Page 17

17 130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 255 Rev. 02/13/26

130 CMR 515.000: MASSHEALTH: GENERAL POLICIES

(C) Deferral of Estate Recovery. Recovery will not be required until after the death of a surviving spouse, if any, or while there is a surviving child who is younger than 21 years old or a child of any age who is blind or permanently and totally disabled.

(D) Waiver of Estate Recovery Due to Undue Hardship. The MassHealth agency will waive its estate recovery claim if the agency determines that satisfaction of the claim would cause an undue hardship. An undue hardship does not exist solely because recovery will prevent any heir from receiving an anticipated inheritance. The duly court-appointed personal representative or public administrator of the deceased member’s probate estate may apply for a waiver of estate recovery due to undue hardship. The application for a waiver and supporting documents must be received by the MassHealth agency within 60 days of the agency’s notice of claim. The types of waiver of estate recovery due to undue hardship are as follows. (1) Waiver of Estate Recovery Due to Residence and Financial Hardship (a) For notice of claims presented on or after November 15, 2003, but before May 14, 2021, recovery will be waived if MassHealth determines all of the following conditions have been met. 1. a sale of real property would be required to satisfy a claim against the member's probate estate; and 2. an individual who was using the property as a principal place of residence on the date of the member's death meets all of the following conditions: a. the individual lived in the property on a continual basis for two years prior to the member’s admission to an institution, or death, and continues to live in the property at the time the MassHealth agency first presented its claim for recovery against the deceased member’s estate; b. the individual has inherited or received an interest in the property from the deceased member's estate as defined in 130 CMR 501.013(A)(2) and 130 CMR 515.011(A)(2); c. the individual is not being forced to sell the property by other devisees or heirs at law; and d. at the time the MassHealth agency first presented its claim for recovery against the deceased member's estate, the gross annual income of the individual’s family group was less than or equal to 133% of the applicable federal-poverty-level income standard for the appropriate family size. 3. The waiver will be conditional for a period of two years from the date the MassHealth agency mails notice that the waiver requirements have been met, or from the date that a court of competent jurisdiction determines that the waiver requirements have been met. If, at the end of that period, all circumstances and conditions that must exist for the MassHealth agency to waive recovery still exist, including meeting the same income standards under 130 CMR 515.011(D)(1)(a)2.d., and the real property has not been sold or transferred, the waiver will become permanent and binding. If, at any time during the two-year period, the circumstances and conditions for the waiver no longer exist, including meeting the same income standards under 130 CMR 515.011(D)(1)(a)2.d.; the property is sold or transferred; or the individual does not use the property as their primary residence, the MassHealth agency will be notified and its claim may be payable in full.