Hotmer v. Ind. Family & Soc. Servs. Admin.
Decision Date | 30 June 2020 |
Docket Number | Court of Appeals Case No. 19A-PL-2694 |
Parties | Randy L. HOTMER, Appellant-Petitioner, v. INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION, Appellee-Respondent |
Court | Indiana Appellate Court |
Attorney for Appellant: Ralph C. Melbourne, Church Langdon Lopp & Banet, LLC, New Albany, Indiana
Attorneys for Appellee: Curtis T. Hill, Jr., Attorney General, Benjamin M. L. Jones, Deputy Attorney General, Indianapolis, Indiana
[1] Randy L. Hotmer purchased two irrevocable annuities; pursuant to the annuities' contract documents, the monthly payments were made to his wife. Hotmer, who was in a nursing home, applied for Medicaid benefits with the Indiana Family and Social Services Administration (FSSA). FSSA ruled that because Hotmer was the owner of the annuities, the income from the annuities must be attributed to him, and because that income resulted in Hotmer exceeding the income limit for Medicaid eligibility, FSSA denied his application. Hotmer petitioned for judicial review of FSSA's ruling, and the trial court affirmed. Hotmer now appeals, arguing that FSSA erred in attributing the annuity income to him and in denying his application. We agree and therefore reverse and remand for further proceedings.
[2] The relevant facts are undisputed. Hotmer was born in 1948. In April 2017, he entered a nursing home for long-term care. Over the next few months, he filled out applications for and ultimately purchased two eight-year annuities, one from Elco Mutual and one from NGL. On the applications, Hotmer directed that the monthly checks be made out to his wife as payee, and he also named her as the primary beneficiary who would be entitled to receive any remaining payments after his death. The annuity contract documents list Hotmer as the annuitant, or the owner, of the annuities, and state that the applications are part of the contracts. The Elco Mutual contract states, "Annuity payments will be made to the Owner, or as otherwise directed by the Owner, beginning on the Annuity Date." Appellant's App. Vol. 3 at 40. The contract further states, Id. at 41. The NGL contract states, "[NGL] will make annuity payments to the Annuitant commencing on the Annuity Date." Id. at 45. The contract further states, Id. at 47.
The ALJ concluded that because the annuity payments were made solely in the name of Hotmer's wife, they were considered available only to his wife, and therefore Hotmer's income did not exceed the limit.
Appellant's App. Vol. 2 at 49.
Id. at 21. Hotmer petitioned for judicial review of the decision pursuant to the Indiana Administrative Orders and Procedures Act (the Act). After a hearing, the trial court affirmed FSSA's decision. Hotmer now appeals.
[6] In an appeal involving an administrative agency's decision, our standard of review is governed by the Act, and we are bound by the same standard of review as the trial court. Walker v. State Bd. of Dentistry , 5 N.E.3d 445, 448 (Ind. Ct. App. 2014), trans. denied . "We do not try the case de novo and do not substitute our judgment for that of the agency." Id.
We will reverse the administrative decision only if it is: (1) arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law; (2) contrary to a constitutional right, power, privilege, or immunity; (3) in excess of statutory jurisdiction, authority, or limitations, or short of statutory right; (4) without observance of procedure required by law; or (5) unsupported by substantial evidence.
Id. (citing Ind. Code § 4-21.5-5-14 ). "A decision is arbitrary and capricious when it is made without consideration of the facts and lacks any basis that may lead a reasonable person to make the decision made by the administrative agency."
Ind. Real Estate Comm'n v. Martin , 836 N.E.2d 311, 313 (Ind. Ct. App. 2005), trans. denied (2006).
[7] "[A] court may not overturn an administrative determination merely because it would have reached a different result." Walker , 5 N.E.3d at 448. "An interpretation of statutes and regulations by an administrative agency charged with the duty of enforcing those regulations and statutes is entitled to great weight unless this interpretation would be inconsistent with the law itself." Id. "Although an appellate court grants deference to an administrative agency's findings of fact, no such deference is accorded to its conclusions of law." Id. "The burden of demonstrating the invalidity of the agency action is on the party who asserts the invalidity." Id. at 449.
[8] For background purposes, we note that Congress established Medicaid in 1965 "to provide medical assistance to needy persons whose income and resources are insufficient to meet the expenses of health care." Brown v. Ind. Family & Soc. Servs. Admin. , 45 N.E.3d 1233, 1236 (Ind. Ct. App. 2015). Id. (citation omitted). ...
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