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Massachusetts Agencies

Medical Assistance Liens

Liens, Special

Chapter 515.012 of the Code of Massachusetts Regulations provides the following regarding liens against property:

  1. (A) Liens. A real estate lien enables the Division to recover the cost of medical benefits paid or to be paid on behalf of a member. Prior to the death of a member, the Division shall place a lien against any property in which the member has a legal interest, subject to the following conditions:
    1. per court order or judgement; or
    2. without a court order or judgement, if all of the following requirements are met:
      1. the member is an inpatient receiving long-term or chronic care in a nursing facility or other medical institution; and
      2. none of the following relatives is residing in the property:
        1. a spouse;
        2. a child under the age of 21, or a blind or permanently and totally disabled child; or
        3. a sibling who has an equity interest in the property and has been living in the house for at least one year prior to the member's admission to the medical institution;
    3. the Division determines that the member cannot reasonably be expected to be discharged from the medical institution and return home; and
    4. the member has received notice of the Division's determination that the above conditions have been met and that a lien will be placed. The notice shall include the member's right to a fair hearing.
  2. Recovery. If property against which the Division has placed a lien under 130 CMR 515.012(A) is sold during the member's lifetime, the Division may recover all payment for services provided on or after April 1, 1995. This provision will not limit the Division's ability to recover from the member's estate in accordance with 130 CMR 515.011.
  3. Exception. No recovery for nursing facility or other long-term-care services may be made under 130 CMR 515.012(B) if the member:
    1. was institutionalized;
    2. notified the Division that he or she had no intention of returning home; and
    3. on the date of admission to a long-term-care institution had long-term-care insurance whose coverage met the requirements of the Division of Insurance regulation at 211 CMR 65.00.
  4. Repayment Deferred.
    1. In the case of a lien on a member's home, repayment under 130 CMR 515.012 shall not be required while any of the following relatives are still lawfully residing in the property:
      1. a sibling who has been residing in the property for at least one year prior to the member's admission to the nursing facility or other medical institution; or
      2. a son or daughter who:
        1. has been residing in the property for at least two years immediately prior to the member having been admitted to a nursing facility or other medical institution;
        2. establishes to the satisfaction of the Division that he or she provided care that permitted the parent to reside at home during the two-year period prior to institutionalization; and
        3. has resided lawfully in the property on a continual basis while the parent has been in the institution.
    2. Repayment from the estate of a member that would otherwise be recoverable under any regulation will still be required even if the relatives described in 130 CMR 515.012(D) are still living in the property.
  5. Dissolution. The Division will discharge a lien placed against property under 130 CMR 515.012(A) if the member is released from the medical institution and returns home.
  6. Verification. The applicant or member must cooperate in providing verification as to whether the conditions under 130 CMR 515.012(A) exist, and in providing any information necessary for the Division to place a lien.
  7. Recording Fee. The Division shall not be required to pay a recording fee for filing a notice of lien or encumbrance, or for a release or discharge of a lien or encumbrance under 130 CMR 515.012

The general statute regarding medical assistance liens is G.L.c. 118E, §34.