Community spouse refused to cooperate; assets have been kept separate; appellant is mentally incompetent and cannot assign to MassHealth any rights to support from her community spouse; application cannot be denied based on spouse’s refusal to cooperate.
Category: Stanley M. Kallianidis
- Issue is whether the community spouse is entitled to an increase in the spousal maintenance needs allowance, based on exceptional circumstances. Appeal denied.
- Appellant failed to pay his patient paid amount so was sent a Notice of Intent to Discharge of Transfer. Records conclude that he has failed to pay for his stay at the nursing facility after reasonable and appropriate notice. Appeal denied.
- Appellant’s PPA lowered due to a change in countable income. MassHealth’s intent to place a lien on the appellant’s property was rescinded.
Appellant’s withdrawal is a disqualifying transfer; intent and lack of fair market value consideration; appellant had intent to qualify for MassHealth because she was in declining health at the time of the transfer, evidenced by the sale of her home and the need to enter an assisted living center.
Although MassHealth’s calculation was correct using the life expectancy table that it did, it was incorrect to ignore the appellant’s life expectancy table from Aviva; MassHealth was presented with a copy of the Aviva table and, without sufficient justification, refused to apply it; this is not acceptable, as a life expectancy table from an annuity company cannot be disregarded for the sole reason that it affords a better outcome for a client; rather it must be afforded “due weight.”
Community spouse refused to cooperate; appellant submitted assignment of spousal support rights to MassHealth; appellant entitled to determination of eligibility.
Appellant made a disqualifying transfer of the value of his half of the property, or $250,000.00, as the transfer precluded MassHealth from placing a lien on it; the action taken, removing the appellant as a joint owner of the property, made it impossible for MassHealth to place a lien on it; MassHealth would have been entitled to a lien because neither the appellant nor his spouse lived in it at the time of application; the appellant did not receive anything for the transfer, thus it is disqualifying; given the proximity between the appellant’s application and the transfer, only a few weeks, qualifying for MassHealth was a factor, thus satisfying the intent requirement.