Opinion
January 22, 1982
Appeal from the Supreme Court, Monroe County, Patlow, J.
Present — Simons, J.P., Hancock, Jr., Doerr, Denman and Schnepp, JJ.
Determination unanimously confirmed and petition dismissed, without costs. Memorandum: Substantial evidence in the record supports the finding that any delay in approving petitioner's application for Medicaid assistance for his mother was caused by his failure to provide complete and accurate information regarding her resources. An applicant for Medicaid has the burden of proving eligibility (see Lavine v. Milne, 424 U.S. 577; Matter of Moffett v. Blum, 74 A.D.2d 625; Matter of Vanderhall v. Toia, 67 A.D.2d 685; Matter of Reynolds v. Berger, 54 A.D.2d 910) and failure to timely submit the required proof provides a basis for denying these benefits ( Matter of St. Francis Hosp. v. D'Elia, 71 A.D.2d 110, affd 53 N.Y.2d 825). The proof principally consisted of the caseworker's "comment sheet" which was admitted into evidence without objection. The quality of this hearsay evidence renders it worthy of belief (see 300 Gramatan Ave. Assoc. v State Div. of Human Rights, 45 N.Y.2d 176; see, also, Matter of Kaminsky v. Brezenoff, 77 A.D.2d 550; 8 Weinstein-Korn-Miller, NY Civ Prac, par 7803.09). Thus, petitioner is not entitled to reimbursement of the funds spent by him for the medical care of his mother during the pendency of the Medicaid application. Medicaid payments may only be made "to the person, institution, state department or agency or municipality supplying [the] medical assistance" (Social Services Law, § 367-a, subd 1; see 18 NYCRR 360.17; see, also, 42 C.F.R. § 447.10, 447.15, 447.25). An otherwise eligible recipient or his family may not be reimbursed funds paid directly to the vendor of the medical care unless the expenses were incurred during an unjustifiable delay in the agency's approval of the Medicaid application (see Matter of Lustig v. Blum, 80 A.D.2d 558; Matter of Kaminsky v. Brezenoff, 77 A.D.2d 550, supra; Matter of Klein v. Blum, 76 A.D.2d 768; Matter of Schwartz v. Toia, 68 A.D.2d 890; Matter of Lawrence v. Lavine, 50 A.D.2d 734; Matter of Cole v. Wyman, 40 A.D.2d 1033). In this case the delay was caused by petitioner and not the agency.