Skip to content

This blog is written by Brian E. Barreira, an estate planning, probate and elder law attorney with offices at 118 Long Pond Road, Suite 206, Plymouth, Massachusetts. Brian has been named a Massachusetts Super Lawyer® in Boston Magazine during 2009-2023, is listed in The Martindale-Hubbell Bar Register of Preeminent Lawyers in the fields of Elder Law and Trusts & Estates, Wills & Probate, and is the Editor of Massachusetts Continuing Legal Education's best-selling Elder and Disability Law in Massachusetts, where he is the co-author of the "Trusts in the MassHealth Context" and "Taxation of Trusts" chapters. Brian also has a webinar series on his youtube channel, https://www.youtube.com/@elderlawwebinar6980.Brian's biographical website, including a webinar registration link and information for new clients, can be found at SouthShoreElderLaw.com

Nothing on this blog should be considered to be legal advice or tax advice.

Preserving Assets and Maximum Income for the Community Spouse in 2024 When the Institutionalized Spouse Enters a Nursing Home and Applies for MassHealth

February 2, 2024

When one spouse enters a nursing home and may be applying for MassHealth, the spouse who remains at home or in assisted living often has some important choices to make with an unbiased legal advisor. There are different layers in MassHealth law, and many persons only seem to know about the bottom layer, so let’s go over that one first. Under 2024 law, the community spouse can supposedly keep only the couple’s home and first $154,140.00 of the other assets owned by either or both of them. The calculation of the community spouse resource allowance includes any asset that has a value, including cash, bank accounts, certificates of deposit, stocks, bonds, mutual funds, ETFs, all types of other motor vehicles, motor homes, vacation properties, timeshares, land, life insurance policies with a cash value over $1,500.00, and (to the great surprise of many people) assets held in revocable trusts.

Unfortunately, this lower layer is where the knowledge of many persons ends, and two other upper layers of the law effectively override the lower layer. One upper layer is that the community spouse can enter into certain types of annuity or promissory note agreements with the spenddown (that is, excess) assets. Some community spouses can keep everything without needing an annuity or a promissory note, and can end up being in a much better financial position without an annuity or a promissory note, due to the other upper layer of MassHealth law that protects income for the community spouse.

At present, the community spouse has the absolute right to an income of at least 2,465.00 per month. This is known as the Minimum Monthly Maintenance Needs Allowance (“MMMNA”). If shelter expenses exceed 30% of this figure, or $739.50, or if a disabled child lives at home, the community spouse is often entitled to keep a higher MMMNA. If the Social Security and pension payable in the name of the community spouse is less than the $2,465.00 figure, at the end of the MassHealth application process the community spouse is allowed to keep some or all of the institutionalized spouse’s income to be brought up to the MMMNA.

If the needs of the community spouse are greater than $3,715.50 per month, a higher amount of income can sometimes be preserved for the community spouse via the fair hearing appeal process, where the need to keep the other assets has to be proved to maintain the financial ability to remain in the community.  A common situation where need can be fairly easily proved is where the community spouse is living in an assisted living facility and needs to be there due to frailty or a medical condition. Once the need to be in assisted living is established, the appeal is primarily about numbers and prevailing interest rates, so the elder law attorney can often handle it alone without the community spouse having to go to the hearing.

Another option to retain greater income for the community spouse is a Probate Court procedure known as separate support.  Since both spouses need legal representation in court, it is important that estate planning be done well in advance so that the institutionalized spouse has a thoroughly-drafted durable power of attorney that allows the appointed agent or attorney-in-fact (who should be somebody other than the person’s spouse) to hire a lawyer.

When spenddown and appeal options are determined by an elder law attorney as potentially unsuccessful, the community spouse can often purchase certain types of immediate annuities and promissory notes, where the assets used to make the purchase then change character from being assets and are treated as the community spouse’s protected income. Unfortunately, the Supreme Judicial Court (“SJC”) has ruled that the Commonwealth of Massachusetts must be the primary beneficiary if the community spouse dies before receiving all of the annuity payments, and the United States Supreme Court has not yet decided whether to take up our appeal.

One other option available to the community spouse, but not often done in Massachusetts, is known as spousal refusal, where the community spouse refuses to cooperate in the payment process. There is currently a case being considered by the SJC, Freiner v. Sudders, which could have an impact on this spousal planning option, which in the past has been successful for my clients.

 

Basics of the New 2023 Massachusetts Estate Tax Law

December 13, 2023

The new Massachusetts estate tax law will be much more straightforward to deal with. There is no estate tax below $2,000,000.00. Once your estate went over $1,000,000.00 under the old law, everything under $1,000,000.00 had also gotten taxed, but that’s no longer the case.  Everybody now gets a credit of $99,600.00, which is what the tax would be on all amounts up to $2,000,000.00. The “net estate,” in general, is the amount of wealth being transmitted, minus debts, expenses, amounts going to spouses or charities, or certain types of trusts for spouses or charities. The tax on the net estate can be calculated using the following chart, with the top tax rate being 16%:

Value of Net EstateTax before creditTax after creditTax rate until next bracket
$2,000,000.00$99,600.00$0.007.2
$2,100,000.00$106,800.00$7,200.008.0
$2,600,000.00$146,800.00$47,200.008.8
$3,100,000.00$190,800.00$91,200.009.6
$3,600,000.00$238,800.00$139,200.0010.4
$4,100,000.00$290,800.00$191,200.0011.2
$5,100,000.00$402,800.00$303,200.0012.0
$6,100,000.00$522,800.00$423,200.0012.8
$7,100,000.00$650,800.00$551,200.0013.6
$8,100,000.00$786,800.00$687,200.0014.4
$9,100,000.00$930,800.00$831,200.0015.2
$10,100,000.00$1,082,800.00$983,200.0016.0

Out-of-state real estate will be taxed. Under the old law, non-Massachusetts real estate was not included, but under the new law it will be included on the Federal Estate Tax Return that needs to be prepared. If a decedent has real estate or tangible personal property located outside of Massachusetts, a determination has to be made as to what percentage those assets are of the gross estate, then the Massachusetts estate tax is reduced by that percentage.

What this means for many people is that they need to relook at how they own non-Massachusetts real estate, as if it’s in their own name, the estate tax is proportionately reduced. It is important to note that real estate held in a business entity such as an LLC or corporation is treated as intangible personal property, not as real estate. While there are considerations other than the Massachusetts estate tax exposure in deciding how to own non-Massachusetts assets for purposes of estate and creditor protection planning, from a pure tax standpoint it would be better not to own non-Massachusetts real estate in a business entity so that the percentage reduction would then apply.

The MCLE Book Entitled “Elder and Disability Law in Massachusetts” Has Been Published

November 17, 2023

Massachusetts Continuing Legal Education has recently published Elder and Disability Law in Massachusetts, and it is now available for sale at https://www.mcle.org/product/catalog/code/1910261B00 . It is primarily intended for lawyers. This ebook contains 44 chapters and 1,478 pages, and replaces the previous book that I was editor of, Estate Planning for the Aging and Incapacitated Client in Massachusetts.

Elder and Disability Law in Massachusetts was organized to keep interrelated topics together in sections. Chapters 1-6 cover “Planning for Incapacity and Disability,” including new chapters about undue influence and thorny ethical issues. Chapters 7-13 cover “Public Benefits and Employment,” Chapters 14-17 cover “Special Issues for Disabled Children and Adults,” including a new chapter about Chapters 18-30 cover “Aging In Place” as an alternative to nursing home care. Chapters 31-44 cover “Care in a Skilled Nursing Facility,” and include the latest cases in our ongoing battles with the MassHealth agency.

