MassHealth’s New Community Spouse Resource Allowance
By Nicholas G. Kaltsas
The Massachusetts legislature
has long recognized that the healthy spouse (Community Spouse) of a nursing home
resident needed protection from the high costs being incurred by a nursing home
resident. Therefore, the Massachusetts legislature built certain protections
against the impoverishment of a Community Spouse into the Massachusetts'
Medicaid Law (called "MassHealth" in Massachusetts). The "Community Spouse
Resource Allowance" ("CSRA") is such a protection. In essence, the CSRA is a
savings account that the healthy spouse is allowed to retain.
The Fiscal Year 2007
Massachusetts budget made a major change to MassHealth Law. The Massachusetts
legislature sought to restore the level of assets a spouse of a nursing home
resident could retain back to pre-2003 standards to determine how much a married
couple may keep if one spouse needs nursing home care. This level, the maximum
permitted under federal law, is $99,540. Governor Mitt Romney vetoed the
legislature’s CSRA restoration language; however, the House and the Senate both
overrode the Governor's veto of the CSRA restoration language in the FY07
budget.
This results in the CSRA asset
limit being increased effective July 1, 2006, the effective date of the budget,
to the federal maximum. This change has important ramifications to seniors and
allows a married couple to keep the first $99,540 of their assets, replacing the
rule that was implemented on January 1, 2003 that said a married couple was
allowed to keep only one-half of their assets up to $99,540. Meaning that if a
married couple needs to place their spouse in a nursing home, the health spouse
living at home will be able to keep more of their money. Community spouses can
now maintain enough assets to allow them to live with dignity.
Technically, the CSRA was
increased to the maximum allowance effective July 1, 2006. However, the Office
of MassHealth has indicated that it will take approximately two weeks for them
to reconfigure their computer system and process applications with the updated
CSRA level. So it isn’t until mid-August that the Office of MassHealth expects
to have their computer system reconfigured. MassHealth caseworkers have been
directed to hold pending applications until the new system is in place.
Although caseworkers will be
reviewing recent denials to see if any denials should
be reopened and eligibility re-determined, as a practical matter, it would seem
advisable to seek the advice of an elder law attorney relative to the denial of
any MassHealth application filed on or after July 1, 2006.
Attorney Kaltsas practices law at Elder &
Disability Law Advocates located at 255 Park Avenue, Suite 1000, Worcester,
Massachusetts. He currently provides free monthly legal clinics to many central
Massachusetts area senior centers, contributes a monthly article that is
published in approximately 20 different Senior Center Newsletters, regularly
lectures on topics of concern to the senior population and teaches the “Elder
Law” course for the Worcester Public Schools in their Nightlife continuing
education program. As a Commission member on the City of Worcester’s Commission
on Elder Affairs, Attorney Kaltsas is committed to educating and serving the
needs of the senior population, and their caregivers.
This article gives general information and not
specific legal advice on individual matters.
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