Ramey v. Reinertson (2001)

Indeed, the Social Security Program Operations Manual System, “which is a set of policies issued by the [Social Security Administration] to be used in processing claims,” Ramey v. Rei-nertson, 268 F.3d 955, 964 (10th Cir.2001) (internal quotation marks omitted), specifically states that “[adjudicators may occasionally find MI [Medical Improvement] based on changes (improvement) in symptoms alone, without associated changes in signs or laboratory findings,” POMS DI 28010.015(…

Therefore, “to the extent the State Medicaid Manual conflicts” with even the “purposes ” of a federal statute, “we do not follow it.” Ramey v. Reinertson, 268 F.3d 955, 963 (10th Cir.2001) (emphasis added).

"The [agency’s] policy guidelines are provided in the [POMS], which is a set of policies issued by the [agency] ‘to be used in processing claims.' ” Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir.2001) (quoting McNamar v. Apfel, 172 F.3d 764, 766 (10th Cir.1999)).

We begin by examining whether there was a constitutional violation and because we discern none, we do not address whether the alleged rights were clearly established. [9] Even though Ruiz may well not have been a due process case, we nonetheless consider whether it bears on the due process right asserted because its basis is somewhat opaque. [10] The State Medicaid Manual is not promulgated under the notice and comment provisions of the Administrative Procedure Act and thus …

The State Medicaid Manual is not promulgated under the notice and comment provisions of the Administrative Procedure Act and thus does not "have the force and effect of law.” Ramey v. Reinertson, 268 F.3d 955, 963 (10th Cir.2001).

See, e.g., Clifford v. Apfel, 227 F.3d 863, 874 (7th Cir.2000) (stating that an ALJ is not bound by another governmental agency’s findings concerning whether a claimant is disabled); Ramey v. Reinertson, 268 F.3d 955, 962 (10th Cir.2001) (noting that whether an applicant meets social security eligibility requirements is “an inquiry that is different from a state’s Medicaid eligibility requirements” (emphasis omitted)).

POMS DI § 24510.060(B)(2)(b); Form SSA-4734-F4-SUP. 12 The POMS “is a set of policies issued by the [Social Security Administration] to be used in processing claims.” Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir. 2001) (quotation marks omitted).

Ramey v. Reinertson, 268 F.3d 955, 957 (10th Cir.2001) (emphasis added) (citing Schweiker v. Gray Panthers, 453 U.S. 34, 36-37 , 101 S.Ct. 2633 , 69 L.Ed.2d 460 (1981)). [21] AR, file #5, p. 724.

Ramey v. Reinertson, 268 F.3d 955, 957 (10th Cir.2001) (emphasis added) (citing Schweiker v. Gray Panthers, 453 U.S. 34, 36-37 , 101 S.Ct. 2633 , 69 L.Ed.2d 460 (1981)). .

“Eligibility for Medicaid is dependent upon a determination of whether an applicant has ‘available’ resources, and coverage will be denied if an applicant’s resources exceed a statutory ceiling.” Hofer , ¶ 31 (citing Ramey v. Reinertson, 268 F.3d 955, 958 (10th Cir. 2001); 42 U.S.C. § 1396a(a)(10)(A)(i)(IV)).

The Program Operations Manual System (“POMS”) “is a set of policies issued by the SSA ‘to be used in processing claims.’” Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir. 2001)(quoting McNamar v. Apfel, 172 F.3d 764, 766 (10th Cir. 1999)).

POMS DI § 24510.060(B)(2)(b); Form SSA-3734-F4-SUP. 19 The POMS “is a set of policies issued by the [Social Security Administration] to be used in processing claims.” Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir. 2001) (quotation marks omitted).

Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir. 2001).

Generally, the Court defers to POMS unless the policy is “arbitrary, capricious, or contrary to law.” Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir. 2001).

Ramey v. Reinertson, 268 F.3d 955, 958 (10th Cir.2001).

App. 3d at 95 (Medicaid Act established that specially designed trusts "were 'no longer a permissible means to shelter assets for purposes of Medicaid eligibility' "), quoting Ramey v. Reinertson, 268 F.3d 955, 959 (10th Cir. 2001).

