Allen v. Utah Department of Health, Division of Health Care Financing

BENCH, Presiding Judge

(concurring in part and dissenting in part):

I concur with part I of the main opinion and dissent from part II.

Whether a “medically needy” applicant may have been eligible for Medicaid by spending down his or her assets is a policy decision delegated in Utah to DHCF by Utah Code Ann. § 26-18-4(1) (1989). We review for reasonableness an agency’s policy based on a legislative grant of discretion to interpret a statute. See Morton Int’l, Inc. v. Auditing Div. State Tax Comm’n, 814 P.2d 581 (Utah 1991).1

I do not believe the policy adopted by DHCF is reasonable since eligibility is de*129termined by when the medically needy applicant applies for benefits. Under DHCF’s policy, the applicant who is savvy enough to spend down his or her assets before applying for medicaid would be eligible, while the applicant who applies for benefits before spending down is not eligible. Because that agency policy is not reasonable, I would allow Allen to spend down his assets before his eligibility is determined.

I would therefore reverse and remand the ease for further proceedings.

. I disagree with the majority's interpretation of Utah Code Ann. § 26-18-2.3(1) (1989) as an expression of intent to limit coverage. The Legislature’s concern for economy and efficiency in the administration of the program simply does not have any logical relationship to the intended coverage of the program.