When Are a MassHealth Applicant’s Intentions Considered in Determining Whether a Disqualifying Transfer Occurred?

by: Brian E. Barreira, Esq.

There are many exceptions to disqualifying transfers in federal Medicaid law that the MassHealth program has been required to implement.   If a potential disqualifying does not fit into the categories of permissible transfers, then MassHealth is required to determine what the MassHealth applicant’s intentions were when the transfer occurred.

One exception to a disqualifying transfer occurs when the MassHealth applicant had made the transfer exclusively for a purpose other than obtaining MassHealth eligibility.  This one situation where ignorance of the law can be an excuse for what was done.  Unfortunately, anybody can claim that he/she didn’t know about the law, so hearing officers expect a compelling case to be made, and if there is even a hint of MassHealth planning or knowledge, they can easily rule against the MassHealth applicant.

Another expectation to a disqualifying transfer involves an attempt to receive fair market value or other valuable consideration.

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  • […] 13. Disqualifying Transfers. Any gifts or below market sales during the five-year lookback period can be treated as disqualifying transfers, and cause a period of MassHealth ineligibility. Unexplained expenditures can often be treated as gifts.  (See What Is Considered a Disqualifying Transfer When Applying for MassHealth?)  Fortunately for MassHealth applicants, exceptions can be made based on the intentions and circumstances that existed when the gift was made.  (See When Are a MassHealth Applicant’s Intentions Considered in Determining Whether a Disqualifying Tra…) […]

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