A Medicaid applicant who made payments to her daughter for more than four years and claimed those payments were made to cover the cost of monthly payments for her mentally ill daughter’s rent could not prove the payments were made for a purpose other than to qualify for Medicaid because she did not prove that her daughter was mentally ill and needed help paying her rent, according to a Massachusetts appeals court. Kaptchuk v. Director Office of Medicaid (Mass. Ct. App., No. 12-P-1279, June 4, 2013).

Over the course of four years, Nina Kaptchuk, a Medicaid applicant, made payments totaling $59,800 to her daughter. Ms. Kaptchuk then entered a nursing home and applied for Medicaid benefits. Ms. Kaptchuk claimed her daughter was mentally ill and the payments were made to cover her daughter’s rent of about $1,150 per month. Unfortunately, Kaptchuk did not introduce any evidence supporting her claim that the daughter was, in fact, mentally ill. Moreover, the daughter never received Social Security disability income benefits or any other form of public assistance.

The state determined the transfers were disqualifying transfers and imposed a penalty period. Ms. Kaptchuk appealed, arguing the payments were made for a purpose other than to qualify for Medicaid. The trial court affirmed, and Ms. Kaptchuk appealed.

The Massachusetts Court of Appeals affirmed, holding that Ms. Kaptchuk did not prove the payments were for a purpose other than to qualify for Medicaid. According to the opinion, the court “found significant the lack of any evidence that these monthly payments were, indeed, rental payments, that the daughter was not able to afford these payments without her mother’s financial assistance, and that the daughter was permanently or substantially disabled.”

For the full text of this decision, click here: Kaptchuk v. Director Office of Medicaid

(Courtesy of the Academy of Special Needs Planners)

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