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Inaccessible assets – MassHealth Appeals

WebAppeal 1813276. Fair Hearing Decision 1813276. Trust cannot be considered countable asset; MassHealth counted $16,000 held in a revocable trust established by the spouse who is now deceased; spouse’s will left estate to appellant; appellant’s attorney currently unable to find someone willing to be trustee (terms of trust require corporate

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WebFair Hearing Decision 1813276. Trust cannot be considered countable asset; MassHealth counted $16,000 held in a revocable trust established by the spouse who is now deceased; spouse’s will left estate to appellant; appellant’s attorney currently unable to find someone willing to be trustee (terms of trust require corporate trustee with 50

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Office of Medicaid BOARD OF HEARINGS

Web1 The MassHealth representative testified the current calculation indicates the community spouse (appellant's wife) has gross income of $1,061.50 (Social Security) and institutional spouse (appellant) has gross ($1,384.52 peincome of $1,nsion/annuity + 814.52

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WebSummary of Evidence The appellant's clinical record was submitted into the record. This included records submitted just prior to and at the hearing (Exhibit 3).

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Office of Medicaid BOARD OF HEARINGS

WebPage 1 of Appeal No.: 1200340 APPEAL DECISION. Appeal Decision: Approved in part; Denied in part Issue: Disqualifying Transfer of Resources Decision Date: 6/11/12 Hearing Date: 03/26/2012 MassHealth’s Rep.: Andrea Pelczar Appellant’s Reps.: Hearing Location: Tewksbury MassHealth Enrollment Center

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WebIn the instant case, MassHealth increased the appellant's PPA to $2,295.00 beginning February 1, 2018. $146.00 for health insurance and a $72.80 personal needs allowance

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Webthe assistance and support provided by the assisted living facility and it is the most appropriate setting for him as he must manage multiple chronic diseases.

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Office of Medicaid BOARD OF HEARINGS

Webresulting in a minimum monthly maintenance needs allowance (MMMNA) of $3,710.00 for the community spouse. (testimony, Exhibit 5) Pursuant to MassHealth regulation, the maximum

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Office of Medicaid BOARD OF HEARINGS

WebOffice of Medicaid. BOARD OF HEARINGS . Appellant Name and Address: Appeal Decision: Approved in part; Denied in part Appeal Number: 1409043 Decision Date: 9/26/14 Hearing Date: 09/09/2014 Hearing Officer: Paul C. Moore Appellant Representative: MassHealth Representative:

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Office of Medicaid BOARD OF HEARINGS

WebThrough a notice dated April 14, 2009ssHealth approved the A, Ma ppellant's application for long term care (LTC) benefits effective March 16, 2009 and established a patient paid amount (PPA) of

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Office of Medicaid BOARD OF HEARINGS

WebAppellant, who is a 55 year-old male, was admitted to Eastpointe on July 21, 2011 after completing a hospital stay at Cambridge Health Alliance.

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WebSummary of Evidence A MassHealth representative testified that the nursing facility is seeking coverage effective November 21, 2017 and that is the date the appellant is otherwise eligible for MassHealth LTC

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Web5. 6. 7. The spouse-in-home deduction, the standard $72.80 personal needs allowance, and $250.23 for health insurance, were deducted from the appellant's income of

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WebSummary of Evidence The MassHealth representative testified that the appellant was a MassHealth recipient who was converted to a Standard long-term care member on September 15, 2015

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Webpay for) a stay at the nursing facility; or (6) the nursing facility ceases to operate (Emphasis added, 130 CMR 610.028(A)). In this case, the facility premised its notice of intent to discharge on the appellant's failure to pay

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WebSummary of Evidence The MassHealth representative testified that the appellant's April 21, 2017 application was denied due to a failure to provide timely verifications (Exhibit 3).

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Webcoverage if the countable income is less than or equal to 100% of the federal poverty level. 130 CMR 519.005. The federal poverty level for a family of one is $1,012.00 per month.

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Web1. 2. 3. 5. 6. 7. Appellant entered the nursing facility on June 22, 2016 and applied for MassHealth long-term care benefits on October 15, 2016 requesting benefits

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WebThe MassHealth representative stated that the appellant lived with her daughter and the appellant's house was transferred to the appellant's daughter, but such transfer was permissible because the

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