Posts tagged "Needham"

Needham v. Director of the Office of Medicaid (Lawyers Weekly No. 11-166-15)

NOTICE:  All slip opinions and orders are subject to formal revision and are superseded by the advance sheets and bound volumes of the Official Reports.  If you find a typographical error or other formal error, please notify the Reporter of Decisions, Supreme Judicial Court, John Adams Courthouse, 1 Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-1030; SJCReporter@sjc.state.ma.us   14-P-182                                        Appeals Court   MAURICE NEEDHAM[1]  vs.  DIRECTOR OF THE OFFICE OF MEDICAID. No. 14-P-182. Essex.     January 14, 2015. – October 20, 2015.   Present:  Katzmann, Sullivan, & Blake, JJ.     Medicaid.  Administrative Law, Regulations, Agency’s interpretation of statute, Agency’s interpretation of regulation.  Probate Court, Judgment, Trust.  Trust, Reformation.       Civil action commenced in the Superior Court Department on December 28, 2012.   The case was heard by Maynard M. Kirpalani, J., on a motion for judgment on the pleadings.     Elizabeth N. Dewar, Assistant State Solicitor, for the defendant. Peter J. Caruso for the plaintiff.      SULLIVAN, J.  This is an appeal pursuant to G. L. c. 30A from a judgment of the Superior Court reversing the denial of long-term care benefits under the Commonwealth’s Medicaid program.  A judge of the Superior Court concluded that the Director of the Office of Medicaid (MassHealth)[2] was bound by an order of a judge of the Probate and Family Court reforming a trust, and was obligated to consider the reformed trust when determining countable assets for purposes of Medicaid eligibility for long-term care benefits.  We conclude that MassHealth is bound by Federal law in making eligibility determinations, that Federal law prohibits recognition of the reformation of the trust within the statutory look-back period, and that MassHealth therefore could not be compelled to consider the reformed trust in evaluating eligibility.  Accordingly, we reverse the judgment and remand for entry of judgment in favor of MassHealth. Background.  The facts of the case are undisputed.  In his February 11, 2011, application for MassHealth long-term care benefits, the plaintiff Maurice Needham[3] disclosed two trusts, one revocable and one irrevocable.  The revocable trust held only the family home valued at $ 412,400, and named the irrevocable trust, of which Needham was also the settlor, as the sole beneficiary.[4]  MassHealth reviewed this and other financial information for purposes of determining whether Needham met the financial eligibility requirements for long-term care under the Medicaid program.  See 130 Code Mass. Regs. § 520.003(A)(1) (2009) (setting an eligibility ceiling of $ 2,000 in countable assets).  The irrevocable trust, also valued at $ 412,400, was deemed countable by MassHealth because a provision of the trust instructed the trustee to accumulate principal and to use it for the settlor’s future needs without regard to the interest of the remaindermen, his children.[5]  MassHealth concluded […]

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Posted by Massachusetts Legal Resources - October 20, 2015 at 4:28 pm

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