As Editor and a co-author of two chapters regarding trust issues, I want to thank the 51 assistant editors and authors who contributed their time and professional knowledge to this endeavor, and the Massachusetts Chapter of the National Academy of Elder Law Attorneys https://massnaela.com/, which provided support and its sponsorship for this project.

Here Are More Key Filings in the Karen Read SJC Case

October 30, 2023

Brian Albert’s brief in opposition to his cell phone information being accessed by the defense:  BD-2023-0343 memorandum

Karen Read’s reply brief (response to briefs of DA and Brian Albert):   SJ-2023-0343 reply to the Commonwealth’s opposition

Karen Read’s motion for supplemental information to be considered by the SJC:  SJ-2023-0343 motion for leave and to impound      SJ-2023-0343 supplemental record appendix

The United States Supreme Court Still Has Not Decided Whether to Take up Our Massachusetts Cases on Annuities of Community Spouses

October 9, 2023

The petition for certiorari to the United States Supreme Court for the Dermody and Mondor cases has not been approved or denied at this point. Rather, after a September 25, 2023 meeting to review the filings of both sides of the case, the Court simply wrote on October 2, 2023: ”The Solicitor General is invited to file a brief in this case expressing the views of the United States.” That could take quite a bit of time, and could be the judicial equivalent of ducking an issue, similar to a legislature sending a bill to a committee for further study. Thus, for the time being, annuities by community spouses in most cases will need to name the Commonwealth of Massachusetts as the primary beneficiary, and utilizing the doctrine of spousal refusal should be considered in many cases.

The SCOTUS filings to date can be found at https://www.supremecourt.gov/search.aspx?filename=/docket/docketfiles/html/public/22-957.html

The Massachusetts Legislature Has Finally Raised the Massachusetts Estate Tax Exemption to $2,000,000.00, Yet Many People Will Still Move Away Because of Our Estate Tax

October 6, 2023

As part of the new Massachusetts tax law signed by Governor Maura Healey on October 4, 2023, the Massachusetts estate tax exemption has been increased to $2,000,000.00. The good news for some families is that the law was made retroactive to January 1, 2023. Our office has reached out to the Massachusetts Department of Revenue and learned that, for any estate that paid an estate tax so far this year, refunds will be automatically processed (eventually) without the need for filing an abatement.

The previous, ill-conceived Massachusetts estate tax law had what was known as a cliff. If the adjusted taxable estate went over $1,000,000.00, the tax on the first million was also payable. The new Massachusetts estate tax law (which continues to be ill-conceived) provides a credit of $99,600.00 when the estate tax is calculated. Since the estate tax on a $2,000,000.00 adjusted taxable estate is $99,600.00, the so-called cliff has been eliminated.

The Massachusetts estate tax is based on the adjusted taxable estate, which is on line 3 on the Federal Estate Tax Return that must be prepared. The fact that gifts do not appear until line 5 on the Federal Estate Tax Return means that gifts will not get pulled back in and be taxed. (I’ll get into strategies in a later blog post.)

Raising the Massachusetts tax exemption to $2,000,000.00 (without any future inflation adjustments) was supposed to be done in the interests of making our state competitive, yet all the Massachusetts legislature did was lift our exemption from the absolute worst in the nation to the second worst (for now). Rhode Island is now in last place at 1,733,264, but since Rhode Island annually adjusts its figure for inflation, we could end up back in last place in a few years. I suppose that, after two decades of lazy inattention to the Massachusetts estate tax (while the median price of a home tripled), we shouldn’t have expected a great deal of deep thought about the ramifications of this type of tax from the Massachusetts legislature. Thus, clients with whom I’ve discussed changing domicile from Massachusetts for estate tax purposes should continue to explore those plans, as it could well be another two decades of lazy inattention before our elected officials get back to relooking at this issue.

The Massachusetts estate tax had actually been repealed in the late 1980’s, effective in 1996, by a Massachusetts legislature that had seen evidence that we were losing so much in income tax revenue from people leaving Massachusetts that the estate tax was not worth keeping. Somehow, that information did not get passed along.

This economic development bill geared towards making our taxes and economy more competitive actually kept in place this Massachusetts estate tax which could quite possibly be a net loss to our economy. (Note: to Governor Healey’s credit, she did propose an increase to $3,000,00.00, and it was our legislature that insisted on the figure being $2,000,000.00.) Putting aside Rhode Island, let’s look at what the other New England states have done, and why people might want to move there for estate tax reasons: New Hampshire, no estate tax; Connecticut, no estate tax below $11,400,000.00; Maine, no estate tax below $6,410,000.00; and Vermont, no estate tax below $5,000,000.00. Let’s also look at some of the states where some of my clients are intentionally moving to avoid our estate tax: Florida, no state estate tax; North Carolina, no state estate tax; South Carolina, no state estate tax; Georgia, no state estate tax; and Arizona, no state estate tax. We are in the minority; there are 33 states that don’t have any type of estate or inheritance tax.

Since staying in Massachusetts and dying while living here is essentially is the same thing as putting a provision in your will giving a part of your estate to the Massachusetts government (as if our income taxes aren’t enough), there is no doubt that people will continue to move out due to the lousy job done by our legislature when they were supposedly working on economic development.

Attached Are the Documents Filed as of 9/18/2023 in the Defendant’s SJC Appeal of Discovery Issues in the Karen Read Case

September 19, 2023
SJ-2023-0343_P009_Petitioner-Defendant_Karen_Read_s_MOTION_For_Leave_to_File_Reply_Brief_and_to_Enlarge_Time_for_Filing_with_Affidavit_of_Counsel_in_Support_

I thank 2nd Assistant Clerk Stephen Cronin for emailing me the attached documents in the Karen Read case where she has appealed a discovery decision made by the trial judge.

SJ-2023-0343_Docket_Sheet(1)

SJ-2023-0343 petition   This is the defendant’s petition to overturn some of the trial judge’s decisions.

SJ-2023-0343 motion to impound   This is the defendant’s motion to keep sensitive items out of public view.

SJ-2023-0343 Commonwealth opposition  This is the prosecution’s opposition.

BD-2023-0343 motion to intervene  This is Brian Albert’s motion to intervene in the case

BD-2023-0343 memorandum   This is a brief summary of why Brian Albert wishes to intervene.

 

 

Has Norfolk County District Attorney Michael P. Morrissey Committed Ethical Violations in His Handling of the Karen Read Case?

September 8, 2023

On Friday afternoon, August 25, 2023, Attorney Michael P. Morrissey, the elected District Attorney of Norfolk County, Massachusetts, took a step that he stated was unprecedented; he issued a public statement in the form of an online video regarding a case his office has been prosecuting over the past year and a half (Commonwealth v. Karen Read, Norfolk Superior Court docket no. 2282-CR-0117). He spent most of his time in the video talking to the public about his view of the facts of the case. Attorney Morrissey’s remarks were not even close to being narrowly tailored, as he seemed to be trying to convince the public that there is no reason to think the defendant is anything but guilty. Media outlets in Massachusetts picked up on Attorney Morrissey’s public statements and repeated his view of the facts, potentially poisoning the jury pool against the defendant. Attorney Morrissey therefore appears to have violated Section (f)(1) of the Massachusetts Rules of Professional Conduct, Rule 3.8, which states: “The prosecutor in a criminal case shall … refrain from making extrajudicial comments that have a substantial likelihood of heightening public condemnation of the accused.” There is no Norfolk County exception in this ethical rule.

