Hutcherson

Rebecca Hutcherson (“Appellant”) appeals the district court’s judgment granting summary judgment to Arizona Health Care Cost Containment System Administration and Thomas Betlach (collectively “AHCCCS”). We hold that the 2006 amendment to 42 U.S.C. § 1396p(c)(l)(F)(i) creates a right in the State to recover as a remainder beneficiary against a community spouse’s annuity for an institutionalized spouse’s medical costs. We further hold that the State’s recovery is not limited to the amount it paid for the institutionalized spouse’s medical costs as of the date of the community spouse’s death. Accordingly, we affirm.

I.

Appellant is the daughter of John and Betty Hutcherson. At some point, Betty required long-term care in a nursing home or similar facility. In June 2007, Betty applied for Medicaid assistance from AHCCCS. Betty did not qualify for Medicaid assistance at that time because the Hutchersons’ assets exceeded the limit to qualify. In order for Betty to qualify for Medicaid assistance, John “spent down” his assets by purchasing an annuity in his name for $100,000. The annuity paid a fixed monthly amount of $2,781.63 for 36 months. AHCCCS was listed as the annuity’s…