Appeal 1812255

Fair Hearing Decision 1812255

Transfer of resources for less than fair market value; appellant retained access to assets in irrevocable trust; trustee then distributed trust assets to children; appellant and spouse changed beneficiaries of spouse’s IRAs to children; spouse passed away 17 days later; not relevant whether trustee was exercising fiduciary duty.

Appeal 1802749

Fair Hearing Decision 1802749

Disqualifying transfer of assets; appellant paid daughter $8,000 in consideration of a “personal service contract”; while not all personal caregiver contracts are per se disqualifying transfers for less than fair market value, here, appellant has not received ascertainable fair market value for his purchase since he was admitted to a nursing home and was already receiving hands on care in the facility; therefore the personal care services under the contract were unnecessary or duplicative.

Appeal 1805795

Fair Hearing Decision 1805795

Daughter withdrew $119,000 from bank account she jointly owned with mother; 7 months later appellant applied for long term benefits; 336 day ineligibility period arising from daughter’s withdrawal; record was left open to allow appellant opportunity to establish why this should not be treated as a disqualifying transfer; nursing facility filed suit under contractual theory against appellant and her daughter; as appellant is not taking any action, the hearing officer concluded the matter had moved beyond the issue of MassHealth eligibility; nursing facility’s legal claim is appropriate course of action for when MassHealth coverage has been conclusively denied.

Appeal 1808954

Fair Hearing Decision 1808954

Disqualifying transfer of $53,703 after appellant sold her home and deposited the proceeds into her grandson’s checking account; grandson cured a portion of this transfer and the ineligibility period was revised; no documentation to support grandson’s claim that he paid appellant’s expenses out of the proceeds from the home sale due to the insufficiency of her income to make ends meet; hearing officer concluded transfer was gift with no fair market value compensation received in return; also concluded there was intent to qualify for MassHealth.

Appeal 1800614

Fair Hearing Decision 1800614

Appellant transferred $13,858 for less than fair market value; ineligibility period of 40 days; eleven transfers made to appellant’s daughter while she was resident in nursing facility knowing she would need funds to provide for her care; daughter could not show evidence that transfers were reimbursements for money she had spent on behalf of appellant.

Appeal 1717373

Fair Hearing Decision 1717373

  • Issue is whether MassHealth applied accurate facts to the controlling regulations when it denied appellant’s application for MassHealth benefits and assessed a period of ineligibility upon determining that appellant had made a disqualifying transfer of assets. MassHealth ordered to rescind denial and re-determine eligibility without any disqualifying transfer period.

Appeal 1801834

Fair Hearing Decision 1801834

Transfer of $12,000 to daughter was disqualifying transfer; daughter did not qualify as “disabled child” because she had not been found permanently and totally disabled by any government agencies authorized to make such determination; daughter also does not meet regulatory definition of permanent and total disability.

Appeal 1800590

Fair Hearing Decision 1800590

Appellant transferred assets during look-back period; disqualifying transfer; transfers not made for fair market value; evidence needs contemporaneous third party independent corroboration to be persuasive; appellant’s age and health did not support argument that transfers were made for purposes other than qualifying for MassHealth.