IN THE MATTER OF THE ESTATE OF FRANCES R. MASON
SJC-13439
Supreme Judicial Court of Massachusetts
December 13, 2023
Barnstable. September 13, 2023. — December 13, 2023.
Budd, C.J., Gaziano, Lowy, Cypher, Kafker, Wendlandt, & Georges, JJ.
NOTICE: All slip opinions and orders are subject to formal revision and are superseded by the advance sheets and bound volumes of the Official Reports. If you find a typographical error or other formal error, please notify the Reporter of Decisions, Supreme Judicial Court, John Adams Courthouse, 1 Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-1030; SJCReporter@sjc.state.ma.us
Medicaid. MassHealth. Lien. Executor and Administrator, Claims against estate. Uniform Probate Code. Repose, Statute of. Statute, Construction, Retroactive application.
Petition filed in the Barnstable Division of the Probate and Family Court Department on June 7, 2017.
A motion to strike was heard by Angela M. Ordonez, J.
The Supreme Judicial Court on its own initiative transferred the case from the Appeals Court.
Christine Fimognari, Assistant Attorney General, for Executive Office of Health and Human Services.
Matthew J. Dupuy for the petitioner.
Patricia Keane Martin, Clarence D. Richardson, Jr., & C. Alex Hahn, for the Massachusetts Chapter of the National Academy of Elder Law Attorneys, amicus curiae, submitted a brief.
Brian E. Barreira, pro se, amicus curiae, submitted a brief.
WENDLANDT, J. Through a cooperative Federal and State regulatory scheme, eligible Massachusetts residents (members) may have their medical costs covered by the State-administered health
In limited circumstances, however, Federal and State statutes permit MassHealth to act during the member‘s lifetime. Relevant here,
may seek to recover Medicaid benefits paid, so long as protections for certain of the member‘s relatives are not applicable. See
This case presents the question whether, in Massachusetts, the Legislature has limited the State‘s implementation of the TEFRA lien program to allow enforcement of a TEFRA lien only if the encumbered property is sold during the member‘s lifetime. We conclude that it has.
Separate from MassHealth‘s authority to enforce a TEFRA lien during a member‘s lifetime, MassHealth may assert a timely claim against a member‘s probate estate to seek to recover Medicaid expenses after the member‘s death. The timing of such a claim presents the second question we must address in this case: whether the three-year statutе of repose of the Massachusetts Uniform Probate Code (MUPC),
Applying these conclusions in the present matter, we affirm the
Frances R. Mason, who was permanently institutionalized in a medical facility in the last months of her life, and we reverse the order insofar as it dismissed MassHealth‘s claim against her estate.3
1. Factual background. The relevant facts are undisputed. From January to August 2008, MassHealth provided Medicaid funds to cover Mason‘s care in a residential nursing facility. On May 2, 2008, MassHealth, having determined that Mason would be institutionalized permanently, recorded a TEFRA lien against Mason‘s home in South Yarmouth (property). As expected, Mason lived her remaining days in the facility, and on August 18, 2008, Mason died testate,4 at the age of eighty-eight. The property was not sold during Mason‘s lifetime while it was subject to the TEFRA lien.
2. Procedural history. In June 2017, nearly nine years after Mason‘s death, Maryann Fells (petitioner), the named executor of Mason‘s will, filed a petition in the Probate and Family Court to open formal probate proceedings to settle Mason‘s estate.5 A personal representative was appointed, and
the personal representative‘s bond was approved on July 20, 2018.
The petition and Mason‘s death certificate were sent to MassHealth.6 On August 13, 2018, MassHealth filed a notice of claim to recover the Medicaid benefits paid for Mason‘s care.7 On September 27, 2021, the property was sold, and the proceeds of the sale were held in escrow.
The personal representative did not object to MassHealth‘s claim;8 however, the petitioner filed a motion to strike both MassHealth‘s lien against the property and MassHealth‘s claim against
motion. She concluded that the TEFRA lien against the property became invalid upon Mason‘s death because the property had not been sold “during her lifetime,” which the judge determined was required to trigger MassHealth‘s right to enforce the lien. In addition, the judge ruled that, although Mason died before the effective date of the MUPC, MassHealth‘s claim against Mason‘s estate was barred by the MUPC‘s three-year statute of repose,
3. Discussion. This case presents two questions of statutory construction, which we review de novo. Conservation Comm‘n of Norton v. Pesa, 488 Mass. 325, 331 (2021).10 First, we address whether a TEFRA lien that has been imposed against a permanently institutionalized member‘s home is enforceable after the member‘s death. Second, we consider whether the MUPC‘s three-year statute of repose applies to MassHealth‘s claim for recovery of Medicaid benefits paid on behalf of a member who died prior to the MUPC‘s effective date.
