Failure to pay facility; grounds sufficient for discharge; however, notice of intent was deficient due to lack of name of person at facility available to answer questions and assist appellant with appeal; also lack of documentation from physician.
Category: Samantha Kurkjy
- Issue is whether MassHealth was correct in determining the appellant’s MassHealth start date. Ordered to change start date.
Appellant’s health improved significantly such that she did not need the facility services; facility provided proper notification of intent to discharge.
- MassHealth determined that appellant is not eligible to receive MassHealth benefits due to excess countable assets. Ordered to rescind notice, re-open application, and determine the appellant’s eligibility based on the determination that the excess asset amount is now $0.
- Issue is whether MassHealth was correct in determining the appellant’s MassHealth benefits start date. Appeal approved to change the appellant’s start date.
- 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.