Estate of Christina M. Robertson
Daniel Tsai, Assistant Secretary for MassHealth et al No. 132973
Date January 16, 2016
MEMORANDUM OF DECISION AND ORDER CROSS MOTIONS FOR
JUDGMENT ON THE PLEADINGS
Honorable Shannon Frison, J.
case arises out of the Office of Medicaid's denial of
Christina M. Robertson's application for long-term
Medicaid benefits. The Office of Medicaid, also known as
MassHealth for the Massachusetts Medicaid program it
administers, see G.L.c. 118E, § 9A, falls under the
authority of the Secretary of the Executive Office of Health
and Human Services. See G.L.c. 6A, § § 16, 16B. Ms.
Robertson's estate brings this action for judicial review
of MassHealth's decision under G.L.c. 30A, § 14.
Both parties now move for judgment on the pleadings. A
hearing has been held on those motions.
following reasons, the plaintiff's Motion for Judgment on
the Pleadings is DENIED . The defendant's Motion
for Judgment on the Pleadings is ALLOWED .
Judicial review of an agency decision is confined to the
administrative record. M.G.L.c. 30A, § 14(4)(5). The
record before MassHealth contained the following facts.
Thomas and Christina M. Robertson were the grantors and
beneficiaries of the Robertson Family Trust, an irrevocable
trust in which they were entitled to income-only
distributions. As a married couple, the Robertsons
established the trust on May 23, 1990. They named two of
their children, William Dale Robertson and Jeanne McKeen, as
trustees. Christina and Thomas funded the trust with titles
to their house in Casco, Maine, their mobile home in
Sturbridge, Massachusetts, their boat, a bank account, and
several life insurance policies. Those assets were valued at
trust directs the trustees to pay Christina and Thomas all of
the net income--that is, dividends and investment
interest--generated by the trust. Section 3.02 governs the
payment of the trust principal to Christina and Thomas
Robertson. It provides:
The trustees shall have discretion to pay the Grantors or on
their behalf so much of the principal of the Trust as is
necessary to provide for their health, including payment for
nursing home care and home health care, for a period of time
ending thirty months after the most recent date that the
Trustees received Trust property from the Grantors. After
that date, the Trustees shall have no discretion to invade
principal on behalf of the Grantors.
Section 5.02 empowers the trustees to terminate the trust
should the existence of the trust jeopardize Thomas or
Christina Robertson's receipt of government benefits. It
[I]f, in the judgment of the Trustees, the primary
beneficiaries require any service or benefit for which they
would qualify for assistance under any federal, state, or
local governmental program but for the existence, size, or
terms of this Trust, and if the costs of such service or
benefit are such that they would, if borne by the Trust, risk
substantial depletion of the Trust, the Trustees may, in
their sole discretion, terminate the Trust and distribute the
Trust corpus to the beneficiaries named in Article 4.01 as
though the Grantors were deceased.
under Section 10.2, Christina and Thomas Robertson retained
the right to live in the homes held by the trust and situated
in Maine and Massachusetts.
M. Robertson applied for long-term care benefits in August
2010 when she was moved to a nursing home. MassHealth denied
her application because it opined that her countable assets
exceeded the program limit of $2, 000. Ms. Robertson appealed
that denial to the Board of Hearings of the Office of
Medicaid. After hearing, the Board denied her appeal. The
hearing officer concluded that the trust principle was
countable and exceeded the $2, 000 program limit. He also
concluded that the trust was a Medicaid Qualifying Trust so
the entire principal was considered available and countable.
Further, the hearing officer decided that, pursuant to
section 3.02 of the trust, the principal was countable for a
period of thirty months (until September 2011) due to Ms.
Robertson's transfer of $14, 000 into the trust via a
check dated March 19, 2009.
Robertson then sought review of the Board of Hearings
decision in the Superior Court via M.G.L.c. 30A, § 14.
Ms. Robertson asked the court to vacate the Board's
decision. MassHealth asked the court to remand the matter
back to the Board. MassHealth contended that, although the
Board had ruled in its favor, the Board's decision was
marred by several procedural and substantive deficiencies
that required correction. Specifically, MassHealth argued
that the hearing officer afforded Ms. Robertson, but not
MassHealth, the opportunity to respond to memoranda submitted
before the hearing and evidence introduced at the hearing;
stated incorrectly that MassHealth failed to introduce
certain evidence and then made an incorrect factual finding
based on that error; and failed to fully address the argument
that the entire trust had always been countable, regardless
of the status of the $14, 000 check. After a hearing in
Superior Court, the Court (Tucker, J.) remanded the matter
back to the Board of Hearings for further proceedings. The
Court found it " unusual" for MassHealth to request
a remand in a matter in which it was the prevailing party,
but found that " the Agency was improperly denied the
opportunity to respond to evidence that Robertson was
permitted to submit following the conclusion of the
hearing." Ms. Robertson moved for reconsideration, and
Justice Tucker denied that motion.
remand, the hearing officer again issued a decision denying
Ms. Robertson's appeal on July 2, 2013. This time, a
different hearing officer decided that trust was a Medicaid
Qualifying Trust; that the principal was available to Ms.
Robertson because section 3.02 must be disregarded as the
trustees had discretion to disburse funds to Ms. Robertson;
and that Ms. Robertson continued to have access to the funds
in the trust because she need only deposit one cent in the
trust to make the entire principal available to her. ...