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Mar 29
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MassHealth Denial Trust Case Overturned

By Uncategorized

Denial of Medicaid Benefits based on Income-Only Trust Overturned

A Massachusetts Superior Court has overturned a MassHealth denial of coverage for a nursing home resident who MassHealth found had countable assets available from a trust she had created.

MassHealth who administers the Medicaid program for Massachusetts residents has been aggressively challenging and contesting applications where the applicant was the beneficiary of an Income-Only trust. MassHealth would take the position that assets held in an Income-Only trust are considered available to the applicant to be used on their own care and thus would disqualify them from Medicaid eligibility.

MassHealth will need to be more welcoming of Income-Only trusts

An Income-Only Trust used for Medicaid purposes states that the grantor of the trust shall, as the name indicates, only be entitled to receive income from the trust. If the terms of the trust also state that the grantor shall never be able to receive principal from the trust, the assets in the trust will not be deemed an available resource for the Medicaid applicant. Massachusetts has not followed this rule and denied Medicaid benefits to applicants despite these terms in the trust. With this new decision, MassHealth has been told that it was improper to deny applicants Medicaid benefits of the the basis of Income-Only Trusts.

This decision is welcome news for many estate planners seeking to clarify the role Income-Only trusts play in the estate planning process.

CLICK HERE TO READ THE ARTICLE

The usage of Trusts in Estate Planning is a critical component. The rules and terms contained in the trust dictate how various governmental agencies will view the trust. Having a clear understanding as to interpretation of language as to important benefits such as tax treatment, control issues or Medicaid qualification is required. This decision with MassHealth brings clarity to language that prior was in flux.

Want to learn more about Irrevocable Income-Only trusts? Contact our office for a no-cost consultation to see if they fit into your estate plan.

Jun 21
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Home Placed In Massachusetts Trust Protected

By News

Ability to Use House Placed In Massachusetts Trust Does Not Render Trust Available

Reversing a lower court, Massachusetts’ highest court rules that two Medicaid applicants’ trusts were not available assets even though the applicants retained the right to use the houses that were put into the trusts. Daley v. Secretary of the Executive Office of Health and Human Services (Mass., No. SJC-12200, May 30, 2017) and Nadeau v. Director of the Office of Medicaid (Mass., No. SJC-12205, May 30, 2017).
James and Mary Daley created an irrevocable trust. They conveyed their interest in their condominium to the trust, but retained a life estate in the property. Seven years later, Mr. Daley was admitted to a nursing home and applied for Medicaid benefits. The state denied him benefits after determining that the trust was an available asset. Lionel Nadeau and his wife created an irrevocable trust and transferred their house into the trust. The trust provided that the Nadeaus had the right to use and occupy the house, which they did until Mr. Nadeau entered a nursing home and applied for Medicaid benefits. As with the Daleys, the state considered the trust a countable asset and denied benefits.

The Daleys and the Nadeaus appealed but following hearings, the state ruled that the trusts were available assets because the Daleys and Nadeaus had the right to occupy and use the properties that were in the trusts. In separate rulings, Massachusetts trial courts held that both trusts were available assets. [Daley v. Sudders, Mass. Super. Ct., No. 15–CV–0188–D; Dec. 23, 2015; and Nadeau v.Thorn, Mass. Super. Ct., No. 14-DV-02278C, Dec. 30,2015]; see The ElderLaw Report, March 2016, p. 5.) The Daleys and Nadeaus appealed and the Massachusetts Supreme Judicial decided both cases together.

The Massachusetts Supreme Judicial court reverses, holding that the trusts are not available assets. According to the court, “where a trust grants the use or occupancy of a home to the grantors [as in the Nadeau’s case], it is effectively making a payment to the grantors in the amount of the fair rental value of that property.” The court adds that these payments “do not affect an applicant’s eligibility for Medicaid long-term care benefits, but they may affect how much the applicant is required to contribute to the payment for that care.” In the Daleys’ case, the court rules that because the Daleys hold a life estate, their use of the home is not considered income and “the continued use of the home by the applicant pursuant to his or her life estate interest does not make the remainder interest in the property owned by the trust available to the applicant.”

Maryland elder law attorney Ron M. Landsman joined the briefing and argument. In reaching its conclusion in the Daley case, the court cites the Elder Law section of West’s Massachusetts Practice series, written by Harry S. Margolis and Jeffrey A. Bloom of the Boston firm of Margolis & Bloom, LLP. For the full text of this decision, go to: http://tinyurl.com/elr-Daley3

Mar 04
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Major Changes Proposed to Massachusetts Medicaid! Will Rhode Island Follow?

By Uncategorized

Massachusetts Medicaid is called MassHealth

Massachusetts Governor Baker’s FY2017 budget proposes a significant  amendment to Massachusetts General Laws chapter 118E to expand the types of property the Commonwealth can seek reimbursement for Medicaid a/k/a MassHealth benefits paid on behalf of certain deceased MassHealth recipients. Expanded estate recovery, as described in Outside Section 11.

source: Boston Magazine

Governor Baker

  • Under current law, the Commonwealth can be reimbursed for MassHealth coverage of nursing home care and community based care provided to persons age 55 and over, from property in the recipient’s probate estate. Federal law requires state Medicaid agencies to file claims against probate estates. Federal law does not mandate recovery against non-probate assets.
  • Similar legislative changes have been rejected twice by the Legislature.

Proposed Change:

  • The Governor proposes to dramatically expand the MassHealth asset recovery by allowing claims against any property in which the decedent had any legal title or interest immediately prior to death.
  • This would expand the pool of assets from which the Commonwealth could seek reimbursement to the decedent’s interest in jointly owned personal and real property, property in which the decedent held only a life interest, and possibly even to property held in a trust of which the decedent was a beneficiary during life.
  • The administrative costs for expanding estate recovery could be astronomical for MassHealth, potentially outweighing the benefits to the program.

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What this Means To You:

  • If enacted into law, Medicaid planning as it has been known and performed and understood in Massachusetts will be forever changed.
  • Ambiguities in the statute language may create questions of law as to what assets may be included in expanded estate recovery, creating possible issues with real estate titles and title insurance claims.
  • Existing estate plans and new estate plans will need to be reviewed to understand the impact of the potential new change on each individual and couple’s plans.

Want To Lean More?

Contact our office for a consultation to discuss how this may impact you and your estate plan.

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