The proper and ethical role of a prosecutor is to seek justice, not simply to win the case. Massachusetts Rules of Professional Conduct, Rule 3.8, Comment [1] makes that very point: “A prosecutor has the responsibility of a minister of justice and not simply that of an advocate.” What this comment to the ethical rule means, in part, is that a criminal investigation should not become one-sided with blinders on once charges are filed.

Massachusetts Rules of Professional Conduct, Rule 3.8(g), which Attorney Morrissey also may have violated and may continue to be violating, states: “The prosecutor in a criminal case shall … not avoid pursuit of evidence because the prosecutor believes it will damage the prosecution’s case or aid the accused.” The defense in this case has recently raised potentially troubling issues that a prosecutor seems to have an ethical duty to look into in the pursuit of justice (as opposed to the pursuit of just trying to win the case). If Attorney Morrissey had actually taken the time and effort to look into the potentially troubling issues (which could possibly indicate that the wrong person is being prosecuted) and found them insignificant, he was in his online video rant effectively and unethically announcing the results of his investigation. A Norfolk County courtroom was the proper and ethical place for such disclosures, not an online video that, having been a politician just about his entire adult life, he should have known large media outlets would pick up on and amplify, to the detriment of the defendant.

Attorney Morrissey’s online video made it sound like he had simply dismissed issues raised by the defense as baseless conspiracy theories. Stubborn, lazy ignorance is not a good trait in anyone, but it would seem to be an especially bad trait for a powerful prosecutor to have in a murder case, and Massachusetts ethical rules frown on that trait. If his office did not with an open mind look into at least some of the issues raised by the defense, then Attorney Michael P. Morrissey may well have already violated his ethical duty as a prosecutor to seek justice.

Minimum Monthly Maintenance Needs (Income) Allowance for Nursing Home Resident’s Spouse Is Now $2,465.00 from 7/1/2023 until 6/30/2024

June 30, 2023

When one spouse is living in a nursing home and the other spouse is living anywhere else, the spouse who is not living in the nursing home (who is known under federal Medicaid law as the “community spouse”) is allowed by MassHealth to keep some (or sometimes all) of the nursing home resident’s income through an income allowance known as the Minimum Monthly Maintenance Needs Allowance (MMMNA). Every July 1st, this figure changes based on federal poverty level guidelines. The MMMNA has now been increased to $2,465.00, effective July 1, 2023, and continuing through June 30, 2024. (This MMMNA figure is the same in 48 states; Alaska and Hawaii have higher figures.)


The income calculation for the community spouse does not end there. If certain basic household expenses are more than 30% of the MMMNA, which is $739.50, the community spouse is entitled to keep an extra amount of the couple’s income. This extra income is known as the Excess Shelter Amount (“ESA”). Between the MMMNA and the ESA, the community spouse can now be entitled to keep as much as $3,715.50 of the married couple’s total income. If even more income is needed, such as where the community spouse is living in an assisted living facility, the community spouse can request a fair hearing and attempt to prove the need for more than $3,715.50 of the married couple’s total income. In some cases, the community spouse would need more than $3,715.50 due to the costs of an assisted living facility but would be required at the fair hearing to prove the need to live there.


Utilizing the MMMNA provisions in Medicaid/MassHealth law is always better than purchasing an immediate annuity with excess assets, since all payments from the annuity are treated as income, and taking that step ends up reducing the amount of the married couple’s income that the community spouse could otherwise keep. Unfortunately, due to the asset rules under Medicaid/MassHealth, in many situations in the past the community spouse has had no choice but to purchase an immediate annuity with the so-called “excess” assets.


What in recent years has become more common as an alternative for dealing with the excess assets has been for the community spouse to refuse to make the excess assets available for expenditure through a process known as spousal refusal. (For more information on spousal refusal, see our webinar titled Can a Spouse Refuse to Cooperate in the MassHealth Application Process?. Whether the community spouse claiming spousal refusal can still be entitled to the MMMNA is an interesting issue that may soon be tested.

In Rudnick v. Rudnick, the Massachusetts Appeals Court Reiterates That a Prenuptial Agreement Must Be Reasonable at the Time of Divorce

June 9, 2023

Under Massachusetts law, a prenuptial agreement must be fair and reasonable at the time it is executed. To be enforceable at the time of divorce, it cannot be unconscionable, and the Probate Court judge assigned to the divorce case looks at whether it should be enforced before proceeding with the case.

In Doris Rudnick v. Leonard W. Rudnick, the husband had shortly before the wedding date sprung a prenuptial agreement on his fiancée, and she signed it the day before the wedding against the advice of her lawyer. Throughout their 25 years together, you almost have to wonder why he even had wanted to marry her, as he was constantly scheming with his family to find ways for her to get nothing. (Perhaps the last-minute suggestion of a prenuptial agreement should be a flashing warning sign to future people getting married.) As a part of the scheme, the husband even generously allowed his wife to spend some of her own money on a new home that, unbeknownst to her, neither of them even owned.

The Probate Court judge in Rudnick vs. Rudnick had found that the husband had breached the agreement, and that the wife had waived too many rights in the prenuptial agreement, and the Massachusetts Appeals Court agreed. The divorce then proceeded as though there was no prenuptial agreement.

The bottom line is that a prenuptial agreement or postnuptial agreement is a contract that has to be fair at the time it is being enforced, so the possibility of a very long marriage has to be considered.

The Dermody and Mondor Cases on Spousal Annuities Have Been Appealed to the U.S. Supreme Court

June 8, 2023

The issue of who or what the beneficiary of an annuity must be for MassHealth purposes is not yet resolved. The parties in Dermody v. EOHHS  and EOHHS v. Mondor et al have filed a joint Petition for Certiorari with the Supreme Court of the United States (“SCOTUS”). You can follow the progress of the case at the  SCOTUS case docket.

As you can see at the SCOTUS site, the procedural games regularly played by the MassHealth agency continue. The Executive Office of Health and Human Services and the Office of the Attorney General waited until the last day for responding to the Petition for Certiorari, then chose not to respond. SCOTUS ordered a response, and the Assistant Attorney General handling the case then asked for extra time to respond.

The Supreme Judicial Court had issued lazy opinions in Dermody and Mondor, in my view. In the case of Hughes v. McCarthy , the Fifth Circuit Court of Appeals had reached the exact opposite conclusion about what Medicaid law requires. The Petition for Certiorari asks SCOTUS to take up our cases and decide whether the Hughes analysis is more intellectually sound. We should know within three months whether SCOTUS will take up the cases.

Terminally Ill Persons Can Now Travel to Vermont to Take Advantage of Its Medical Aid In Dying Law

May 12, 2023

Terminally ill persons in Massachusetts have no assisted suicide option under Massachusetts law, but now they can travel to Vermont for that purpose. On May 2, 2023, Vermont changed its “medical aid in dying” law to allow terminally ill persons from other states to take advantage of it to end their lives. (There are nine other states that have an assisted suicide law, but, with the exception of Oregon, those states limit the availability of their laws to their state residents.)