In construing a statute, we begin with its plain language. Metcalf v. BSC Group, Inc., 492 Mass. 676, 681 (2023).
“[A] statute must be interpreted according to the intent of the Legislature ascertained from all its words construed by the ordinary and approved usage of the language, considered in connection with the cause of its enactment, the mischief or imperfection to be remedied and the main object to be accomplished, to the end that the purpose of its framers may be effectuated” (citation omitted).
Harvard Crimson, Inc. v. President & Fellows of Harvard College, 445 Mass. 745, 749 (2006). “Ordinarily, where the language
We construe “[a] properly promulgated regulation . . . in the same manner as a statute.” Harvard Crimson, Inc., 445 Mass. at 749. Where an agency construes a statute, “[w]e give
deference to agency interpretations in areas where the Legislature has delegated decision-making authority tо the agency when the ‘interpretation is not contrary to the plain language of the statutes or their underlying purposes.‘” Metcalf, 492 Mass. at 681, quoting Mullally v. Waste Mgt. of Mass., Inc., 452 Mass. 526, 533 (2008). However, deference is “not abdication, and this court will not hesitate to overrule agency interpretations of statutes or rules when those interpretations are arbitrary or unreasonable.” Armstrong v. Secretary of Energy & Envtl. Affairs, 490 Mass. 243, 247 (2022), quoting Moot v. Department of Envtl. Protection, 448 Mass. 340, 346 (2007), S.C., 456 Mass. 309 (2010).
a. Enforcement of a TEFRA lien after the member‘s death. With these principles in mind, we turn to the first question on appeal: whether, having placed a TEFRA lien against the property of a member who is permanently institutionalized, MassHealth may enforce the TEFRA lien after the member‘s death. Because TEFRA liens are creatures of Federal and State statutes, our analysis begins with a review of these statutes. See, e.g., City Elec. Supply Co. v. Arch Ins. Co., 481 Mass. 784 (2019) (analyzing statute governing mechanic‘s liens to resolve dispute involving mechanic‘s lien); Drummer Boy Homes Ass‘n v. Britton, 474 Mass. 17 (2016) (analyzing statute governing condominium liens to resolve dispute involving condominium
lien); Ropes & Gray LLP v. Jalbert, 454 Mass. 407 (2009) (analyzing statute governing attorney‘s liens to resolve dispute involving attorney‘s lien); Luchini v. Commissioner of Revenue, 436 Mass. 403 (2002) (analyzing statute governing tax lien to resolve dispute involving tax lien).
The Massachusetts Medicaid statutes,
To be eligible for Medicaid benefits, applicants generally must show that their income and assets fall below a defined level, thereby reserving the program‘s resources for those in most need. See
But pertinent to the present matter, an applicant‘s ownership interest in his or her primary residence is not included in the eligibility calculus unless the equity interest exceeds a threshold
ii. Imposition of TEFRA liens. Because an individual‘s ownership interest in his or her home generally is not counted for purposes of determining eligibility for Medicaid coverage, “[i]t is . . . possible . . . for an elderly individual who anticipates needing nursing home care to give his[ or ]her home to a family member or friend without fear of losing or being denied [M]edicaid eligibility . . . assur[ing] that the home will not be . . . subject to any recovery action.” S. Rep. No. 97-494, at 38 (1982). In part to address this potential avenue to thwart a State plan‘s efforts to recover Medicaid benefits paid, Congress passed the Tax Equity and Fiscal Responsibility of Act of 1982 (TEFRA), codified in relevant part at
Specifically, TEFRA authorizes a State Medicaid agency to place a lien13 against the real property of a permanently institutionalized member, defined as an eligible individual (1) who is an inpatient of a medical institution; and (2) whom the State Medicaid agency has determined, after notice and an opportunity for hearing in accordance with the State‘s established administrative procedures, “cannot reasonably be expected to be discharged from the medical institution and to return home.”14
Significantly, TEFRA liens comprise an exception to the Medicaid Act‘s general prohibition barring State Medicaid agencies from imposing a lien against the property of an individual “prior to his death on account of medical assistance paid or to be paid on his behalf under the State plan.”
The Medicaid Act provides that States are not required to use TEFRA liens as part of their efforts to recover Medicaid benefits paid.15 See
In Massachusetts, the Legislature has codified the general prohibition against imposing liens during a member‘s lifetime other than as expressly authorized by the Medicaid Act; accordingly, it permits MassHealth to impose TEFRA liens. See
(2017). Instead, “we consider such guidance carefully for its persuasive power.” Id., citing Wos v. E.M.A. ex rel. Johnson, 568 U.S. 627, 643 (2013).
if the member is released from the medical institution and returns home“).
