A Massachusetts trial court rules that in cases where the state counts trust assets when determining Medicaid eligibility, the state must provide a clear statement of specific reasons for denying benefits in the standard denial notice. Maas v. Sudders (Mass. Super. Ct., No. 18-129-D, June 22, 2018) and Hirvi v. Sudders (Mass. Super. Ct., No. 18-845-D, June 22, 2018).
Jean Maas and Henry and Eva Hirvi each applied for Medicaid benefits. The state denied benefits based on excess assets that were held in trust. The denial notice listed the excess assets under "other assets" and did not explain why the state was denying benefits.
Ms. Maas and the Hirvis each filed a lawsuit against the state, arguing that the denial notices were insufficient. According to federal regulations, a denial notice must contain a clear statement of the reasons supporting the denial. Ms. Maas and the Hirvis asked for declaratory judgment.
The Massachusetts Superior Court grants declaratory judgment, holding that the state's denial notice was insufficient. According to the court, the state fails "to give any 'reason' – let alone a clear statement of a specific reason – for the most essential determination of all: why the [state] deemed the asset (trust) countable." The court rules that in cases where the state counts trust assets for Medicaid eligibility purposes, the state's standard notices of denial of eligibility violate federal regulations.
For the full text of this decision, click here.
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