1 of 1 SENATE DOCKET, NO. 1700 FILED ON: 1/16/2025 SENATE . . . . . . . . . . . . . . No. 876 The Commonwealth of Massachusetts _________________ PRESENTED BY: Robyn K. Kennedy _________________ 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. _______________ PETITION OF: NAME:DISTRICT/ADDRESS :Robyn K. KennedyFirst Worcester 1 of 2 SENATE DOCKET, NO. 1700 FILED ON: 1/16/2025 SENATE . . . . . . . . . . . . . . No. 876 By Ms. Kennedy, a petition (accompanied by bill, Senate, No. 876) of Robyn K. Kennedy for legislation to establish criteria for Masshealth hardship waivers. Health Care Financing. [SIMILAR MATTER FILED IN PREVIOUS SESSION SEE SENATE, NO. 762 OF 2023-2024.] The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Fourth General Court (2025-2026) _______________ 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 is hereby amended by inserting after section 28 the 2following section:- 3 Section 28A. 4 (a) A nursing facility resident may claim undue hardship in order to eliminate the period 5of ineligibility. 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 2 of 2 10determination. An individual may request an undue hardship waiver within 90 days after the 11date of the final decision to impose a period of ineligibility, including judicial appeals. 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 facility need not express an intent to discharge the individual for 25nonpayment in 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.