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Carlini v. Velez

United States District Court, D. New Jersey

June 4, 2013

JAMES CARLINI, Plaintiff,
v.
JENNIFER VELEZ, COMMISSIONER, NEW JERSEY DEPARTMENT OF HUMAN SERVICES, et al., Defendants

Appearances: ROTHKOFF LAW GROUP, Jane Fearn-Zimmer, Cherry Hill, NJ, Counsel for Plaintiff.

STATE OF NEW JERSEY, OFFICE OF THE ATTORNEY GENERAL, Jennifer Lauren Finkel, Trenton, NJ, Counsel for Defendants.

OPINION

Page 483

HONORABLE Joseph E. Irenas, Senior United States District Judge.

Plaintiff James Carlini initiated this action on November 26, 2012, by filing a Complaint against Jennifer Velez in her capacity as Commissioner of the New Jersey Department of Human Services, and Valerie Harr in her capacity as the Director of the Division of Medical Assistance and Health Services. The Complaint alleges that Defendants violated

Page 484

Plaintiff's rights under 42 U.S.C. § 1983 by denying him benefits under New Jersey's Medical Assistance, or Medicaid, Program. [1] Pending before the Court is Plaintiff's Motion for a Preliminary Injunction. For the reasons discussed below, Plaintiff's motion will be granted.

I.

Plaintiff James Carlini currently resides in the skilled nursing unit at the Palace in Maple Shade. Mr. Carlini is considered the " institutionalized spouse" for Medicaid purposes.

Plaintiff's wife, Mary Carlini, currently resides at Sunrise of Newtown Square, a senior living commmunity. (Pl.'s Reply Mem., at 4.) Mrs. Carlini is considered the " community spouse" for Medicaid purposes.

On or about January 31, 2012, Mrs. Carlini purchased an annuity (the " Annuity" ) in the amount of $310,000. (Def.'s Mem. in Opp., at 1.) The Annuity was issued by the PHL Variable Insurance Company, and calls for equal monthly payments in the amount of $8,617.75 to Mrs. Carlini for a period of thirty-six months. (Pl.'s Reply Mem., at 2.) Mrs. Carlini's life expectancy at the time she purchased the Annuity was 10.03 years, and thus the Annuity is actuarially sound. (Compl. ¶ 17.) Additionally, the Annuity is permanently irrevocable, and non-transferrable. (Compl. Ex. A.)

The Annuity names the State of New Jersey as the first remainder beneficiary, stating:

[b]eneficiary in the first position is to be the State of New Jersey as the remainder beneficiary in the first position for at least the total amount of medical assistance paid on behalf of the institutionalized individual (irrevocably).

(Pl.'s Reply Mem., at 2). Section six of the Annuity (" Section Six" ) further states that:

[i]n all cases in which a payment is to be made to the State, a representative from the State is required to provide reasonable documentation concerning the amount to be paid to the State. [The PHL Variable Insurance Company] reserve[s] the right to require that the representative from the State and either a representative from the estate of the Owner, the Secondary ...

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