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MASSHEALTH AND DIVISION OF MEDICAL ASSISTANCE

Under Massachusetts law, MassHealth has an interest in the estate of a decedent that received recoverable benefits during his/her lifetime.

commerce-acts-books-477966-mAny time you petition to probate the estate of a deceased family member, loved one, or friend in Massachusetts, you must send a copy of the petition to the Massachusetts Division of Medical Assistance (“DMA”).  If you hire a probate lawyer to help, the attorney will file a petition and take care of this detail but if you choose to probate an estate without legal counsel, notice to the DMA is required.   The Petition for the estate must be filed in the county where the decedent resided at the date of death (Essex County, Middlesex County, etc.).  The petition must include a sworn statement that copies of the petition and death certificate have been sent to the DMA by certified mailM.G.L. c. 118E, s. 32.  The purpose for the notice is to allow MassHealth its right to pursue recovery of any medical assistance or benefits the decedent received from MassHealth.  If benefits were provided to a decedent while alive for which the DMA is authorized to recover, it can (and likely will) pursue recovery from the Estate.

A copy of the petition and a death certificate of the decedent must be sent to the DMA, for both formal or informal probate, by certified mail M.G.L. c. 190B s. 3-403(g).  In a formal probate, the petitioner must give notice by certified mail along with a copy of the petition and death certificate.  In an informal probate, M.G.L. c. 190B s. 3-306(g) requires the petitioner to give written notice 7 days prior to filing the petition.

A recent Massachusetts Appeals Court case involving probate litigation provides some illustration on how tricky estate matters can become, even in a relatively modest estate, when the DMA is involved.  The reach and authority of the DMA in recovery of estate assets for medical care are broad. Maestranzi v. O’Brien, et al.

In the O’Brien case, Michael J. O’Brien died with a Will in 2011.  At his death he owned a one-half interest in property.  His half interest in the property was part of the probate estate and had to be probated according to the terms of his Will.  Two claims were made against the estate, one by his sister from a judgment she had against Michael from 2003; and the second a claim by MassHealth for recovery of medical treatment and assistance that had been provided to Mr. O’Brien.  The assets of Mr. O’Brien’s estate were not sufficient to cover both claims, and the probate court judge determined that his sister’s claim had priority over MassHealth.

The story did not end there.  In 2014 the Personal Representative of Mr. O’Brien’s estate sought to re-open and challenge the 2003 case where his sister got judgment.  The DMA then filed a motion to intervene in the case between the estate and his sister and join in the effort to set aside the judgment.  The Superior Court allowed MassHealth to intervene in the case.

The sister argued that MassHealth lacked standing and statutory authority to intervene, and that the Superior Court judge abused his discretion by permitting MassHealth to intervene.

The Appeals Court disagreed and held:

“Here, there was no clear abuse of discretion by the Superior Court judge permitting MassHealth to intervene permissively. MassHealth’s claim seeking to vacate a judgment attaching the only significant asset of the estate raises the same questions of law and fact raised by the estate in its attempts to vacate that same judgment. MassHealth has a compelling interest in recouping public money spent on O’Brien’s care, which can only be satisfied if the asset under levy is returned to the estate. Moreover, MassHealth’s failure to intervene at an earlier stage of the proceeding is justified as it had no cognizable interest in the litigation until O’Brien died with insufficient assets to satisfy MassHealth’s claim.

While this decision is unpublished, it is persuasive authority and provides interesting insight into just how far the reach of MassHealth and DMA goes, under M.G.L. c. 118E, s. 31(c).