- Issue is whether MassHealth was correct in denying coverage prior to a date due to resource transfers. MassHealth ordered to rescind the notice and determine MassHealth eligibility without regard to the resource transfers.
Category: Chelsea
Appeal 1601683
Community spouse refused to cooperate; appellant lacked mental ability to assign rights to her spousal support to MassHealth.
Appeal 1601683
- MassHealth denied appellant’s long-term care application for failure to provide requested verifications. Appeal approved. Appellant deemed to have provided sufficient information for MassHealth to determine her eligibility.
Appeal 1703276
Fair Hearing Decisions 1703276
- Issue is whether MassHealth was correct in determining that Appellant’s assets exceed MassHealth’s limits. Appeal denied.
Appeal 1702063
- Appeal is whether the PPA should be reduced to reflect an increase in the MMMNA for the community spouse. Appeal denied.
Appeal 1700155
- Appellant not eligible for MassHealth because she transferred assets resulting in a penalty period. MassHealth needed to adjust the ineligibility period reducing the transfer amount and provide the appellant 30 days to cure the remaining transfer amount.
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 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.
Appeal 1412045
Community spouse refused to provide information about her assets; appellant has assigned to MassHealth right to support from the community spouse.
Appeal 1216920
Community spouse refused to disclose her assets (assets held by her individually); community spouse had assigned to MassHealth the institutionalized spouse’s rights to support; community spouse’s responsibility to disclose assets held individually is waived if the institutionalized spouse’s right to support from the community spouse has been assigned to the state; MassHealth ordered to proceed with substantive determination of eligibility.
MassHealth Appeals 