- Issue is whether MassHealth was correct in determining the appellant’s PPA to the nursing facility. MassHealth ordered to modify their calculations based on specific determinations.
Category: Partial approval
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 1603358
- MassHealth denied appellant for MassHealth benefits because MassHealth determined that appellant transferred assets for less than fair market value and calculated a period of ineligibility. Appeal is partially approved. Decision is to adjust impermissible asset transfer amount and recalculate disqualification ineligibility period.
Appeal 1600798
- Appellant denied for LTC benefits because she did not give MassHealth the information it needed to decide her eligibility within the required time frame. A disqualifying transfer of resources was found as the appellant recently gave away or sold assets to become eligible for MassHealth services. This transfer created a period of ineligibility.
Appeal 1600128
- 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 MassHealth’s intent to place a lien on the appellant’s property was rescinded.
Appeal 1200340
MassHealth determined that the appellant transferred assets when she paid her son and daughter-in-law for services under a personal care contract; compensation for a variety of personal services; the services she received were not worth the $48,550 that she paid but did have some value; remanded for MassHealth to redetermine the period of ineligibility.
Appeal 0807837
APPROVED IN PART as to the transferred resources for which appellant received fair-market value, and DENIED IN PART as to the remaining transfers; $1,000.00 transfer to appellant’s granddaughter was a disqualifying transfer; Appellant has not received something tangible with intrinsic value for this exchange; majority of receipts submitted are for normal personal expenses such as groceries, restaurants, moving-related expenses, prescription medication, doctors’ co-payments, parking for medical appointments, and clothing; reimbursement for all of these expenses is reasonable, and that appellant received fair-market value for the reimbursed funds.
MassHealth Appeals 