Opinion ID: 1954136
Heading Depth: 1
Heading Rank: 2

Heading: Verification of the Trust Corpus

Text: The AAU ruled that the petitioner must provide as part of his MEAD application any information about the trust (including but not limited to the trust instrument and the financial records of the trust) reasonably necessary to determine [the petitioner's] income and resource eligibility for the MEAD program. On appeal, the State argues that information about the trust corpus is necessary to determine whether in fact the trust qualifies for exclusion under 42 U.S.C. § 1396p(d)(4)(A), and to determine the petitioner's income eligibility, which may be affected by distributions from the trust. With respect to income, the State argues that [a]ccess to Trust corpus at the time of initial application and annual redeterminations enables [DHHS] to compare the corpus value at the prior eligibility point and to then verify that disclosures of distributions, if any, were fully disclosed and accurate. The petitioner does not dispute that trust distributions may count as income and that DHHS is therefore entitled to verify the purpose, recipient and amount of those distributions. However, he argues that this information can be verified through less intrusive means, such as an affidavit from a trustee or bank manager, without disclosing the value of the trust corpus. As did the AAU, we reject the State's argument that it is entitled to obtain information about the trust corpus as part of the petitioner's initial eligibility determination for the purpose of determining whether the trust qualifies under 42 U.S.C. § 1396p(d)(4)(A). Indeed, DHHS stipulated that without the contested reimbursement language the trust qualifies in every respect. Moreover, New Hampshire's regulation governing verification of inaccessible resources suggests that even if DHHS had not stipulated to the trust's validity, the only documents DHHS would be required or entitled to request for the purpose of verifying that the trust is excluded would be the trust agreement itself. See N.H. Admin. Rules, He-W 606.78(a)(1)(a) (eff. June 1, 2000; amended July 21, 2006) (The following documents shall be used to verify inaccessible resources: . . . [f]or irrevocable trust funds, the trust instrument or agreement.). However, we agree that DHHS has authority to request information that is reasonably necessary for the second purpose identified by the State, namely, verification of the petitioner's income eligibility, and we affirm the AAU's ruling to this extent. In its role as administrator of the Medicaid program, DHHS is charged with ensuring that only financially eligible individuals are approved to participate. See RSA 167:3-c (Supp.2006) & RSA 167:4 (Supp. 2006) (directing DHHS to adopt and administer financial eligibility rules). DHHS' authority to require that Medicaid applicants provide certain financial information is coextensive with this duty. As part of an eligibility determination, the State is required by 42 C.F.R. § 435.948(a)(6) (eff. Feb. 28, 1986) to verify [a]ny . . . income, resource, or eligibility information relevant to determinations concerning eligibility or correct amount of medical assistance payments available from agencies in the State. . . . New Hampshire verification requirements provide, in relevant part, that [a]ll general, categorical, technical, and financial factors related to the determination of eligibility and level of benefit for . . . all categories of financial and medical assistance, shall be verified at . . . [i]nitial determinations. . . . N.H. Admin. Rules, He-W 606.01(a) (eff. Oct. 24, 1997; superseded Oct. 24, 2005 & Apr. 13, 2007). Applicants are solely responsible for providing DHHS with acceptable verification pursuant to Rule He-W 606.01(b) (eff. Oct. 24, 1997), and DHHS is required to deny an application if an applicant fails to provide information that is required to verify any factor required for determining eligibility or benefit level, including income eligibility. N.H. Admin. Rules, He-W 606.01(c). The petitioner has pointed us to no authority and we are aware of none that requires DHHS to verify an applicant's income through the least intrusive means available. To the extent, therefore, that information about the trust corpus is reasonably necessary to ascertain whether trust distributions are to be counted as income to the petitioner for Medicaid eligibility purposes, DHHS may request, and the petitioner is required to provide, such information. Reversed in part; affirmed in part; and remanded.