App. 3d at 95 (Medicaid Act established that specially designed trusts “were ‘no longer a permissible means to shelter assets for purposes of Medicaid eligibility’ ”), quoting Ramey v. Reinertson, 268 F.3d 955, 959 (10th Cir. 2001). ■ Further supporting our conclusion is Mrs. Zander’s observation in her main brief that “[t]he Illinois land trust is ‘*** a legal fiction whereby an individual converts his ownership interest in real property to ownership in personal property.’ …

Furthermore, the SMM “is not promulgated under the notice and comment provisions of the [Federal] Administrative Procedure Act and thus does not ‘have the force and effect of law’ ” (Hobbs v Zenderman, 579 F3d 1171 , 1186 n 10 [2009], quoting Ramey v Reinertson, 268 F3d 955, 963 [2001]).

“Not surprisingly, Congress responded to the use of this technique with condemnation.” Ramey v. Reinertson, 268 F.3d 955, 958 (10th Cir. 2001).

"Not surprisingly, Congress responded to the use of this technique with condemnation." Ramey v. Reinertson, 268 F.3d 955, 958 (10th Cir.2001).

Ramey v. Reinertson, 268 F.3d 955, 962 (10th Cir.2001).

See, e.g., Stroup v. Barnhart, 327 F.3d 1258, 1262 (11th Cir. 2003) (POMS does not have the force of law, but can be persuasive); Ramey v. Reinertson, 268 F.3d 955, 963 (10th Cir.2001) (SMM does not have force and effect of law, but is entitled to some deference).

Ramey v. Reinertson (10th Cir. 2001), 268 F.3d 955, 958 (citation omitted).

Ramey v. Reinertson (10th Cir. 2001), 268 F.3d 955, 958 (citation omitted).

It is a "cooperative federal-state venture designed to afford medical assistance to persons whose income and resources are insufficient to meet the financial demands of necessary care and services." Ramey, 268 F.3d at 957 (internal citations omitted).

It is a "cooperative federal-state venture designed to afford medical assistance to persons whose income and resources are insufficient to meet the financial demands of necessary care and services." Ramey, 268 F.3d at 957 (internal citations omitted).

See Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.; Ramey v. Reinertson, 268 F.3d 955, 957-58 (10th Cir. 2001).

Ramey v. Reinertson, 268 F.3d 955, 958 (10th Cir. 2001).

See Ramey v. Reinertson, supra. Yet, Congress and the states participating in the joint federal-state Medicaid program began to realize that many individuals were receiving Medicaid benefits when they had irrevocable trusts containing assets which would otherwise have made them ineligible for public assistance Id.

See Ramey v. Reinertson, supra .

Servs., 225 Mich.App. 318 , 570 N.W.2d 684, 685 (1997); Ronney, 532 N.W.2d at 913-14 ; Allen, 542 N.W.2d at 754 ; 570 N.W.2d at 685 ; see Ramey v. Reinertson, 268 F.3d 955, 961 (10th Cir.2001).

See Ramey v. Reinertson, 268 F.3d 955, 958-59 (10th Cir. 2001) (discussing this phenomena and Congressional response in enacting 42 U.S.C. § 1396a(k) and its subsequent replacement with "another statute even less forgiving of such trusts").

See Ramey v. Reinertson, 268 F.3d 955, 964 (10th Cir. 2001).

See Ramey v. Reinertson, 268 F.3d 955, 961 (10th Cir. 2001); see also Miller v. State Dept. of S.R.S., 275 Kan. 349, 356-57 , 64 P.3d 395 (2003) ("Medicaid was designed to provide basic medical care for those without sufficient income or resources to provide for themselves.").

Medicaid “provides joint federal and state funding for medical care for individuals who cannot afford to pay their own medical costs.” Arkansas Dept. of Health and Human Servs. v. Ahlborn, 547 U.S. 268, 275 (2006); see Ramey v. Reinertson, 268 F.3d 955, 958 (10th Cir. 2001) (explaining that, “[i]n *222 structuring the Medicaid program, Congress chose to direct [the] limited funds to persons who were most impoverished” (quotation omitted)).

See Ramey v. Reinertson, 268 F.3d 955, 958-59 (10th Cir.2001); Ira Stewart Wiesner, OBRA '93 and Medicaid: Asset Transfers, Trust Availability, and Estate Recovery Statutory Analysis in Context (“Wiesner”); 19 Nova L.Rev. 679, 682-83 nn. 10 & 11 (1995), also published at 47 Soc.

See Ohlson v. Weil, supra; see also Ramey v. Reinertson, 268 F.3d 955 (10th Cir.2001).

See Ramey v. Reinertson, 268 F.3d 955, 959 (10th Cir. 2001).

See Ramey v. Reinertson , 268 F.3d 955, 959 (10 th Cir. 2001).