The Office of the Medicaid Inspector General (OMIG) may withhold payments to recover from Petitioner, the operator of a methadone clinic and provider of Medicaid-covered services, the full $1,857,401 in overpayments assessed following an audit. OMIG notified Petitioner than it had been overpaid $1,857,401 in claims from 2003 through 2007. OMIG informed Petitioner that it had twenty days to agree to settle these claims for a lower amount or OMIG would begin to withhold a percentage of Petitioner’s payments. When Petitioner did not agree to settle after twenty days and failed timely to commence an administrative appeal to challenge the audit findings, OMIG commenced withholding. Petitioner commenced this article 78 proceeding seeking to prohibit OMIG from liquidating the full amount in overpayments and a declaration that OMIG can collect only $1,460,914, the amount for which Petitioner declined to settle. The Court of Appeals held that OMIG was not precluded from seeking to withhold the full $1,857,401 amount. View "West Midtown Management Group, Inc. v. State" on Justia Law
Aponte moved into his mother's one-bedroom New York City Housing Authority (NYCHA)-owned apartment and cared for her until she died in 2012. Two requests for Aponte to be granted permanent permission to live with his mother were denied. After she died, Aponte requested to be allowed to lease her apartment as a "remaining family member." NYCHA denied his request, finding that Aponte lacked permanent permission to reside in the apartment; management properly denied such permission because Aponte's presence would have violated occupancy rules for overcrowding. A person lacking permanent permission to reside in an apartment is not eligible for RFM status. The Court of Appeals upheld the denial. Under its rules, NYCHA could not have granted Aponte permanent permission to reside in his mother's apartment, and thus could not have granted his request for RFM status. NYCHA's rules contemplate that a tenant may require a live-in home-care attendant, either for a transient illness or the last stages of life, and expressly allow for such an attendant as a temporary resident, even if that permission will result in "overcrowding," regardless of whether the attendant is related to the tenant. NYCHA's policy is not arbitrary and capricious for not allowing Aponte to bypass the 250,000-household waiting line as a reward for enduring an "overcrowded" living situation while caring for his mother. View "Aponte v Olatoye" on Justia Law
Posted in: Government & Administrative Law, Landlord - Tenant, New York Court of Appeals, Public Benefits, Real Estate & Property Law
The question underlying these proceedings was whether the State must consider and pay claims submitted after the effective date of the legislative deadline for pre-2006 reimbursement claims set forth in Section 61 of the 2012 amendment to the Medicaid Cap Statute, which provides that no reimbursement claims shall be made for a category of Medicaid disability expenses paid by counties to the State prior to 2006. In these appeals, the latest round in a decade-long struggle between the counties and the State over Medicaid payments, several counties challenged the constitutionality of Section 61. The Court of Appeals held (1) Section 61 is constitutional; and (2) the State is under no obligation to address outstanding county reimbursement claims filed after April 1, 2012, and the State is not required to initiate an administrative review of its records to identify and pay for any pre-2006 claims. View "County of Chemung v. Shah" on Justia Law
Beginning in 1989, Petitioner received public assistance from New York City Department of Social Services. Petitioner gave birth to a son, Michael, the next year. Michael was added to Petitioner’s public assistance case, and Petitioner assigned her right to child support for Michael. In January 2007, the Social Security Administration (SSA) determined that Michael was eligible to receive Supplemental Security Income (SSI), retroactive to September 2005. Because Michael’s eligibility for SSI made him ineligible for public assistance, the City removed him from Petitioner’s case in January 2007 but continued to collect child support arrears that had accrued prior to January 2007. In 2011, Petitioner requested a review from the City to determine whether she was owed any excess child support payments. The City determined that it owed no payments because it had not collected sufficient child support arrears to exceed the public assistance provided to Petitioner’s household. The State confirmed the City’s determination. Petitioner then commenced this N.Y. C.P.L.R. 78 proceeding challenging Respondents’ determinations as arbitrary, capricious and erroneous as a matter of law. Supreme Court denied the petition, and the Appellate Division affirmed. The Court of Appeals affirmed on the grounds that the City had not yet collected child support arrears that exceeded the unreimbursed benefits Petitioner’s family received. View "Hawkins v. Berlin" on Justia Law
Petitioner, a New York City police officer, retired in 2004 and was awarded disability benefits. In the following years, the police department received information indicating that petitioner was not disabled; that he made false representations to the Police Pension Fund ("Fund"); and that he had ingested cocaine, thus becoming ineligible to return to duty. At issue was whether the city should continue to pay petitioner a pension. The court affirmed the Appellate Division's order annulling the termination of petitioner's pension benefits and held that the benefits can only be terminated by the trustee of the Fund, who has not taken necessary action.
Posted in: Constitutional Law, Government & Administrative Law, Labor & Employment Law, New York Court of Appeals, Public Benefits