Long term care facilities already face a significant financial burden providing care to MassHealth residents because of low reimbursement rates. This financial burden becomes overwhelming when a resident’s application for Medicaid benefits is denied. It is all too common that Applicants (and long term care facilities) fail to hold MassHealth accountable for violations of Federal Medicaid law and the unwarranted denials of applications for benefits. This trend must stop.
Our recent trial court successes have had a dramatic impact on an individual’s right to Medicaid (MassHealth in Massachusetts). Mary E. Daley v. Secretary of the Executive Office of Health and Human Services, 477 Mass. 188 (2017) – held that in a properly drafted Irrevocable Trust, the Applicant’s retention of a life estate in his or her primary residence does not make the equity in a home owned by the trust a countable asset for the purpose of determining Medicaid eligibility. In Hirvi et al v. Sudders, et al (Suffolk CA No. 18-845-D), in a decision dated June 22, 2018, the Court held that to comply with Federal regulations, when MassHealth issues a denial notice, it must provide a clear statement of the specific reasons supporting the denial.
Elder & Disability Law Advocates has specialized knowledge of Federal Medicaid Law and is experienced in litigation. In an effort to enforce Federal Medicaid law in Massachusetts, Elder & Disability Law Advocates has successfully represented clients in administrative proceedings and has sued MassHealth in Massachusetts Trial Courts.
Do you have a resident that has been unjustly denied Medicaid benefits, or received a denial notice that does not disclose the specific reason for the denial? Elder & Disability Law Advocates needs your help. We are looking for cases to try so we can build on our recent Trial Court success. Can we help establish your resident’s eligibility for Medicaid benefits?