MASSHEALTH REVISES ELIGIBILITY DIVISOR

MassHealth must impose a period of ineligibility for payment of nursing facility services when it has determined that a MassHealth applicant or member has made a disqualifying transfer of resources. When calculating the period of ineligibility, MassHealth uses the average cost to a patient paying privately for nursing facility services in the Commonwealth. Periodically, this figure is revised to reflect increased costs.

Effective March 1, 2007, the penalty for transferring assets was revised to reflect the average cost of $246 a day to $256 a day (or one day of ineligibility for every $256 transferred).

The dateMassHealth receives the application or eligibility review form determines which of the following amounts to use when calculating the period of ineligibility for a disqualifying transfer of resources.

• If received before March 1, 2007: use $246.

• If received on or after March 1, 2007: use $256.

For example, for an application filed prior to March 1, a transfer of $100,000 would have caused 406 days of ineligibility, while if the application was filed after that date, the same transfer would cause 390 days of ineligibility.

--Adapted from: The Margolis & Associates Weekly , e-mail bulletin, May 07, 2007 and MassHealth Eligibility Operations Memo 07-07, March 15, 2007 .

 

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