Planning for Life

Chalk Up Another Loss to MassHealth

Posted by Harry S. Margolis on September 28, 2021

By Harry S. Margolis


In a case, Estate of Sotirios A. Koutoukis, et al., v. Secretary of the Executive Office of Health and Human Services (Mass. Land Court No. 20 MISC 000004 (RBF), September 17, 2021), involving an effort to reform a scrivener's error in a life estate deed, the Massachusetts Land Court rejects MassHealth's opposition saying that MassHealth "cannot create a dispute of material fact simply by declaring it disputes a material fact." It must "provide some evidence that disputes the fact" which it failed to do in this case.

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Topics: MassHealth, MassHealth lien, life estate, estate recovery

New MMMNA Figures Released, But What's an MMMNA?

Posted by Harry S. Margolis on August 2, 2021

By Harry S. Margolis

MMMNA-Margolis-Bloom-nursing home-wellesley

MassHealth has issued the new Minimum Monthly Maintenance Needs Allowance (MMMNA) numbers for the rest of 2021 and the first half of 2022 which increase the amount of income the spouse of a MassHealth-covered nursing home resident may keep. (I'll explain below why this is a bit of a misstatement of the rules, but I can't think of a better way to say it.)

They are a minimum of $2,177.50 and a maximum of $3,259.50 a month.

How the MMMNA Works

Here's what this means:

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Topics: MassHealth, MMMNA, spousal impoverishment, CSRA

Limited POA Does Not Make Trust Countable SJC Rules

Posted by Harry S. Margolis on July 27, 2021

By Harry S. Margolis

In Patricia A. Fournier vs. Secretary of the Exec. Office of Health & Human Services (SJC-13059, July 23, 2021), the Supreme Judicial Court finally puts to rest a MassHealth argument that property in an irrevocable trust may be countable if the grantor retains a limited power of appointment to charity. The SJC had left this question open in the prior case of Daley v. Secretary of the Exec. Office of Health & Human Servs., 477 Mass. 188, 203 (2017).

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Topics: long-term care planning, MassHealth, irrevocable trust

Why Must Centenarian Resort to GoFundMe to Pay for Home Care?

Posted by Harry S. Margolis on July 6, 2021

By Harry S. Margolis

The Boston Globe reported that Juliet Bernstein, a Cape Cod resident who turned 108 years old last Friday, has raised $72,000 on GoFundMe to pay for her home care. Since the article ran, she has raised another $50,000.


Ms. Bernstein has had to resort to this source of funding because neither Medicare or MassHealth will pay for her care and her children don't have the means to contribute more than they have already. She has taken out home equity loans on her home and her oldest daughter, who is 80 years old herself, has taken out a reverse mortgage on her own home to help pay for her mother's care.

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Topics: MassHealth planning, MassHealth, home care, estate recovery

Let’s Clarify the MassHealth Notice Sent to All Members That is Causing Anxiety and Confusion

Posted by Patricia C. D'Agostino on June 23, 2021

MassHealth Planning - Margolis-and-Bloom-Patricia C. Dagostino

MassHealth recently sent this notice about estate recovery out to many beneficiaries. We anticipate the agency will send this notice to another batch of members at the beginning of July, we are receiving a lot of calls from clients asking what this means and so here is a brief summary.

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Topics: MassHealth planning, MassHealth, Estate Planning, MassHealth lien, estate recovery

SJC Rules House in Nominee Trust Not a Countable Asset for MassHealth

Posted by Harry S. Margolis on February 9, 2021

By Harry S. Margolis


In the latest of a long line of cases debunking MassHealth legal theories, in Guilfoil vs. Sec. of the Exec. Office of Health and Human Services (SJC-12922, February 9, 2021), the Massachusetts Supreme Judicial Court (SJC) finds that an applicant's life interest in a home held by a nominee trust is not a countable asset for purposes of her eligibility for MassHealth coverage of her nursing home care. We also note that this is the latest in a long line of MassHealth trust cases litigated by Lisa N. Neeley of Mirick O'Connell in Worcester.

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Topics: MassHealth, nominee realty trust

SJC Imposes Time Limit on MassHealth Estate Recovery

Posted by Harry S. Margolis on January 5, 2021

By Harry S. Margolis


In an important case, the Supreme Judicial Court rules that MassHealth may not seek estate recovery against the estate of a beneficiary more than three years after her death. In the Matter of the Estate of Jacqueline Ann Kendall (SJC-12881, December 28, 2020) involves a claim by MassHealth for reimbursement of $104,738.23 it had paid for the care of Jacqueline Ann Kendall before she died on August 7, 2014.

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Topics: MassHealth, MassHealth lien, estate recovery

The Challenge of Protecting The House When One Spouse is in a Nursing Home

Posted by Harry S. Margolis on October 30, 2020

 By Harry S. Margolis


Clients with a spouse in a nursing home can find themselves facing a difficult planning decision due to the large growth in value of their homes since they purchased them. When one spouse is in a nursing home, normally we advise transferring the house to the healthy spouse. But that can have unfortunate capital gains consequences, depending on which spouse passes away first and whether the surviving spouse sells the house.

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Topics: MassHealth planning, nursing homes, MassHealth, asset protection, capital gains

System Failures: Policing, Public Health, Education, Housing, Long-Term Care

Posted by Harry S. Margolis on June 14, 2020

By Harry S. Margolis


System Failures in the United States

The coronavirus pandemic and murder of George Floyd have laid bare the failures of public health and policing in the United States. Those failures are not news. We've known that we spend much more per capita on health care than any other nation with uneven results and a system where a health event can bankrupt a family.

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Topics: long-term care planning, MassHealth, Medicaid

What is Settlement Planning?

Posted by Harry S. Margolis on April 1, 2020

A settlement or award of damages in a personal injury case means the end of litigation. It’s the biggest step – but only the first step – in assuring your financial future. You need to make sure that the award is maximized, that the funds are safeguarded, and that you preserve your eligibility for public benefits. This involves a number of issues, including:

Resolving Liens – Personal injury settlements and awards to minor or disabled plaintiffs are often subject to claims by Medicare, Medicaid (MassHealth), or private insurers. These must be resolved prior to any distribution of funds. It's often best that this be done as part of settlement negotiations, because a lien holder—the state, federal government, or insurance company—has an incentive to help the case settle. Your personal injury attorney will resolve any of these liens as part of the litigation.

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Topics: Medicare, special needs planning, MassHealth, personal injury settlement

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