Category: At Issue in Fair Hearing
Appeal 1604297
- Appellant purchased an annuity that lasts beyond the appellant’s life expectancy, and therefore made a disqualifying transfer of assets resulting in a period of ineligibility. Appeal denied.
Appeal 1607197
- Facility notified appellant of its intent to transfer her to a different center because she failed to pay for services rendered at the facility. Decision is to proceed with the transfer.
Appeal 1603358
- MassHealth denied appellant for MassHealth benefits because MassHealth determined that appellant transferred assets for less than fair market value and calculated a period of ineligibility. Appeal is partially approved. Decision is to adjust impermissible asset transfer amount and recalculate disqualification ineligibility period.
Appeal 1602466
- Appellant denied for MassHealth Standard benefits for LTC residents because MassHealth determined that the appellant transferred assets for less than fair market value resulting in a period of ineligibility. Appeal denied.
Appeal 1600269
- Appellant’s long-term care application denied because MassHealth determined there had been a disqualifying resource transfer (this resulted in an ineligibility period). The transfer was an annuity which was a private, inter-family, unsecured agreement found to be disqualifying.
Appeal 1601813
- MassHealth approved appellant for long-term care benefits and established a PPA but the appellant’s community spouse is appealing for an increase based upon significant financial duress arising from exceptional circumstances. Appeal denied.
Appeal 1603204
- Facility informed the appellant of its intent to discharge her for nonpayment. The issue is whether the facility is justified in seeking to discharge the appellant, and whether it followed proper procedures in doing so. Appeal is approved. Decision is to rescind notice and provide reasonable and appropriate notice to the appellant and her representative to pay for (or have Medicaid or Medicare) her stay at the facility.
Appeal 1702339
- MassHealth denied the Appellant’s application for long term care benefits due to excess assets. Ordered to allocate all income (minus PNA) and excess assets to the Community Spouse and to establish eligibility date consistent with the application date.
Appeal 1600586
Appellant did not demonstrate by preponderance of evidence that spouse would not cooperate; no evidence of noncooperation besides appellant’s own statement in a letter.
MassHealth Appeals 