August 7, 2018

Re:      Mass v Sudders, et al, Suffolk Superior Court (1884CV00129-D)  and  Hirvi, et al v Sudders, et al, Suffolk Superior Court (1884CV00845-D)

In the cases of Hirvi, et al v Sudders, et al, Suffolk Superior Court (1884CV00845-D) and
Mass v Sudders, et al, Suffolk Superior Court (1884CV00129-D), the Suffolk Superior Court has DECLARED that in cases where MassHealth counts trust assets for Medicaid eligibility purposes, the MassHealth’s standard notices of denial of eligibility violate Federal Medicaid Law found at 42 C.F.R. § 431.2l0(b) by failing to provide a clear statement of the specific reasons supporting the denial.

The two lawyers who are counsel of record, respectively, in the above-referenced cases are Nicholas G. Kaltsas, Esq. from Elder & Disability Law Advocates, of Worcester, Massachusetts and Brian E. Barreira, Esq. of Plymouth, Massachusetts. We want you to know that a Due Process violation found in a MassHealth Notice is not limited to cases involving trusts. MassHealth must follow Federal Medicaid Law in their assessment of MassHealth applications – including the requirement that the specific reasons for any denial are listed on any Denial Notice. However, we must be proactive if we are going to force MassHealth to follow federal law because the court needs actual litigation to expand on its Declaratory Judgement. This is where you come in.

As you know, long term care facilities already face a significant financial burden providing care to MassHealth residents because of low reimbursement rates. Significant delays caused by the failure of MassHealth to adhere to Federal Medicaid Law further exacerbate the problem.  Elder & Disability Law is looking for suitable cases where it can represent applicants before MassHealth, the Board of Hearings and/or Massachusetts Trial Courts if necessary, to further reinforce MassHealth’s obligation to adhere to Federal Medicaid Law. It is all too common that Applicants (and long term care facilities) fail to hold MassHealth accountable for violations of Federal Medicaid Law. We must change that.

If you think you might be able to help our effort, or you know of residents that can benefit from high quality legal representation, I would be happy to discuss this with you in greater detail. To contact me, call me at 508-755-6525, or click here to send me an email message.

Nicholas G. Kaltsas, Esq.