Vermont’s law requires that those who seek to use it be capable of making and communicating their health care decision to a physician. Patients are required to make two requests orally to the physician and then to submit a written request that is signed in the presence of two or more witnesses who are not interested persons (which includes relatives and other persons who could end up inheriting early). Witnesses must sign and confirm that the patient appeared to understand the nature of the written request and was free from duress or undue influence at the time. The law, not yet updated to remove the Vermont residency requirement, can be found at https://legislature.vermont.gov/statutes/fullchapter/18/113 , and answers to frequently asked questions can be found at https://www.healthvermont.gov/sites/default/files/documents/pdf/Act39_faq.pdf

In Dermody v. Executive Office of Health and Human Services, the Supreme Judicial Court Rules that the Annuities of Community Spouses Must Name the Commonwealth of Massachusetts as Beneficiary

March 13, 2023

It has become commonplace for a person whose spouse is in a nursing home to purchase an immediate annuity with the so-called “excess” assets when applying for MassHealth. The payments are not treated as excess assets, but instead are treated as the community spouse’s monthly income. In Dermody v. Executive Office of Health and Human Services, 491 Mass. 223 (2023), the Supreme Judicial Court (“SJC”) has ruled that the community spouse who purchases such an annuity must name the Commonwealth of Massachusetts as the beneficiary which will receive the remaining payments if the community spouse dies before receiving all of the annuity payments. According to the opinion, the Commonwealth is limited to collecting reimbursement from the annuity payments for the MassHealth benefits received by the institutionalized spouse.

The SJC had the briefs of the parties for over a year before issuing this decision, yet provided very little intellectual analysis of the federal Medicaid law, especially where a federal court had reached the opposite conclusion in a deeper reading of the federal law in 2013. The SJC seems to have begun deciding the case by assuming, without actual evidence, that it knew the purpose of the part of the Deficit Reduction Act (DRA”) that dealt with annuities and other asset transfers. There had been some generic floor statements about the DRA from politicians when it was passed, but nothing specific about annuities, and there was no legislative history of the DRA to justify the SJC making this shockingly lazy, pivotal assumption. Unfortunately, unless someone decides to take a similar case to the federal court system, this decision will be the final word on annuities purchased in Massachusetts by community spouses.

The Dermody decision still leaves community spouses with several options, including:

  1. Where most immediate annuities tend to be for 5 years, the community spouse could take the chance that he/she will survive the 5 years or opt for a shorter term. There are companies that sell annuities that return all payments within 2 years, and some that may go even shorter. It probably makes sense to go with the shortest payment feasible, but consider that if a large IRA is being annuitized, a short annuity may increase the overall federal income taxes payable.
  2. The community spouse could enter into a promissory note agreement with a family member that mimics the 5-year annuity payout. (As I had pointed out to the SJC in my brief in the case accompanying Dermody, the DRA had opened the door to the purchase of promissory notes that had no required payout to the state. This is why it was foolish for the SJC to have jumped to the lazy conclusion that it knew what the legislative purpose of the entire DRA was.)
  3. As is routinely done in Michigan, an “SBO” Trust could be created and funded with the so-called “excess” assets. The mandatory payouts from the trust to the community spouse would mimic an annuity payout.
  4. Spousal refusal was included in the 1988 federal law that created the community spouse resource allowance. The community spouse must disclose all assets under the regulations of the MassHealth agency, but then can simply refuse to spend the excess assets. While the MassHealth agency would technically have the right to sue the community spouse for the support of the institutionalized spouse, it never has done so to date, and such an event would seem unlikely unless an extremely wealthy person attempted to utilize this strategy.

Minimum Monthly Maintenance Needs Allowance for Nursing Home Resident’s Spouse Increased to $2,288.75 during 7/1/2022-6/30/2023

July 26, 2022

When one spouse is living in a nursing home and the other spouse is living anywhere else, the spouse who is not living in the nursing home (known under Medicaid and MassHealth law as the “community spouse”) is allowed by Medicaid or MassHealth to keep some (or sometimes all) of the nursing home resident’s income through an income allowance known as the Minimum Monthly Maintenance Needs Allowance (MMMNA).  Every July 1st, this figure changes based on federal poverty level guidelines.  The MMMNA was $2,177.50 from July 1, 2021 until June 30, 2022, and it will increase from $2,177.50 to $2,288.75 from July 1, 2022 through June 30, 2023.

If certain basic household expenses are more than 30% of the MMMNA, which is $686.63 from July 1, 2022 until June 30, 2023, the community spouse is entitled to keep extra income, known as the Excess Shelter Amount (“ESA”).  Between the MMMNA and the ESA, the community spouse can now be entitled to as keep as much as $3,435 of the married couple’s total income.  If even more income is needed, such as where the community spouse is living in an assisted living facility, the community spouse can request a fair hearing and attempt to prove the need for more than $3,435 of the married couple’s total income.

Utilizing the MMMNA provisions in Medicaid/MassHealth law is always better than purchasing an immediate annuity, since all payments from the annuity are treated as income, and taking that step ends up reducing the amount of the married couple’s retirement income that the community spouse could otherwise keep.  Unfortunately, due to the asset rules under Medicaid/MassHealth, in many situations the community spouse has no choice but to purchase an immediate annuity with excess assets.

In Hornibrook v. Richard, the SJC Sidesteps Its Responsibilities and May Have Made Practicing Law in Massachusetts Probate Court More Complicated

September 30, 2021

In Hornibrook v. Richard, 488 Mass. 74 (2021), the Supreme Judicial Court of Massachusetts (“SJC”) has ruled that when a court-appointed Conservator has explicit authorization from the Probate Court to take some financial action on behalf of the protected person, the Conservator cannot be sued because the Conservator is functioning as an arm of the Probate Court and therefore has quasi-judicial immunity. Where a judge is entitled to judicial immunity and therefore is “exempt from liability to an action for any judgment or decision rendered in the exercise of jurisdiction vested in him by law, and a Conservator is appointed by a judge, the SJC decided that since a “conservator is a nonjudicial person fulfilling quasi judicial functions … the conservator shares in the judge’s absolute immunity.”

Unfortunately, the SJC did not bother to express any opinion whatsoever about whether the Conservator would have quasi-judicial immunity for taking actions that are based on the powers automatically given to Conservators under Massachusetts law. If Massachusetts law gives a Conservator the power to take some discretionary actions, and if the Conservator is protected from liability by relying on those powers, why couldn’t the SJC have come right out and made that point? In ducking that question, it seems that the SJC, which is supposedly in charge of the administration of justice in the Commonwealth of Massachusetts, apparently did not think through whether it was creating a needless mess for the courts below it in the court hierarchy. Conservatorships were already messy; in some situations, a conservatorship has been established due to some degree of family dysfunction, and every Conservator is ultimately answerable to anybody who inherits from the person under conservatorship. The SJC could have opted to establish guidelines as to when a Conservator would have protection from being second-guessed and sued, but by not commenting the SJC may have done the opposite and opened the door to concerns as to when Massachusetts law can be relied upon as protection for the Conservator’s actions.

The SJC may have unintentionally set in place a new system where a cautious Conservator, or any Conservator who is represented by a cautious lawyer, will have an incentive to obtain explicit permission from the Probate Court for almost any action to be taken so that the Conservator will definitely end up having quasi-judicial immunity. The same reasoning could be applied to Guardianships and Estates, with cautious lawyers not relying on the discretion provided by Massachusetts law and instead attempting to get clear-cut judicial approval of anything even remotely questionable. Thus, Probate Courts could end up with extra work from the motions being filed to obtain quasi-judicial immunity, and much of that extra work would have been needless if the SJC had stepped up and extended its reasoning to at least some of the discretionary powers that are given to Conservators under Massachusetts law.

