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HOUSE DOCKET, NO. 3927 FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1402
The Commonwealth of Massachusetts
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PRESENTED BY:
Bridget Plouffe
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to protect MassHealth applicants facing undue hardship.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Bridget Plouffe9th Plymouth1/17/2025 1 of 2
HOUSE DOCKET, NO. 3927 FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1402
By Representative Plouffe of Brockton, a petition (accompanied by bill, House, No. 1402) of
Bridget Plouffe for legislation to establish criteria for MassHealth hardship waivers. Health Care
Financing.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Fourth General Court
(2025-2026)
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An Act to protect MassHealth applicants facing undue hardship.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 Chapter 118E of the General Laws, as appearing in the 2022 Official Edition, is hereby
2amended by inserting after section 28 the following section:—
3 Section 28A.
4 (a) A nursing home resident may claim undue hardship in order to eliminate the period of
5ineligibility. In accordance with P.L. 109-171 amending Section 1917(c)(2)(D) of the Social
6Security Act, the division shall establish procedures for determining whether undue hardship
7exists as a result of the imposition of a period of ineligibility, which shall include written notice
8to said individual that an undue hardship exception exists, a timely process for determining
9whether an undue hardship waiver shall be granted and an opportunity to appeal an adverse
10determination. An individual may request an undue hardship waiver within 90 days after the date
11of the final decision to impose a period of ineligibility, including judicial appeals. 2 of 2
12 (b) There shall be a rebuttable presumption that an institutionalized individual is eligible
13for an undue hardship waiver if the individual provides documentation that all of the following
14criteria are met:
15 1) the individual has insufficient available resources, excluding the community spouse
16resource allowance, to provide medical care, food, shelter, clothing and other necessities of life
17such that the individual would be at risk of serious deprivation or harm;
18 2) the individual has made reasonable attempts to retrieve the transferred resources or
19receives adequate compensation;
20 3) there is no available less costly alternative to institutional care that would meet the
21individual's care needs; and
22 4) the period of ineligibility will not be a mere inconvenience to the applicant but rather
23will create a situation that would subject the applicant to risk of serious deprivation.
24 (c) A nursing home need not express an intent to discharge the individual for nonpayment
25in order for a hardship waiver to be granted.
26 (d) The division shall promulgate regulations incorporating these criteria for
27consideration of an undue hardship waiver request.