Submitted by Health-Law-Anno... on 07/23/2020 - 4:21pm.
We just wanted to let you know about some items we recently posted to MassLegalServices.
This appeal was about whether the CSN time that MassHealth authorized for a medically complex child was adequate, or whether additional time is medically necessary. Counsel on this case, Andrew Cohen, helped the appellant create a parallel CSN rubric that addressed each area of evaluation, and he obtained doctor's letters and orders substantiating each intervention that required an increase in time. This persuaded the hearing officer to order MassHealth to increase CSN time for each area of evaluation. Congratulations Andrew!
This was a Medicaid Estate Recovery case in which EOHHS was pursuing a reimbursement claim against the estate of a single parent who died at home, leaving her disabled adult son living in the home. The personal representative applied for a hardship waiver of estate recovery on behalf of the disabled adult son. EOHHS denied the request and sued the estate for the full amount of the claim on the grounds that the son didn't have a sufficient legal interest in the house. Counsel for the estate, Peter Benjamin, did a great job briefing the issue and persuading the judge to keep the home in the family. Judge Roach denied the state's motion for summary judgment and granted summary judgment for the estate. Congratulations Peter!
1. Reduction of PCA Hours: Thank you to Nancy Lorenz for sharing this 30A complaint about a reduction in PCA hours.
2. Transgender Health Care: Thank you to Andrew Cohen for sharing this 30A complaint about MassHealth's denial of coverage for medically necessary facial feminization surgeries for a transgender woman.
Powerpoints on MassHealth and disability:
1. 2019 MTF powerpoint on MassHealth eligibility based on disability
2. 2015 DES powerpoint on MassHealth's disability determination process