Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 520.000 - MassHealth: Financial Eligibility
Section 520.023 - Trusts or Similar Legal Devices Created on or after August 11, 1993
Universal Citation: 130 MA Code of Regs 130.520
Current through Register 1531, September 27, 2024
The trust and transfer rules at 42 U.S.C. 1396p apply to trusts or similar legal devices created on or after August 11, 1993, that are created or funded other than by a will. Generally, resources held in a trust are considered available if under any circumstances described in the terms of the trust, any of the resources can be made available to the individual.
(A) Look-back Period for Transfers into or from Trusts.
(1)
Look-back
Period.
(a) For transfers made
before February 8, 2006, the look-back period is 36 months for trusts where all
or any portion of the income or principal of an irrevocable trust can be paid
to or for the benefit of the nursing-facility resident, but is paid instead to
someone else.
(b) The look-back
period is 60 months
1. for transfers made on
or after February 8, 2006, subject to the phase-in described in
130 CMR
520.019(B)(2), if all or any
portion of the income or principal of a trust can be paid to or for the benefit
of the nursing-facility resident, but is instead paid to someone
else;
2. if payments are made from
a revocable trust to other than the nursing-facility resident and are not for
the benefit of the nursing-facility resident; or
3. if payments are made into an irrevocable
trust where all or a portion of the trust income or principal cannot under any
circumstances be paid to or for the benefit of the nursing-facility
resident.
(2)
Period of Ineligibility Due to a Disqualifying
Transfer. The MassHealth agency determines the amount of the
transfer and the period of ineligibility for payment of nursing- facility
services in accordance with the rules at
130 CMR
520.019(G).
(B) Revocable Trusts.
(1) The entire principal
in a revocable trust is a countable asset.
(2) Payments from a revocable trust made to
or for the benefit of the individual are countable income.
(3) Payments from a revocable trust made
other than to or for the benefit of the nursing- facility resident are
considered transfers for less than fair-market value and are treated in
accordance with the transfer rules at
130 CMR
520.019(G).
(4) The home or former home of a
nursing-facility resident or spouse held in a revocable trust is a countable
asset. Where the home or former home is an asset of the trust, it is not
subject to the exemptions of
130 CMR 520.007(G)(2) or
(8).
(C) Irrevocable Trusts.
(1)
Portion
Payable.
(a) Any portion of the
principal or income from the principal (such as interest) of an irrevocable
trust that could be paid under any circumstances to or for the benefit of the
individual is a countable asset.
(b) Payments from the income or from the
principal of an irrevocable trust made to or for the benefit of the individual
are countable income.
(c) Payments
from the income or from the principal of an irrevocable trust made to another
and not to or for the benefit of the nursing-facility resident are considered
transfers of resources for less than fair-market value and are treated in
accordance with the transfer rules at
130 CMR
520.019(G).
(d) The home or former home of a
nursing-facility resident or spouse held in an irrevocable trust that is
available according to the terms of the trust is a countable asset. Where the
home or former home is an asset of the trust, it is not subject to the
exemptions of
130 CMR 520.007(G)(2) or
(8).
(2)
Portion not
Payable. Any portion of the principal or income from the principal
(such as interest) of an irrevocable trust that could not be paid under any
circumstances to or for the benefit of the nursing-facility resident will be
considered a transfer for less than fair-market value and treated in accordance
with the transfer rules at
130 CMR
520.019(G).
(D) Exemptions to the Trust Rules.
(1)
Special-needs Trusts and Pooled Trusts. Under federal
trust exemption regulations at
42 U.S.C.
1396(p)(d)(4) special-needs
trusts and pooled trusts as defined in
130 CMR
515.001: Definition of Terms
are not subject to the income and asset countability rules at 130 CMR
520.023(B) and (C).
(2)
Revision of a Trust to Comply with the Criteria of a Special-needs
or Pooled Trust. The MassHealth agency will not deny or terminate
MassHealth due to excess assets if a trust is revised to comply with the
criteria of a special-needs trust or a pooled trust in accordance with the
rules at
130 CMR
520.019(J).
(3)
Burial Trust. A
burial trust is a trust established to pay solely for various funeral and
burial expenses of the individual or the spouse. An irrevocable burial trust
meeting the criteria of
130 CMR 520.008(F)
is not a countable asset.
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