Topics of discussion

Topics of Discussion

Correspondence with CMS on PEME.
  • Ron M. Landsman ltr to Barbara Collins, 12-18-2003
  • Gale Arden ltr to Ron M. Landsman, 9-13-2004
  • Smith v. McCann, Order Denying Motion to Dismiss, Balt. Cnty Cir. Ct., No. 24-C-05-007421, Order, 3/10/2006 , Granting in Part and Denying in Part Motion to Dismiss. Defendants moved to dismiss for lack of jurisdiction failure to exhaust, and failure to state a claim. The court dismissed the third of three counts, based on the failure to comply with the State Plan, but denied the motion as to Count One, which alleged a violation of Federal law, and Count Two, which alleged a violation of State law.

    Smith v. McCann, Balt. Cnty Cir. Ct., No. 24-C-05-007421, Memorandum, and Order, 1-18-2008 , Granting Plaintiff’s Motion for Summary Judgment. The parties filed cross-motions for summary judgment on the merits of whether Maryland’s failure to give PEME deductions violated Federal and State law, and the Court ruled that they did. As to Federal law, the Court applied the Chevron doctrine and held it was bound by the Federal agency’s interpretation of its Federal statute. As to Federal law, the Court held that the Maryland regulation, which followed the Federal statute verbatim, had to be read the same way, and that he State could change the regulation only by going through its statutorily required notice-and-comment rule-making; filing and getting approval of a State Plan amendment did not relieve it of that obligation.

    Timm v. Dept. of Public Health and Human Services , 343 Mont. 11, 184 P.3d 994 (2008). A PEME claim was raised in a Medicaid application; the Montana Supreme Court held that Montana was required by Federal law to allow PEME deductions.

    Maryland Department of Health and Mental Hygiene v. Centers for Medicare and Medicaid Services, 542 F.3d 424 (4th Cir. 2008) , affirming In re Disapproval of Maryland SPA 05-06. After first agreeing with CMS and filing a State Plan Amendment reluctantly allowing a PEME deduction for expenses incurred within the three calendar months preceding an application, Maryland changed its mind and sought approval of an SPA that allowed no deduction for expenses incurred prior to eligibility. CMS denied the request, relying largely on its reading of Congress’ intent in enacting 42 U.S.C. § 1396a(r)(1)(A)(i) and (ii), which stopped CMS from allowing a broader change permitting states to limit deductions. The Fourth Circuit affirmed, again largely on Chevron grounds.

    State Plan – Supplement 3 to Attachment 2.6-A