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2 130 CMR: DIVISION OF MEDICAL ASSISTANCE

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

130 CMR 515.000: MASSHEALTH: GENERAL POLICIES

515.001: Definition of Terms

The terms listed in 130 CMR 515.001 have the following meanings for purposes of MassHealth, as described in 130 CMR 515.000 through 522.000: MassHealth: Other Division Programs.

Activities of Daily Living (ADLs). Self-care activities including, but not limited to, bathing, grooming, dressing, eating, and toileting.

Affidavit. A written or printed statement of fact sworn to or affirmed before a person having legal authority to administer such an oath.

American Indian or Alaska Native. A person who (1) is a member of a federally recognized tribe, band, or group as defined in Title 25 of the U.S.C.; (2) is an Eskimo, Aleut, or other Alaska Native enrolled by the Secretary of the Interior pursuant to the Alaska Native Claims Settlement Act at 43 U.S.C. 1601; or (3) has been determined eligible to receive healthcare services from Indian Health Care Providers as an Indian pursuant to 42 CFR § 136.12 or Title V of the Indian Health Care Improvement Act.

Annuity. A legal instrument that makes payments for a designated period of time or for life, regardless of whether the payments are principal, interest, or both.

Appeal. A written request, by an aggrieved applicant or member, for a fair hearing.

Appeal Representative. A person who (1) is sufficiently aware of the appellant’s circumstances to assume responsibility for the accuracy of the statements made during the appeal process and has provided the Office of Medicaid Board of Hearings with written authorization from the appellant to act on the appellant’s behalf during the appeal process; (2) has, under applicable law, authority to act on behalf of an appellant in making decisions related to healthcare or payment for healthcare. Appeal representatives may include, but are not limited to, guardians, conservators, executors, administrators, holders of power of attorney, or healthcare proxies; (3) is a licensed attorney who notifies the MassHealth Board of Hearings that they represent the appellant in an appeal. This shall also include a nonlawyer supervised by a licensed attorney; or (4) is an authorized representative meeting the requirements of 130 CMR 501.001: Appeal Representative (1), (2), or (3).

Applicant. A person who completes and submits an application for MassHealth and is awaiting the decision of eligibility.

Application. See Senior Application.

Asset Limit. The maximum dollar value of assets that can be owned by, or available to, the applicant, the member, or their spouse, which, if exceeded, results in ineligibility.