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.
Category: Denial
Appeal 1805691
Appellant’s health improved significantly such that she did not need the facility services; facility provided proper notification of intent to discharge.
Appeal 1800679
Notice of discharge meets regulatory requirements; nursing facility involved appellant and his guardian in discharge planning; fact that appellant has not found place he wants to live is out of control of nursing facility; physician indicated appellant medically cleared for discharge; place to which appellant will be discharged is safe and appropriate.
Appeal 1800590
Appellant transferred assets during look-back period; disqualifying transfer; transfers not made for fair market value; evidence needs contemporaneous third party independent corroboration to be persuasive; appellant’s age and health did not support argument that transfers were made for purposes other than qualifying for MassHealth.
Appeal 1714972
- 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.
Appeal 1800544
Facility notified appellant of debt owed; facility provided reasonable and appropriate notice of the debt owed; appellant failed to pay; physician confirmed that 24-hour care by a home health agency will meet appellant’s needs.
Appeal 1703222
- Issue is whether MassHealth was correct in determining that the appellant transferred an amount for less than fair market value resulting in a MassHealth ineligibility period. Appeal denied.
Appeal 1705801
- Issue is whether the community spouse is entitled to an increase in the spousal maintenance needs allowance, based on exceptional circumstances. Appeal denied.
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.
MassHealth Appeals 