Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 520.000 - MassHealth: Financial Eligibility › Section 520.017 - Right to Appeal the Asset Allowance or Minimum-monthly-maintenance-needs Allowance

Current through Register 1525, July 5, 2024
(A)
Request for an Adjustment to the Community Spouse's Asset
			 Allowance
. After the institutionalized spouse has applied for
			 MassHealth Standard and has received a notice of approval or denial for
			 MassHealth Standard, either spouse may appeal to the Office of Medicaid Board
			 of Hearings to request an adjustment to the asset allowance. The purpose of the
			 adjustment is to generate sufficient income, as determined by the MassHealth
			 agency, for the community spouse to remain in the community.
(B)
Minimum-monthly-maintenance-needs Allowance
. The
			 minimum-monthly-maintenance- needs allowance is the amount needed by the
			 community spouse to remain in the community. This amount is based on a
			 calculation that includes the community spouse's shelter and utility costs in
			 addition to certain federal standards, in accordance with
			 130 CMR
			 520.026(B)(1).
(C)
Adjustment of the Amount of
			 Asset Allowance
. If either spouse claims at a fair hearing that
			 the amount of income generated by the community spouse's asset allowance as
			 determined by the MassHealth agency is inadequate to raise the community
			 spouse's income to the minimum- monthly-maintenance-needs allowance, the
			 fair-hearing officer determines the gross income available to the community
			 spouse as follows
(1) The fair-hearing officer
			 determines the gross amount of income available to the community spouse. The
			 fair-hearing officer includes the amount of the income that would be generated
			 by the spouse's asset allowance if $10,000 of the asset allowance were
			 generating income at an interest rate equal to the deposit yield quoted in the
			 Bank Rate Monitor Index as of the hearing date for money market accounts, and
			 if the remainder of the spouse's asset allowance were generating income at an
			 interest rate equal to the highest deposit yield quoted in the Bank Rate
			 Monitor Index as of the hearing date for any term not to exceed 2½
			 years.
(2) If the community
			 spouse's gross income under 130 CMR 520.017(C)(1) is less than the
			 minimum-monthly-maintenance-needs allowance (MMMNA), then the fair-hearing
			 officer allows an amount of income from the institutionalized spouse (after the
			 personal-needs deduction described in
			 130 CMR
			 520.026(A)  ) that would
			 increase the community spouse's total income to equal, but not to exceed, the
			 MMMNA. 130 CMR 520.017(C)(2) applies to all hearings held on or after September
			 1, 2003, regardless of the date of application.
(3) If after the fair-hearing officer has
			 increased the community spouse's gross income under 130 CMR 520.017(C)(1) and
			 (2), the community spouse's gross income is still less than the MMMNA, then the
			 fair-hearing officer increases the community spouse's asset allowance by the
			 amount of additional assets that, if generating income at an interest rate
			 equal to the highest deposit yield in the Bank Rate Monitor Index as of the
			 hearing date for any term not to exceed 2½ years, would generate
			 sufficient income to raise the income total to the MMMNA.