No evidence that appellant made transfer with intent other than to assist a specific child in need; medical event that caused appellant’s short-term placement in skilled nursing facility was not reasonably foreseeable; intent behind transfers was not to gain MassHealth eligibility.
Category: At Issue in Fair Hearing
Appeal 1800094
Transfer of home to trust within look-back period not disqualifying because the trust then sold the home for fair market value, and then proceeds were used to pay for new house in which Appellant had ownership interest; transfer of $42,000 is disqualifying because insufficient evidence to verify that it was repayment for work on the appellant’s former home.
Appeal 1717185
- Issue is whether Appellant is entitled to an adjustment to the PPA where his spouse was living in an assisted living facility. Appeal denied.
Appeal 1805351
Community spouse did not meet exceptional circumstances criteria for increased Spousal Maintenance Needs Allowance; spouse testified she needed an increase to cover day-to-day bills and to assist her adult disabled child; regulations only allow increase where needs arise from medical condition, frailty, or similar special needs of the community spouse.
Appeal 1804208
No exceptional circumstances; testified only to normal expenses such as rent and utilities; only medical expenses were co-pays.
Appeal 1805159
Appellant discharged from nursing facility to homeless shelter; discharge was warranted; location of discharge approved by appellant’s physician; appellant does not need services of skilled nursing facility.
Appeal 1803632
Community spouse is entitled to her actual MMMNA amount; this amount is based on basic necessities such as shelter and utilities; appellant is on fixed income and has little savings and multiple medical conditions.
Appeal 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 1803606
- Issue is whether the appellant’s jointly-held real estate should be deemed non-countable. MassHealth ordered to disregard appellant’s jointly-owned real estate from countable assets and to approve the application if otherwise eligible.
Appeal 1800448
MassHealth application denied because verifications not submitted; missing verifications were assets of community spouse; community spouse’s refusal to cooperate with application process cannot be basis for denial of MassHealth application; appellant is mentally incompetent to assign rights of support to MassHealth.
MassHealth Appeals 