There is a sound basis to increase the MMMNA; the community spouse has medical issues which require ongoing care and him residing in an assisted living facility.
Category: Radha Tilva
Appeal 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 1702063
- Appeal is whether the PPA should be reduced to reflect an increase in the MMMNA for the community spouse. 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 1406406
Transfers were for less than fair market value; appellant’s brother did not possess a present life estate interest in the trust; the amount transferred to him upon the sale of the property was a disqualifying transfer.
MassHealth Appeals 