It appears that the failure of the SJC to make any comment could open the door to frivolous litigation. For the protection of fiduciaries that are under the supervision of the Probate Court, such as Conservators, Guardians, Personal Representatives of estates and Trustees of testamentary trusts, the SJC did provide a bare minimum degree of guidance, however, for we now know that if the fiduciary is acting under a specific court delegation of authority, the fiduciary would have quasi-judicial immunity from lawsuits. Thus, it now may make a great deal of sense when filing an initial petition for the appointment of the fiduciary, or when filing a petition to expand the powers of a fiduciary, to add a lengthy list of the legal and practical issues that the fiduciary may encounter and a request for the authority to deal with these issues. By taking this step, the fiduciary will arguably have the explicit authority from the Probate Court that in the current view of the SJC causes the fiduciary to have quasi-judicial authority. In other words, the petitioner should perhaps act as though there were no Massachusetts laws on the books and simply include the Massachusetts laws as an attachment to the petition so that the Court would specifically grant those powers. These steps may sound unnecessary in a normal case, but that is what the SJC hath wrought; until the SJC ends up with a case that is specifically about whether a fiduciary can be protected by the powers granted in Massachusetts law, and then cannot sidestep its responsibilities to the judicial system, this may be the best way to protect fiduciaries against frivolous lawsuits such as the one that had been filed in the Superior Court in the Hornibrook case.

In Fournier v. Secretary of the Executive Office of Health and Human Services, the Supreme Judicial Court Has Eliminated Most of the MassHealth Agency’s Convoluted Arguments Against Irrevocable Trusts

July 27, 2021

On July 23, 2021, in Fournier v. Secretary of the Executive Office of Health & Human Services, Supreme Judicial Court of Massachusetts (“SJC”) docket number SJC-13059, the SJC ruled that a limited power of appointment (“LPA”), also known as a special power of appointment, in an income-only irrevocable trust does not cause the trust to be treated as a countable asset for MassHealth purposes. In so doing, the SJC explained how a trust is to be properly scrutinized by the MassHealth agency from this point forward and thereby debunked many of the MassHealth lawyers’ favorite conspiracy theories in their decade-long battle against irrevocable, income-only trusts.

As the SJC notes in its opinion, the Fournier case picked up where the case of Daley v. Secretary of the Executive Office of Health and Human Services, 477 Mass. 188 (2017) had left off. When the SJC was in the process of writing its opinion in the Daley case, it spotted a provision in the Nadeau trust that had not been brought up by any of the parties. This provision, an LPA, allowed the settlor of the trust (who was the MassHealth applicant) to “appoint” — or give — trust property to non-profit entities, and the SJC surmised that it could be used collusively to pay for care at a non-profit nursing home. As the SJC correctly points out in this decision, the proper interpretation of a trust is an issue of law, so the SJC could have requested briefs from the parties (especially where it had received a motion for reconsideration on this very issue) and could have ruled right then and there in Daley as to whether an LPA in a trust was problematic for MassHealth purposes. Instead, the SJC took the lazy route and, with inartful language, remanded the issue to the MassHealth agency, causing years of litigation for many MassHealth applicants during which the MassHealth agency lawyers falsely claimed that the SJC had actually ruled against the LPA in the Nadeau trust.

Following many fair hearings and legal briefs by several lawyers on this issue in several MassHealth fair hearings, the Fournier case reached the SJC, which has now ruled that an LPA cannot be abused to benefit the settlor of the trust. Thus, the needless ruckus caused by the SJC in Daley was finally resolved by the SJC, which ruled definitively against the MassHealth agency’s misguided, ill-researched arguments against trusts, by simply stating:

In short, for trust principal to be considered countable under the “any circumstances” test, the terms of the trust must give the applicant a direct path to reach or benefit from the trust principal.

It sounds as though the SJC could be fed up with the MassHealth lawyers’ antics; this sentence has extreme significance because it shuts down almost all of the conspiracy theories advanced by MassHealth lawyers about theoretical collusion involving two-step transfers from trusts and the later usage of the transferred funds for the settlor.

The SJC also shut down the ludicrous arguments by MassHealth lawyers that the agency was somehow authorized to ignore fundamental tenets of Massachusetts trust and property law:

MassHealth’s hypothesized appointment is not permitted under established principles of trust and property law. … MassHealth argues that “[S]tate law principles do not necessarily control the [F]ederal law analysis of Medicaid eligibility.” To the extent MassHealth’s contention is that State trust and property law do not factor into our analysis, this argument is misguided. We routinely have looked to established principles of trust and property law for guidance when applying the Federal “any circumstances” test for Medicaid eligibility. See, e.g., Guilfoil, 486 Mass. at 800 (applying principles of property law to conclude that “the retention by an applicant of a life estate in his or her primary residence [held in trust] does render the property a countable asset” for Medicaid eligibility determination); Guerriero, 433 Mass. at 632-633, citing Restatement (Second) of Trusts (1959) (“there were no remaining circumstances in which the trustee retained discretion to pay out principal to” settlor for purposes of determining settlor’s eligibility for MassHealth benefits). Because the Medicaid program is, by design, a partnership between the Federal and State governments, “Congress did not pass a [F]ederal body of trust law, estate law, or property law when enacting Medicaid. It relied and continues to rely on [S]tate laws governing” the operation of trusts for purposes of determining an applicant’s eligibility for Medicaid benefits. Lewis v. Alexander, 685 F.3d 325, 347 (3d Cir. 2012), cert. denied, 568 U.S. 1123 (2013).

Although the SJC did not need further grounds to rule against the MassHealth agency, it took pains to point out that the fiduciary duties of the trustee of the trust must be respected by the agency:

In addition, we conclude that the terms of the Misiaszek trust do not permit Misiaszek to exercise her limited power of appointment for her benefit because doing so would require the trustee to violate her fiduciary duties. … [T]he trustee is required by the Massachusetts Uniform Trust Code to “administer the trust solely in the interests of the beneficiaries.” G. L. c. 203E, § 802 (a). See G. L. c. 203E, § 801 (“Upon acceptance of a trusteeship, the trustee shall administer the trust in good faith, in accordance with its terms and purposes and the interests of the beneficiaries” [emphasis added]). “If the trustee violates any duty to a beneficiary, the trustee will be liable for ‘breach of trust.'” Guerriero, 433 Mass. at 632, citing Restatement (Second) of Trusts § 201 (1959). Because an appointment of the trust principal to a nonprofit or charitable nursing home as payment for Misiaszek’s care would be solely for Misiaszek’s benefit, and Misiaszek herself is an impermissible appointee, the trustee would not be able to effectuate the appointment without exposing herself to civil liability for violating her fiduciary duties to Misiaszek’s children. These concerns further underscore our conclusion that the plain terms of the Misiaszek trust neither intend for nor permit Misiaszek to exercise her limited power of appointment for her benefit as contemplated by MassHealth.

While the Fournier decision is probably not surprising to anybody who has researched the law on powers of appointment, it is important to note that the SJC cited cases and Restatements of Law involving special powers of appointment that had not been reserved, but rather had been given to the powerholder by somebody else. Thus, the significance of Fournier is that, instead of carving out an exception for public policy and governmental benefit purposes, the SJC applied the existing law to LPAs that had been reserved by the settlor of the trust.

