a result, Mrs. Wojchowski's remaining assets of approximately $387,000 could be subject to a support recovery claim by the defendants. Following the ALJ's determination, the plaintiffs brought this action claiming that the defendants' allocation of Mr. Wojchowski's Social Security Benefits violates the anti-alienation provision of the Social Security Act, and the income determination provisions of the Medicaid Catastrophic Coverage Act.

DISCUSSION

I. Defendants' Motion to Dismiss

Rule 12(b)(6) of the Federal Rules of Civil Procedure provides for dismissal of the Complaint where the plaintiff has failed to state a claim upon which relief can be granted. When evaluating a Rule 12(b)(6) motion, the court must ascertain, after presuming all factual allegations in the pleading to be true and viewing them in the light most favorable to the plaintiff, whether or not the plaintiff has stated any valid ground for relief. Ferran v. Town of Nassau, 11 F.3rd 21, 22 (2d Cir. 1993), cert. denied, 513 U.S. 1014 (1994). The court may grant a Rule 12(b)(6) motion only where "`it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief.'" Allen v. WestPoint-Pepperell, Inc., 945 F.2d 40, 44 (2d Cir. 1991) (quoting Conley v. Gibson, 355 U.S. 41, 45-46 (1957)).

II. Consideration of Mr. Wojchowski's Social Security Benefits in Determining Mrs. Wojchowski's Income does not Violate the Anti-Alienation ...


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