ALICE REEVES, APPELLANT,
v.
STATE OF FLORIDA, DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, APPELLEE
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The court held that the hearing officer erred in presuming notice of ineligibility was received without evidence of HRS's mailing practices.
[1] A presumption of receipt of a mailed notice cannot be applied without evidence of the sender's general office practices regarding mailing such notices.
[2] Equitable estoppel may bar a claim for recoupment of overpaid benefits when a recipient detrimentally relies on the continued provision of benefits after eligibility has…
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Join FLexlaw to unlock all legal intelligenceAlice Reeves appealed a hearing officer's order allowing HRS to recoup Medicaid overpayments. Reeves argued equitable estoppel, claiming reliance on r…
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DAVIS, Judge.
Alice Reeves appeals a hearing officer’s final order finding that HRS is entitled to seek recoupment of an overpayment of Medicaid benefits in the amount of $2351.06 when and if she becomes capable of repaying it. The hearing officer erroneously applied a presumption that Ms. Reeves had received notification of ineligibility, and therefore we reverse and remand for further proceedings.
Ms. Reeves asserts that the doctrine of equitable estoppel should bar any claim for repayment, based upon her detrimental reliance upon the fact that HRS mailed her the Medicaid cards which she used for a year after her eligibility had actually lapsed. The hearing officer held that the doctrine of equitable estoppel could not apply unless there was a misrepresentation of a material fact and that Ms. Reeves could not rely upon receipt of the Medicaid cards as such a misrepresentation because HRS had mailed her a letter informing her that a change in regulations regarding income levels had made her ineligible for the benefits. Ms. Reeves testified that she did not remember receiving that letter, but the hearing officer presumed that the letter was mailed and received, based upon the fact that a copy was in HRS’s files.
In the absence of any evidence whatsoever regarding the normal office practices of HRS with regard to mailing such notices, the hearing officer erred in applying that presumption. See Brown v. Giffen Industries, Inc., 281 So. 2d 897, 899-900 (Fla.1973) (“proof of general office practice satisfies the requirement of showing due mailing”); Florida East Coast Properties, Inc. v. Coastal Construction, Inc., 553 So. 2d 705, 706 (Fla. 3d DCA 1989) (discussing evidence of the routine practice of an organization necessary to permit reliance on a presumption that the conduct of the organization on a particular occasion was in conformity with that practice).
Accordingly, this case is REVERSED and REMANDED for further proceedings consistent with this opinion.
ALLEN and KAHN, JJ., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Authorities Cited
- Brown v. Giffen Indus., Inc., 281 So. 2d 897 (Fla. 1973)
- Fla. E. Coast Props., Inc. v. Coastal Constr. Prods., Inc., 553 So. 2d 705 (Fla. 3d DCA 1989)