- Issue is whether MassHealth was correct in determining the appellant’s MassHealth benefits start date. Appeal approved to change the appellant’s start date.
Category: Approval
Appeal 1706559
- Issue is whether MassHealth was correct in determining that the appellant’s spouse’s assets exceed the limit for MassHealth. Other issue is whether the appellant is allowed to retain the excess assets in order to meet her MMMNA. Appeal is approved.
Appeal 1708218
Property was transferred before look-back period; attorney’s failure to timely register sale not fatal; evidence was that appellant intended to surrender control of property prior to look-back period.
Appeal 1706272
- Issue is whether MassHealth was correct in determining the appellant’s PPA to the nursing facility. Other issue is whether the appellant’s spouse is entitled to an increased spousal allowance to help pay for a needed stay in an assisted living facility. Appeal is approved.
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 1702776
- MassHealth denied the appellant’s application. Ordered to re-determine eligibility based on the determination that the excess asset amount is now $0 after a shift of excess assets to the community spouse to help pay for a necessary stay in assisted living.
Appeal 1700501
- Appeals calculation of the PPA. MassHealth ordered to recalculate the PPA because the community spouse needs more income to make mortgage payments.
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 1702339
- MassHealth denied the Appellant’s application for long term care benefits due to excess assets. Ordered to allocate all income (minus PNA) and excess assets to the Community Spouse and to establish eligibility date consistent with the application date.
MassHealth Appeals 