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S 876

Relates to the manner in which certain provisions of the correction law are enforced

2025 Regular Session Introduced by Jamaal Bailey and 3 co-sponsors

Creates an undue-hardship waiver for MassHealth nursing facility residents to suspend or erase transfer-penalty periods, with a 90-day filing window and eligibility presumption.

REFERRED TO CRIME VICTIMS, CRIME AND CORRECTION
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Bill Summary · S 876

Summary — S. 876: "An Act to protect MassHealth applicants facing undue hardship"

Status: Introduced Jan 16, 2025; referred to committee (see Legislative Actions).
Filed by: Senator Robyn K. Kennedy (First Worcester).
Subject: Amends Chapter 118E (MassHealth) to establish procedures and criteria for undue hardship waivers for nursing facility residents subject to a period of ineligibility.

Purpose

The bill creates a statutory process in Massachusetts for MassHealth applicants who are institutionalized (nursing facility residents) to seek an “undue hardship” waiver that would eliminate or suspend a period of Medicaid ineligibility that arises from certain asset transfers. It implements procedural protections (notice, timely determination, appeal rights) and defines criteria that create a rebuttable presumption of eligibility for a hardship waiver.

Key provisions

  • Adds new Section 28A to Chapter 118E (Massachusetts General Laws).
  • Establishes that a nursing facility resident may claim undue hardship to eliminate a period of ineligibility (the transfer-penalty period).
  • Requires the Division (MassHealth/appropriate state division) to adopt procedures consistent with P.L. 109-171 (which amended 42 U.S.C. §1917(c)(2)(D)), including:
    • Written notice to the individual that an undue hardship exception exists.
    • A timely administrative process to decide waiver requests.
    • Opportunity to appeal adverse determinations.
  • Sets a 90-day filing window: an individual may request a hardship waiver within 90 days after the final decision imposing the period of ineligibility (including after judicial appeals).
  • Creates a rebuttable presumption that an institutionalized individual is eligible for a hardship waiver if the individual documents all of the following:
    1. Insufficient available resources (excluding the community spouse resource allowance) to meet basic needs (medical care, food, shelter, clothing) such that the person would face serious deprivation or harm.
    2. Reasonable attempts to retrieve transferred resources or receipt of adequate compensation.
    3. No less costly alternative to institutional care that meets the person's care needs.
    4. The period of ineligibility would subject the person to risk of serious deprivation (not merely an inconvenience).
  • Clarifies that a nursing facility does not need to express intent to discharge for nonpayment for a hardship waiver to be granted.
  • Directs the Division to promulgate regulations incorporating these criteria.

Who is affected

  • Primary: MassHealth applicants/residents in nursing facilities subject to asset-transfer penalty periods.
  • Secondary: Community spouses (resource allowances referenced), nursing facilities, MassHealth administrative staff, and state regulators who must adopt implementing rules.
  • Fiscal impact: Could reduce enforcement of penalty periods in eligible cases, potentially increasing short-term MassHealth expenditures; also increases administrative workload to process waivers and appeals.

Procedural / timeline notes

  • Bill introduced and filed Jan 16, 2025.
  • Hearing noted for 07/01/2025 (per provided actions).
  • Committee activity entries in the provided record are inconsistent (multiple committee referrals listed); the bill text and filing identify it as a Massachusetts General Court bill to amend Chapter 118E.

Relation to federal law

  • Implements state-level procedures consistent with federal statutory language (P.L. 109-171 amendment to the Social Security Act) that permits states to grant undue hardship exceptions to transfer-penalty rules.

Notes: Some metadata in the provided packet (committee names, sponsor lists) appear inconsistent with the bill text and the Massachusetts origin; the bill text and caption identify Senator Robyn K. Kennedy as the filer and Chapter 118E (MassHealth) as the target.

Compiled from official sources — confirm details with the bill’s official record.

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