The additional significance of this case is that the SJC has informed the MassHealth agency, as well as the courts below and fair hearing officers at the agency, how to properly interpret a trust within the context of federal Medicaid trust law. This is a welcomed decision which will prevent MassHealth lawyers from concocting all sorts of ways that trusts might not pass muster. My favorite still is the one where they argued the trust failed to protect the assets because the assets could be given from the trust to the children, who could then buy an expensive sports car and let the MassHealth applicant “profit” from the driving experience. See Does “Imputed Driving Value” Somehow Make an Irrevocable Trust a Countable Asset for MassHealth Purposes?

An SJC decision is binding on the entire system of justice in Massachusetts. From now on, MassHealth agency lawyers, MassHealth fair hearing officers, Superior Court judges and Massachusetts Appeals Court judges have now all been instructed that before an irrevocable trust can be struck down as not protecting assets in it on a MassHealth application, (A) Massachusetts probate, property and trust law needs to be considered, not just the federal Medicaid trust law, (B) a trust has to be read as a whole, with the settlor’s intentions being considered, (C) for a trust to be problematic, there has to be a “direct path” of the trust’s assets to or for the benefit of the settlor, and (D) the trustee’s fiduciary duties and liability to the remainderpersons of the trust must be treated seriously in determining whether a direct path of the assets actually exists for the benefit of the settlor.

Moving forward in Massachusetts, the detailed holding in the Fournier case should severely limit future litigation about irrevocable, income-only trusts in the MassHealth context. There is a case now pending and temporarily stayed in the Massachusetts Appeals Court where the MassHealth agency had raised issues regarding the collusive usage of LPAs with family members to find a way to benefit the settlor of the trust, and it would seem that the SJC’s sharp, unambiguous language in Fournier about LPAs and fiduciary duties of trustees would dispose of those arguments. In other cases, there are other arguments still being made by MassHealth agency lawyers about the trustee potentially entering into all sorts of investment schemes and letting the settlor benefit from them even though the trust forbids giving principal to or for the settlor; many of these arguments concoct a direct path of the assets of the trust to the settlor by arguing that investments can be made by the trustee to make principal directly available, but these arguments also presume that the trustee can get away with these schemes without fiduciary liability, which the SJC just highlighted in Fournier as an issue to be seriously considered. Let’s hope those arguments don’t continue to waste the time of elder law attorneys and we don’t need to have the SJC spank the MassHealth agency again in the future like the agency has gotten spanked four times in Massachusetts appellate courts about its positions against trusts since 2016 in Heyn v. Director of the Office of Medicaid, 89 Mass. App. Ct. 312 (2016), then in Daley v. Secretary of the Executive Office of Health and Human Services, 477 Mass. 188 (2017), then in Guilfoil v. Secretary of the Executive Office of Health and Human Services, 486 Mass. 788 (2021), then again in 2021 in this case. In all of these cases the briefs were written and oral arguments were made not by lawyers in the MassHealth agency, but rather by lawyers in the Office of the Attorney General of Massachusetts, so let’s hope the AG’s Office has also learned a lesson here about parroting the MassHealth agency’s frivolous arguments about trusts.

The SECURE Act Has Changed How a Large IRA Should Be Dealt With in an Estate Plan

July 15, 2021

When the Setting Every Community Up for Retirement Enhancement (“SECURE”) Act became federal law on December 20, 2019, it significantly changed the rules about when money has to be withdrawn (and thereby taxed) from inherited IRAs and defined contribution plans such as 401(k)s and 403(b)s. For deaths that occur after 2019, the SECURE Act requires the entire balance of an inherited IRA to be distributed or withdrawn within 10 years of the death of the original IRA owner.

The exceptions to this 10-year rule are when the beneficiary is a surviving spouse, a disabled or chronically ill person (as defined by the IRS), a person not more than ten years younger than the IRA owner, or a child who hasn’t reached the age of majority. A minor child who later reaches the age of majority then becomes subject to the 10-year rule.

The IRA can be partially or fully withdrawn at any time and in any installments desired by the beneficiary during that 10-year period after the original IRA holder’s death. The IRS has recently published its interpretation of the new rules in Publication 590-B (2020), Distributions from Individual Retirement Arrangements (IRAs), and decided that the IRA beneficiary must also make required minimum distributions during that 10-year period (unless the remaining amount in the IRA is withdrawn before the 10 years are up). There is no leeway in the SECURE Act for most beneficiaries, and the penalty for not complying with the withdrawal requirements is a punishing 50% federal excise tax, which is much higher than the highest federal income tax bracket.

Before this change in the federal income tax laws, the normal thought process of many financial planners was for an original IRA holder to take out the bare minimum from the IRA, let the IRA grow and stretch out the family’s withdrawal process for as long as possible, sometimes for generations. Now that the beneficiaries in the next generation are required to drain the IRA within 10 years, that type of thinking almost needs to get reversed. Where the beneficiaries will be adding their IRA withdrawals on top of their other taxable income, and that tax rate can be higher than what the original IRA holder has been paying, it may make sense in many cases for the original IRA holder to be withdrawing much more from the IRA annually, perhaps to the top of the current 24% federal income tax bracket when considering the IRA holder’s other income.

During the estate planning process, most parents want to treat their children equally, even where one child is much more financially successful than another child, so this tax law change needs to be factored into the estate plan. Treating the children equally does not necessarily mean leaving each of them with an equal share of each asset; is an estate plan really equal if the wealthier child would be saddled with greater income taxes as an equal beneficiary of a large IRA? To truly make the inheritance roughly “equal,” it may make sense in some families to leave a larger percentage of a large IRA to the child in the lower income tax bracket, and to leave more of the other assets to the wealthier child.

In Guilfoil v. Sudders, the SJC Approved the Use of Nominee Trusts in MassHealth Planning

March 15, 2021

In Guilfoil v. Sudders, 486 Mass. 788 (2021), the Supreme Judicial Court of Massachusetts (“SJC”) has for the first time tackled the issue of how nominee trusts should be treated under federal Medicaid trust law. In this case, the MassHealth applicant had a life estate listed on the nominee trust’s Schedule of Beneficiaries, and her children owned vested remainder interests. Among the MassHealth agency’s arguments were that the trust was revocable because any beneficiary could require termination, and that the vested remainder beneficiaries could amend the trust to make the MassHealth applicant the sole beneficiary (thereby creating a “circumstance” whereby principal could be made available to the applicant).

Previous SJC decisions in the non-MassHealth context had generally treated nominee trusts as principal-agency relationships instead of trusts. Relying on existing Massachusetts case law, the SJC shot down all the MassHealth agency’s arguments. Although the SJC could possibly have ruled that the actuarial value of the life estate was a countable trust asset until deeded out to the life tenant, the SJC ruled definitively that a life estate in a nominee trust is not a countable asset for MassHealth purposes.

In dismissing the agency’s argument that the beneficiaries could amend the trust to return the real estate to the MassHealth applicant, the SJC stated that such an event would involve an independent act by those beneficiaries. By reiterating language from the 2016 Heyn case in the Massachusetts Appeals Court that had nixed a two-step transfer analysis, the SJC adopted the exact same reasoning:

This “gifting” would constitute an action outside the termination and is not a scenario contemplated within the four corners of the trust document. “Medicaid does not consider assets held by other family members who might, by reason of love but without legal obligation, voluntarily contribute monies toward the grantor’s support.” Heyn v. Director of the Office of Medicaid, 89 Mass. App. Ct. 312, 318-319 (2016). Guilfoil at 798.

Given that a nominee trust has now received the SJC’s approval as a MassHealth planning device, Massachusetts elder law attorneys who wish to use such “trusts” should not open the door to challenges by the MassHealth agency by changing the basic language seen by the SJC; perhaps the nominee trust form approved by the Real Estate Bar Association of Massachusetts should be utilized.

