Guerriero v. Commissioner of the Division of Medical Assistance

745 N.E.2d 324, 433 Mass. 628, 2001 Mass. LEXIS 184
CourtMassachusetts Supreme Judicial Court
DecidedApril 3, 2001
StatusPublished
Cited by8 cases

This text of 745 N.E.2d 324 (Guerriero v. Commissioner of the Division of Medical Assistance) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Guerriero v. Commissioner of the Division of Medical Assistance, 745 N.E.2d 324, 433 Mass. 628, 2001 Mass. LEXIS 184 (Mass. 2001).

Opinion

Cowin, J.

This case concerns Jeannette Guemero’s application for Medicaid benefits. The division of medical assistance (division) denied the application on the ground that Guemero held sufficient, available resources as a beneficiary of the principal of a self-settled trust. Guemero filed a complaint in the Superior Court pursuant to G. L. c. 30A, § 14, challenging the division’s inclusion of the trust principal as a basis for denying her benefits. Relying on an amendment to the Medicaid statute enacted by Congress in 1993, a Superior Court judge reversed the division’s decision. We granted the division’s application for direct appellate review. We affirm the judgment of the Superior Court but on grounds different than those on which the trial judge relied.

[629]*6291. Background. On June 18, 1987, Jeannette Guerriero (Guerriero) established the Guerriero Family Trust (trust), an irrevocable, inter vivos trust, naming Guerriero and her living issue as beneficiaries. Article IV of the trust provides the trustee with the discretion to pay income or principal of the trust to “the SETTLOR,” Guerriero, or her then living issue as the trustee “deems necessary or advisable.” Article XX of the trust provides that “the SETTLOR does not reserve any right to alter, amend, revoke or terminate this Trust in whole or in part.”

On February 4, 1991, Guerriero signed a notarized document entitled “Waiver of Jeannette L. Guerriero,” in which she declared that she did “irrevocably and unequivocably [szc] waive, renounce and refuse to accept any and all right, title or interest which [she] may have now or in the future in the principal of the ‘Guerriero Family Trust.’ ” Approximately seven years later, on May 15, 1998, Guerriero submitted an application for Medicaid benefits to the division. In evaluating Guerriero’s application, the division counted the assets in the trust, which the division valued at $87,118. Because of the program limit of $2,000 for “countable assets,”1 the division determined that Guerriero was not eligible for Medicaid and denied Guerriero’s application for benefits.

Guerriero appealed to the division’s board of hearings (board), which upheld the division’s decision. Guerriero then filed the present action seeking review of the division’s decision. Citing 42 U.S.C. § 1396p(d)(3)(B)(ii), as enacted in 1993, the Superior Court judge overturned the division decision, concluding that the division should have excluded the principal of the trust because Guerriero’s waiver deprived the trustee of any discretion to pay trust principal to Guerriero.2

2. Medicaid qualifying trusts. As explained in the related case of Lebow v. Commissioner of the Div. of Med. Assistance, ante 171, 172 (2001), Congress enacted 42 U.S.C. § 1396a(k)(l) to [630]*630deal with the emergence of Medicaid qualifying trusts (MQTs). Enacted in 1986, this section originally provided:

“In the case of a medicaid qualifying trust . . . the amounts from the trust deemed available to a grantor, for purposes of [determining Medicaid eligibility], is the maximum amount of payments that may be permitted under the terms of the trust to be distributed to the grantor, assuming the full exercise of discretion by the trustee or trustees for the distribution of the maximum amount to the grantor. For purposes of the previous sentence, the term ‘grantor’ means the individual referred to in paragraph (2).”

42 U.S.C. § 1396a(k)(l).

When this section was enacted, § 1396p(c)(l) of the Medicaid statute already provided a thirty-month look-back period for discovering transfers of assets for less than fair market value made in order to render the transferor eligible for Medicaid benefits.3 At the time Congress inserted § 1396a(k)(l) governing MQT’s, the look-back period contained in § 1396p(c)(l) had been part of the Medicaid statute for approximately four years. Pub. L. 97-248, Title I, § 132(b), 96 Stat. 370 (1982).

In 1993, Congress amended the Medicaid statute, repealing the entire provision of § 1396a(k) and replacing it with § 1396p(d). Cohen v. Commissioner of the Div. of Med. Assistance, 423 Mass. 399, 405-406 & n.13 (1996). With specific regard to irrevocable trusts, § 1396p(d)(3)(B) now excludes [631]*631“any portion of the trust from which, or any income on the corpus from which, no payment could under any circumstances be made to the individual.” 42 U.S.C.A. § 1396p(d)(3)(B)(ii) (West Supp. 2000). The 1993 legislation also amended the look-back period in § 1396p(c), by lengthening the look-back period to thirty-six months and creating a longer, trust-specific look-back period of sixty months. 42 U.S.C.A. § 1396p(c)(B)(i) (West Supp. 2000). The 1993 amendments apply only to trusts created after the effective date of the statute. Cohen v. Commissioner of the Div. of Med. Assistance, supra at 406, citing Pub. L. 103-66, § 13611(e)(2)(C), 107 Stat. 627 (1993).

Relying on the amended portions of the statute, specifically § 1396p(d)(3)(B)(ii), the Superior Court judge ruled that the assets of the trust could not be counted in determining Medicaid eligibility because after the “irrevocable waiver” was executed by Guerriero, “no payment could under any circumstances be made to the individual.” The judge’s reliance on this section was in error because the amended statutory section applies only prospectively, and the trust was established in June, 1987, almost six years prior to the amendment’s enactment. Thus, the trust is subject to review under the earlier 42 U.S.C. § 1396a(k) (1988).

3. Counting Assets Under 42 U.S.C. § 1396a(k). As we explained in Cohen v. Commissioner of the Div. of Med. Assistance, supra at 413:

“[An MQT] is any trust established by a person (or that person’s spouse) under which that person may receive any payments. This general definition is qualified only by the requirement that the trustees must be permitted to exercise some discretion — that is, the conditions for distribution may not be completely fixed for all circumstances.”

If the trust qualifies as an MQT, we proceed under the statute to determine how much money is deemed available:

“That amount is the greatest amount that the trustees in any set of circumstances might have discretion to pay out to the beneficiary. Thus, if there is a peppercorn of discretion, then whatever is the most the beneficiary might under [632]*632any state of affairs receive in the full exercise of that discretion is the amount that is counted as available for Medicaid eligibility.”

Id. Accordingly, in order to decide if the principal of the trust is “available” to Guerriero, we must determine whether the trustee maintained discretion to distribute principal to Guerriero under the terms of the trust after the execution of the “irrevocable waiver.”

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Cite This Page — Counsel Stack

Bluebook (online)
745 N.E.2d 324, 433 Mass. 628, 2001 Mass. LEXIS 184, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guerriero-v-commissioner-of-the-division-of-medical-assistance-mass-2001.