Accusations of Medicaid Fraud Can Be Devastating.

An accusation of Medicaid fraud by state employees can be very stressful… to say the least.  Send a letter to a scared caregiver, the one who signed a MassHealth Application, even though the nursing home or some other company hired by the nursing home actually filled out the application and immediately the relative thinks they are going to jail.  Attorney Tom Mullen of Quincy has successfully fought these charges on behalf of overwrought families.

The Special Investigator from the State Auditor’s Office

Unfortunately for the family, “the debt collection letter” comes not from a private debt collector; but rather you receive an official letter from the Special Investigator of The State Auditor’s Office  . . .  that is, if you are lucky and your letter is not from the Attorney General’s office or even the U.S. Attorney.

How does this even happen?  First, of course, there are people who actually believe they are smarter than the government.  But they’re not. They are criminals. We’re not here to defend those people; rather, we’re speaking about innocent people who signed a MassHealth Application at a time when their loved one was entering a nursing home-possibly the most stressful time in a person’s life.

Technology Today Quickly Finds Errors

Just remember how long it took with today’s technology to track down the Boston Marathon Terrorist Bombers.  MassHealth will track people and constantly re-examine information even after the nursing home resident has been approved for MassHealth.  Often adults who sign a MassHealth Application are not even aware of the full financial picture of the nursing home resident – even of their own mother.  A few of the more common ‘triggers’ are a “no” response to questions such as:

Dangerous Questions on the MassHealth Application

Have any assets been transferred in the last five years?”  Well, a gift to anyone requires a “yes” answer; but if the worker assigned to the application only asks you for two years worth of bank account records, you might not even know your mother “lent” your sister money three or four years ago.  Then there is the question of houses sold and questions regarding trusts and life estates. Unfortunately, most people have no idea of the difference between a life estate and a trust. Often, having been told by a parent that their home is protected, this question is glossed over.

Nursing Home Placement is Extremely Stressful

Placing a loved one into a nursing home is often actually worse than burying them.  It is known to be one of the most stressful times in a family’s life.  Some nursing homes as part of their admission process start the Medicaid application within days of admission and sometimes even as a part of the admission process itself. Papers are rustled about and pushed into the hands of otherwise calm, cool and collected adult children while their mother sits moaning in a wheelchair in the corridor waiting to be admitted.  The usual well-composed adult child is now afraid that a frown, or a “no” or “let me look at this paper at home” response will result in a delayed  admission, even perhaps a non-admission to the nursing home.

Filling Out the MassHealth Application is Daunting

Often the nursing home employees or subcontractor immediately starts to bombard the distraught son or daughter with financial questions which often are hastily answered in order to simply make the worker “go away”. This seventeen page Application with one Supplement and two Attachments is more often than not often never thoroughly reviewed by the family; or if it is, family conversations are like this:  “What exactly is an annuity anyways?”  Or, “Well they (the nursing home person) said there was no trust, I guess that document Ma signed years ago isn’t a trust after all.”  Or: “Good , they didn’t ask for five years worth of bank records; I guess when Dad paid my daughter’s $25,000 tuition bill three years ago, that doesn’t matter.”  Now we have a serious problem, since you signed the Application under the pains and penalties of perjury !

Caught !

Years later, MassHealth conducts a full review of mother’s finances, or perhaps a deferred annuity previously unknown and therefore never reported – is found by the family and cashed .  The insurance company sends mother and the Massachusetts Department of Revenue a 1099 tax reporting form.

Or years later a MassHealth Employee routinely types mother’s social security number into a database and discovers a bank account; or a MassHealth employee sits at a computer terminal at the Registry of Deeds all day just checking names, and discovers the deed still has mother’s name on it.  Neither asset never known to the family, and therefore never reported.

Please don’t blindly sign a Medicaid Application.  Please look at every single question on that application !

Please, if you have questions regarding MassHealth, call me, Attorney Tom Mullen of Quincy.  I will be glad to help.

Thomas R. Mullen
Thomas R. Mullen has been an attorney since 1977 and has devoted his practice exclusively to elderlaw since 1988. He is nationally recognized as one of the foremost experts on Medicaid planning. His additional Practice areas include estate planning and trusts for disabled people, as well as assisting attorneys with Medicaid lien allocations and the Medicare Secondary Payer Act. In the Spring 2013 issue of the National Academy of Elder Law Attorneys (NAELA) Journal, Attorney Thomas R. Mullen of Quincy, Mass. was described by the Academy’s Massachusetts past president and law professor William J.Brisk as being “a prominent and innovative elderlaw attorney.”