Worcester firm wins MassHealth appeal for deceased client
Patrick Tinsley of Fletcher Tilton was one of the plaintiff's attorneys.
A Massachusetts Superior Court decision upholding MassHealth’s decision to terminate an elderly woman’s long-term care benefits because it counted a trust she owned as an asset was overturned by the state Appeals Court last week, in a decision the plaintiff’s lawyers said will have statewide repercussions.
The Appeals Court reversed decisions of both the Board of Hearings and superior court, which found MassHealth was right to terminate the benefits of the now-deceased Everlenna Roche, because of a trust she transferred to title her Westborough home, retaining a life estate, in the early 2000s.
The nursing home she lived in is now entitled to MassHealth payments from the date of denial up until the patient’s date of death, according to Frederick M. Misilo, chair of the Elder law and Special Needs Practice Group and Trust and Estate Department at Fletcher Tilton, the Worcester firm representing the plaintiff.
In 2011, Roche moved into a skilled nursing facility in Westborough and applied for MassHealth benefits to pay for the cost of her care, according to court documents. She was approved, and continued to receive benefits until March 2013, when MassHealth notified her that her benefits would be terminated because it considered her former residence, held by the trust, as a countable asset worth more than the maximum asset value allowed to keep her eligible.
Roche appealed the decision, and the MassHealth Board of Hearings upheld the denial on Oct. 8, 2013, a little over a month after her death. After a motion for rehearing was denied, the plaintiff appealed to superior court. The appeal was filed after a judge upheld the administrative decision.
MassHealth claimed the investment powers extended to the trustee would have allowed the income beneficiary of the trust to access trust principal through the purchase of an annuity, according to a release. An amicus brief from attorneys of the Massachusetts Chapter of the National Academy of Elder law Attorneys was submitted in support of the case.
“This decision not only helps Massachusetts residents breathe easier but, by compelling the state to abide by its own rules, it speaks to the very foundation of a democratic society,” Richard C. Barry, Jr., president of Fletcher Tilton, said in a release.
Sharon Torgerson, a spokesperson for the Executive Office of Health and Human Services, said in a statement that MassHealth is reviewing the decision.
“We are reviewing the decision and will determine whether a further appeal is warranted.”
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