Limited Powers of Appointment in Irrevocable Trusts Are Wrongfully Challenged by the MassHealth Agency

March 11, 2021

In drafting irrevocable trusts, much concern has to be given to the attitude of the MassHealth agency against irrevocable trusts, especially where the agency ends up having the weight of the Office of the Attorney General of the Commonwealth of Massachusetts on its side against any trusts that end up in Massachusetts courts. Unfortunately, many of the concerns raised at fair hearings by MassHealth agency lawyers lack serious legal research and call upon hearing officers to focus on phrases instead of reading the trust as a whole as the agency had urged the courts to do in the Doherty case.

Many of the arguments made by the MassHealth agency in claiming that powers of appointment make irrevocable trusts countable almost seem to assume an elaborate scheme whereby the holder of the power initially reserved the power with the intention of later acting in a self-serving manner.[1]  One such example is a power to appoint assets to family members, especially where the language in the power of appointment allows the appointment to be made subject to conditions; the agency often claims that the conditions could be to give the appointed assets to the power holder. Another such example often raised by the MassHealth agency in claiming that powers of appointment make irrevocable trusts countable is that a power of appointment exercisable to make donations to charitable or nonprofit organizations can be utilized to have the appointed assets pay for the power holder’s services.[2] Under Massachusetts statutory and case law and the Restatements of Property and Trusts, however, the power holder of a limited power of appointment is prohibited from exercising the power of appointment in favor of the power holder.[3]

A limited power of appointment is not an interest in property.[4]  There is nothing in federal Medicaid trust law that prohibits limited powers of appointment in irrevocable trusts; neither is there any such prohibition in the State Medicaid Manual, which is issued by the MassHealth agency’s federal oversight organization and is binding on the agency.[5]  If in the Medicaid context Congress had wanted state Medicaid agencies to consider the impact of limited powers of appointment in irrevocable trusts, Congress could have incorporated some of the so-called grantor trust rules, Internal Revenue Code sections 671-679, whereby the reservation of certain powers result in the settlor being treated as the owner of a trust for tax purposes.  These Internal Revenue Code provisions were passed by Congress long before it passed Medicaid trust laws, are very detailed, and indicate that Congress is aware that there are many varieties of trust provisions where settlors can reserve varying degrees of control over irrevocable trusts, yet Congress did not opt to subject irrevocable trusts to such scrutiny in the Medicaid context.

A settlor cannot exercise a limited power of appointment collusively with an appointee to utilize it to pay the settlor’s personal expenses, as a limited power of appointment is exercisable only in favor of permissible appointees, and any attempt to exercise a limited power in favor of an impermissible appointee is legally ineffective.  Restatement 3rd Property (Wills and Donative Transfers) § 19.15.[6]  Where an appointment is made with the purpose and expectation that some or all of the appointed property or some collateral benefit will pass to an impermissible appointee, the appointment is ineffective:

An appointment to a permissible appointee is legally ineffective to the extent that it was (i) conditioned on the appointee conferring a benefit on an impermissible appointee, (ii) subject to a charge in favor of an impermissible appointee, (iii) upon a trust for the benefit of an impermissible appointee, (iv) in consideration of a benefit conferred upon or promised to an impermissible appointee, (v) primarily for the benefit of the appointee’s creditor, if that creditor is an impermissible appointee, or (vi) motivated in any other way to be for the benefit of an impermissible appointee.” Restatement 3rd Property (Wills and Donative Transfers) §19.16.[7]

Such an attempt to benefit personally from a limited power of appointment is “frequently referred to as a ‘fraud on the power.’” Restatement 3rd Property (Wills and Donative Transfers) Chapter 19 Part D Introduction and § 19.15.[8] 

Looking at a limited power of appointment from the standpoint of the power holder’s creditor reaches the same conclusion, that it cannot benefit the power holder. If a limited power of appointment could be used (or abused) for personal benefit, it would seem that this issue would have come up in the bankruptcy context, where a court-appointed bankruptcy Trustee would have looked to expand the bankruptcy estate by pulling in assets that are subject to the power. Yet, no such case exists. The settlor’s creditors cannot reach the assets subject to such a power:

“[T]he creditors of the donee[9] of a nongeneral power of appointment (one that cannot be exercised for the economic benefit of the power holder), whether or not presently exercisable, cannot reach the property subject to the power for the satisfaction of their claims[].”  …  “The rights of creditors with respect to trust property over which the debtor has a power of appointment depend on the nature of the power. For example, the creditors of the donee of a nongeneral power of appointment (one that cannot be exercised for the economic benefit of the power holder), whether or not presently exercisable, cannot reach the property subject to the power for the satisfaction of their claims; nor is the property subject to the expenses of administering the donee’s estate.”  Restatement (Third) of Trusts, § 56, comment b (2003)  “Property subject to a nongeneral power of appointment is exempt from claims of the donee’s creditors and from liability for expenses of administering the donee’s estate.” Restatement 3rd Property (Wills and Donative Transfers) §22.1. “Because a nongeneral power of appointment is not an ownership-equivalent power, the donee’s creditors have no claim to the appointive assets, irrespective of whether or not the donee exercises the power. Restatement (Third) of Property § 22.1, comment a. 

Federal bankruptcy law has long reached the same conclusion, that limited powers of appointment do not represent assets available to the power holder:

Section 541(b)(1) of the federal Bankruptcy Code of 1978 (11 U.S.C. § 541(b)(1)) provides that ‘Property of the estate does not include any power that the debtor may only exercise solely for the benefit of an entity other than the debtor.’ This provision excludes from the federal bankruptcy estate property subject to a nongeneral power of the donee-bankrupt.  Restatement 3rd Property (Wills and Donative Transfers) §22.1 cmt d.

The simple reason that there are no bankruptcy cases holding that limited powers of appointment are problematic is that the power to appoint principal is not a power to make payment of the power holder’s personal expenses unless the power is so broad that it is a general power of appointment. Further, of practical significance is that the power holder does not have actual control over the assets, and cannot exercise any such power without going through the Trustee, who controls the assets. The Trustee then has to determine whether the attempted exercise of the power is legally effective, given that both the Trustee and the power holder have fiduciary duties under the Massachusetts Uniform Trust Code.

2. Discussion. The interpretation of a written trust is a matter of law to be resolved by the court. See Mazzola v. Myers, 363 Mass. 625, 633 (1973). The rules of construction of a contract apply similarly to trusts; where the language of a trust is clear, we look only to that plain language. See Harrison v. Marcus, 396 Mass. 424, 429 (1985). … When interpreting trust language, . . . we do not read words in isolation and out of context. Rather we strive to discern the settlor’s intent from the trust instrument as a whole and from the circumstances known to the settlor at the time the instrument was executed.” Hillman v. Hillman, 433 Mass. 590, 593 (2001), citing Pond v. Pond, 424 Mass. 894, 897 (1997).

