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In re Estate of Vollmann

Supreme Court of Nebraska

May 12, 2017

In re Estate of Herman M. Vollmann, deceased.
v.
Nebraska Department of Health and Human Services, appellee. Cathy Densberger, Personal Representative of the Estate of Herman M. Vollmann, deceased, appellant,

         1. Summary Judgment: Appeal and Error. An appellate court will affirm a lower court's grant of summary judgment if the pleadings and admitted evidence show that there is no genuine issue as to any material facts or as to the ultimate inferences that may be drawn from those facts and that the moving party is entitled to judgment as a matter of law.

         2. Administrative Law: Statutes: Appeal and Error. To the extent that the meaning and interpretation of statutes and regulations are involved, questions of law are presented, in connection with which an appellate court has an obligation to reach an independent conclusion irrespective of the decision made by the court below.

         3. Medical Assistance: Federal Acts: States. The Medicaid program provides joint federal and state funding of medical care for individuals whose resources are insufficient to meet the cost of necessary medical care.

         4. ___: ___: ___. A state is not obligated to participate in the Medicaid program; however, once a state has voluntarily elected to participate, it must comply with standards and requirements imposed by federal statutes and regulations.

         5. Medical Assistance. Neb. Rev. Stat. § 68-919(1)(a) (Cum. Supp. 2014) provides that a recipient of medical assistance under the medical assistance program, who was 55 years of age or older at the time the medical assistance was provided, is indebted to the Department of Health and Human Services for the total amount paid for medical assistance on the recipient's behalf.

         [296 Neb. 660] 6. Statutes: Appeal and Error. Statutory language is to be given its plain and ordinary meaning, and an appellate court will not resort to interpretation to ascertain the meaning of statutory words which are plain, direct, and unambiguous.

         7. Statutes: Legislature: Intent. Components of a series or collection of statutes pertaining to a certain subject matter are in pari materia and should be conjunctively considered and construed to determine the intent of the Legislature, so that different provisions are consistent, harmonious, and sensible.

         8. Administrative Law: Statutes. Properly adopted and filed agency regulations have the effect of statutory law.

         9. Decedents' Estates: Administrative Law: Medical Assistance. Under the Medical Assistance Act, Neb. Rev. Stat. §§ 68-901 to 68-974 (Reissue 2009 & Cum. Supp. 2014), where a Medicaid recipient is not survived by a spouse or by a child who is either under the age of 21 or is blind or totally and permanently disabled and where no undue hardship as provided in the Department of Health and Human Services' rules and regulations would result, the beneficiaries of a recipient's estate are not entitled to an inheritance at the public's expense.

         Appeal from the County Court for Otoe County: John F. Steinheider, Judge. Affirmed.

          Phillip Wright for appellant.

          Douglas J. Peterson, Attorney General, and Ronald L. Sanchez, Special Assistant Attorney General, for appellee.

          Heavican, C.J., Wright, Miller-Lerman, Cassel, Stacy, Kelch, and Funke, JJ.

          Cassel, J.

         INTRODUCTION

         In this appeal, we must determine whether "medical assistance" provided to a Medicaid recipient includes costs for his room and board and other "nonmedical" expenses at nursing facilities. A chain of statutes and regulations dictates that it does. Because federal law requires a state to seek recovery of medical assistance, [1] those costs can be recovered from the [296 Neb. 661] recipient's estate. The county court granted a summary judgment for that recovery, and we affirm.

         BACKGROUND

         On September 4, 2014, Herman M. Vollmann died at the age of 78. The Nebraska Department of Health and Human Services (DHHS) filed a claim for $22, 978.35 for services provided to Vollmann while he resided at two different nursing homes and was over 55 years old. Cathy Densberger, personal representative of Vollmann's estate, disallowed the claim.

         DHHS filed a petition for allowance of the claim. Densberger objected. The parties filed cross-motions for summary judgment. The evidence showed that DHHS paid $20, 545.07 to one nursing home facility for nursing facility services on Vollmann's behalf and paid $2, 012.66 to a different facility. The amounts paid were based on the per diem rates calculated under Nebraska's plan less Vollmann's monthly share of cost obligation. But Densberger asserted that only $360.45 of the claim was for "'medical expense' or medical treatment."

         The county court sustained DHHS' motion for summary judgment and overruled Densberger's motion. The court determined that the services which Densberger defined as room and board clearly fell within the parameters of services provided under the Medical Assistance Act.[2] Densberger appealed, and we moved the case to our docket.[3]

         ASSIGNMENTS OF ERROR

         Densberger assigns that the county court erred in (1) determining that DHHS was entitled to amounts for room and board or other nonmedical expenses, (2) allowing DHHS to "effectively receive the entire value of [Vollmann's] estate, " and (3) granting DHHS' motion for summary judgment.

         [296 Neb. 662] STANDARD OF REVIEW

         An appellate court will affirm a lower court's grant of summary judgment if the pleadings and admitted evidence show that there is no genuine issue as to any material facts or as to the ultimate inferences that may be drawn from those facts and that the moving party is entitled to judgment as a matter of law.[4]

         To the extent that the meaning and interpretation of statutes and regulations are involved, questions of law are presented, in connection with which an appellate court has an obligation to reach an independent conclusion irrespective of the decision made by the court below.[5]

         ANALYSIS

         OVERVIEW OF MEDICAID

         The Medicaid program provides joint federal and state funding of medical care for individuals whose resources are insufficient to meet the cost of necessary medical care.[6] The program provides federal financial assistance to states that choose to reimburse certain costs of medical treatment for needy persons.[7] Between 50 and 83 percent of a state's expenditures for services under an approved state plan are paid for by the federal government[8]; this is referred to as the "Federal medical assistance percentage."[9]

         A state is not obligated to participate in the Medicaid program; however, once a state has voluntarily elected to participate, it must comply with standards and requirements [296 Neb. 663] imposed by federal statutes and regulations.[10] A state risks the loss of part or all federal funding if it does not comply with the provisions of the Medicaid program.[11] Nebraska elected to participate in the Medicaid program through ...


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