California Advocates for Nursing Home Reform v. Bonta

105 Cal. App. 4th 127 (2003) ; Clearinghouse Number: 55065

Description

Evidence That “Estate Recovery” Policies Were “Regulations” Subject to Administrative Procedure Act Is Sufficient to Reverse Summary Judgment

Abstract

The California appellate court held that plaintiff-appellants produced considerable evidence that the department of health services’ policies and practices for estate recovery in the Medicaid program were “regulations” subject to the state Administrative Procedures Act and void because they were not promulgated in accordance with the Act. The policies pertained to the government’s recovery of the cost of Medicaid benefits from the estates of recipients who owned valuable residential property exempt from consideration when recipients were deemed eligible to receive such benefits. Plaintiff-appellants (a nonprofit corporation advocating on behalf of Medicaid-eligible individuals, their families, and the corporation’s executive director) sued defendant-respondents (department and its officials) in state court. In addition to claiming that department’s estate recovery policies and procedures constituted regulations, plaintiffs also alleged that respondents’ “underground guidelines and criteria” violated the state Welfare and Institutions Code because they conflicted with validly enacted regulations. On cross motions for summary judgment, the trial court granted department’s motion; the trial court found that certain internal policy directives were not “regulations” within the meaning of the Act because they were “unnecessary.” Reversing the judgment, the appellate court found that appellants’ uncontradicted evidence showed that department intended the named policies and practices to apply generally and that they implemented specific estate recovery provisions of the federal Medicaid law and state Medi-Cal Act. Whether or not such regulations were “necessary,” department failed to negate a necessary element of appellants’ case or demonstrate that there was no material issue of fact.

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Attorney Information
Docket Date
2003-01-08 00:00:00+00:00