M.G.L. c. 203E § 105 establishes “the duty of a Trustee to act in good faith and in accordance with the terms and purposes of the trust and the interests of the beneficiaries.” The Massachusetts Uniform Trust Code requires in general that fiduciary duties apply to all trusts, and is more specific about those duties in Article 8, including s. 802 (duty of loyalty), s. 803 (duty of impartiality) and s. 808 (powers to direct). For a Trustee to exercise any power, M.G.L. c. 203E § 815(b) requires that fiduciary duties must apply: “The exercise of a power shall be subject to the fiduciary duties prescribed by this article.”  To determine those fiduciary duties, the Trustee is required to read the trust as a whole.[10]  In Ferri v. Powell-Ferri, 476 Mass. 651 (2017), the SJC recently summarized how to interpret a trust properly under Massachusetts law:

It is fundamental that a trust instrument must be construed to give effect to the intention of the donor as ascertained from the language of the whole instrument considered in the light of circumstances known to the donor at the time of its execution.” Watson v. Baker, 444 Mass. 487, 491 (2005), quoting Powers v. Wilkson, 399 Mass. 650, 653 (1987). … “In determining the meaning of a contractual provision, the court will prefer an interpretation ‘which gives a reasonable, lawful and effective meaning to all manifestations of intention, rather than one which leaves a part of those manifestations unreasonable, unlawful or [of] no effect'” (citation omitted) Siebe, Inc. v. Louis M. Gerson Co., 74 Mass. App. Ct. 544, 550 n.13 (2009). 

Ferri at 654-655.  (emphasis added)

If the Trustee determines that the self-serving exercise of a power of appointment is inconsistent with the trust, read as a whole, then the Trustee cannot take action based on the power holder’s direction, especially where the power holder also has fiduciary duties to the beneficiaries. These points are codified in M. G. L. c. 203E § 808, which states:

(b)  If the terms of a trust confer upon a person, other than the settlor of a revocable trust, power to direct certain actions of the Trustee, the Trustee shall act in accordance with an exercise of the power, unless the attempted exercise is manifestly contrary to the terms of the trust or the Trustee knows the attempted exercise would constitute a serious breach of a fiduciary duty that the person holding the power owed to the beneficiaries of the trust.

(c) A person who holds a power to direct is presumptively a fiduciary who is required to act in good faith with regard to the purposes of the trust and the interests of the beneficiaries. The holder of a power to direct shall be liable for any loss that results from a breach of fiduciary duty.

Thus, if the power holder directed the Trustee to distribute trust assets to a nonprofit nursing home or to a relative in a way that may benefit the settlor, the combination of sections 105, 815(b) and 808 of M.G.L. c. 203E prevents the Trustee from taking such action if it would violate the terms of the trust which prohibit distributions of principal to or for the benefit of the settlor. 

The MassHealth agency’s argument that limited powers of appointment cause a trust to be countable is missing an important element. In the oral arguments preceding the decision in Daley, SJC Chief Justice Ralph Gants pressed the MassHealth agency’s lawyers three times to tell him how the nursing home would get paid if the trusts were found countable. Under federal Medicaid trust law, for a trust to be deemed countable, there has to be a direct mechanism within the trust so that payments could be made to or for the MassHealth applicant or his/her creditors, which would include the nursing home that is providing long-term care. A limited power of appointment does not provide such a mechanism to make the creditor whole.  If a MassHealth applicant is denied benefits due to a problematic trust yet the unpaid nursing home cannot thereafter reach that trust to be reimbursed for the nursing home resident’s unpaid debt, the nursing home would be caught in the middle, and have no source of payment. It strains credulity that Congress would have passed a federal Medicaid trust law whereby a medical provider such as a nursing home would be required to provide extensive, expensive, ongoing health care services to a person who has no potential public or private source of payment.


[1] Hearing Officer Brook Padgett, in Fair Hearing Decision 1604346, has chastised the agency on this point: “MassHealth must review the Trust instrument as a whole, and it does not have free rein to create any scenario which in theory may allow hypothetical access to principal through some convoluted scheme, without concern as to whether the action is prohibited by the Trust or regardless of the fiduciary responsibility and duties of the Trustee.”

[2] This agency argument practically presumes that the drafting attorney intentionally placed this option into the trust after having discussed how to utilize it, and also presumes that a nursing home run as a nonprofit organization would agree to accept payment in this fashion.

[3] The Restatements have detailed coverage of limited powers of appointment because such powers have been utilized for many decades in estate planning, such as in multi-generational estate tax planning and charitable trusts.

[4] Restatement 3rd Property (Wills and Donative Transfers) §22.1 Comment a (“a nongeneral power of appointment is not an ownership-equivalent power.”  Restatement 2nd (Donative Transfers) 13.6, Comment b (“Where a non-general power has been created, the donee is not in the position of an owner either as a matter of common-law doctrine or the practicalities of the situation.)

[5] When the United States Department of Health and Human Services or its Centers for Medicare and Medicaid Services issues an interpretation of federal law in the State Medicaid Manual, the state Medicaid agencies are bound by it. The Foreword to the State Medicaid Manual, at B.1., states:  “Contents.– The manual provides instructions, regulatory citations, and information for implementing provisions of Title XIX of the Social Security Act (the Act). Instructions are official interpretations of the law and regulations, and, as such, are binding on Medicaid State agencies. This authority is recognized in the introductory paragraph of State plans.”

[6] See also Pitman v. Pitman, 314 Mass. 465, 476 (1943) (“[T]here is a fraudulent exercise of a power not only where the donee acts corruptly for a pecuniary gain but where he acts primarily for his own personal advantage or that of a third person who is a non-object of the power and thereby abuses the power [].”)

[7] This issue was raised in New York two decades ago, and the United States District Court for the Northern District of New York held that although the settlor had reserved a limited power of appointment over an irrevocable trust, in the absence of bad faith or fraud, the remote possibility of collusion between the settlor and beneficiaries should not be considered in determining whether the assets of the trust are available for federal Medicaid trust purposes. Verdow v. Sutkowy, 209 F.R.D. 309, 316 (N.D.N.Y. 2002).

[8] See also Annotation, “Validity and effect of agreement by donee of power of appointment respecting its exercise or nonexercise,” 163 A.L.R. 1449 (1944).

[9] Note that the holder of a power of appointment is known here as a “donee.”

[10] “When interpreting trust language, . . . we do not read words in isolation and out of context. Rather we strive to discern the settlor’s intent from the trust instrument as a whole[].” Hillman v. Hillman, 433 Mass. 590, 593 (2001), citing Pond v. Pond, 424 Mass. 894, 897 (1997). Under proper trust interpretation, where possible inconsistencies or ambiguities should not be read in the worst possible way, the prohibition against the distribution of principal in the trust to or for the benefit of the MassHealth applicant should not be tossed aside.

Here Is the Massachusetts State Plan on Medicaid, Unavailable Online

January 28, 2020

Through a Massachusetts Freedom of Information Act request, I have received the Massachusetts State Plan on Medicaid. This is the contract between Massachusetts and the federal government on how the joint federal-state Medicaid plan will be run in Massachusetts. This State Plan is unavailable online, so I am posting it here.

1.0 MA Medicaid State Plan copy – Section 1 of 7 – AS OF JULY 6 2016

2.0 MA Medicaid State Plan copy – Section 2 of 7 – AS OF DECEMBER 31 2019

3.0 MA Medicaid State Plan copy – Section 3 of 7 – AS OF DECEMBER 31 2019

4.0 MA Medicaid State Plan copy – Section 4 of 7 – AS OF DECEMBER 31 2019

5.0 MA Medicaid State Plan copy – Section 5 of 7 – AS OF JULY 6 2016

6.0 MA Medicaid State Plan copy – Section 6 of 7 – AS OF JULY 6 2016

7.0 MA Medicaid State Plan copy – Section 7 of 7 – AS OF JULY 6 2016

MA CHIP State Plan – AS OF JULY 6 2016