The hearing officer ruled that the primary beneficiary of a spousal annuity does not have to be “Commonwealth of Massachusetts” without limiting language. Since the MassHealth regulation only allows estate recovery to the extent of MassHealth benefits correctly paid, the beneficiary language can be limited to track the regulation.
Transfer of resources for less than fair market value; appellant retained access to assets in irrevocable trust; trustee then distributed trust assets to children; appellant and spouse changed beneficiaries of spouse’s IRAs to children; spouse passed away 17 days later; not relevant whether trustee was exercising fiduciary duty.
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.
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.
- Appellant denied for benefits because he did not give MassHealth the information about his spouse’s assets and income that it needed to decide his eligibility.
- Appellant denied because he has more countable income than MassHealth benefits allows (even with a PCA disregard). Therefore, he does not meet MassHealth eligibility requirements.
- Issue is whether MassHealth was correct in determining the appellant’s MassHealth start date. Ordered to change start date.
No exceptional circumstances; testified only to normal expenses such as rent and utilities; only medical expenses were co-pays.
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.
- Issue is whether MassHealth was correct in determining that the appellant had given away real estate in part to qualify for MassHealth benefits. Appeal denied.