MassHealth maintains that
We disagree. While § 34 sets forth the circumstances pursuant to which a TEFRA lien may be imposed and one event pursuant to which the lien shall dissolve, the enforcement
authority of MassHealth is delineated expressly in the recovery provisions of the Medicaid Act and the cognate State provisions. See
iii. Estate recovery. Prior to 1993, when Congress enacted a recovery mandate for States participating in the Medicaid program, the Medicaid Act did not require State Medicaid plans to recoup Medicaid benefits paid. See
member‘s estate.18 See
Under the Medicaid Act, however, a State plan‘s recovery efforts are strictly circumscribed; tellingly, in detailing the conditions that permit recovery, the act starts with language of prohibition. See
In Massachusetts, as the Medicaid Act requires, the Legislature carefully circumscribes MassHealth‘s authority to recoup Medicaid benefits paid, and generally prohibits
MassHealth from recovering Medicaid expenditures until after the member‘s death.19 See
iv. Enforcing a TEFRA lien. One exception to this general prohibition against predeath recovery concerns a State agency‘s ability to recover Medicaid expenses incurred on behalf of a permanently institutionalized member whose real property is subject to a TEFRA lien. For such a member, the Medicaid Act gives State Medicaid agencies an option; they “shall seek adjustment or recovery from the individual‘s estate or upon sale of the property” (emphasis added).
See
Because the Medicaid Act specifies that a State agency may enforce a TEFRA lien “upon sale” of the encumbered property, see
concluded that a TEFRA lien generally may be enforced after the member‘s death, stating:
“If the home owner dies with a TEFRA lien still on the property, Medicaid recovery occurs as part of the estate
settlement process. If the property is conferred as part of the recipient‘s estate to someone without a protected interest in it (e.g., an adult child), the transferee must pay off Medicaid‘s claim in order to receive a clear title to the property” (emphasis added).
HHS Policy Brief No. 4, supra at 7. Thus, under the Medicaid Act, unless the permanently institutionalized member is discharged from the medical facility and returns home (at which time the TEFRA lien shall dissolve), a State may opt to allow a TEFRA lien to run with the encumbered property until the underlying debt it secures is paid. The question in this case is whether the Legislature has opted to take advantage of this available option.
A. Massachusetts‘s lifetime sale requirement. In Massachusetts, as permitted by the Medicaid Act, the Legislature has authorized MassHealth not only to attempt to recover Medicaid expenditures from the estate of a permanently institutionalized member, but also to commence recovery efforts prior to such a member‘s death under certain conditions. Specifically,
which [MassHealth] has a lien or encumbrance under
Importantly, unlike the
And while not dispositive, see note 16, supra, HHS has concluded:
“In Massachusetts, TEFRA liens . . . give the State authority to recover Medicaid payments for a member‘s long-term care expenses if his or her property is sold while the member is alive. . . .
“If there was a [TEFRA] lien on the member‘s real property, [MassHealth] must release it after they have received notification of the member‘s death and a copy of the death certificate” (emphasis added).
Office of Assistant Secretary for Policy and Evaluation, United States Department of Health and Human Services, Medicaid Liens and Estate Recovery in Massachusetts, at 3, 13 (Apr. 2005) (HHS Policy Brief No. 5).23
That structure evinces a legislative intent to cabin narrowly MassHealth‘s authority to recover from members, precluding any means of recovery except as affirmatively provided. See Department of Pub. Welfare v. Anderson, 377 Mass. 23, 27 n.3 (1979) (“The primary purpose of both the Federal and State statutes is to bar recovery . . . In both statutes, the clause permitting recovery from the estate . . . appears as an exception and therefore should
Indeed, such a construction would be at odds with the Legislature‘s decision to limit the scope of MassHealth‘s authority to enforce TEFRA liens beyond that required under the
Our construction of MassHealth‘s authority to enforce a TEFRA lien also finds support in the рurpose that gave rise to the TEFRA lien program, discussed in part 3.a.ii, supra, to thwart efforts by a permanently institutionalized member to evade estate recovery by transferring his or her home, which is usually the member‘s only significant asset, to a family member. By expressly limiting MassHealth‘s authority to enforce a TEFRA lien to “during [the member‘s] lifetime,” the Legislature narrowly targeted the estate recovery avoidance tactic that Congress sought to foreclose. See St. 1997, c. 43, § 94 (enacting
The broad authority MassHealth advocates also runs counter to the Legislature‘s decision to limit the scope of the recoverable estate to the “probate” estate.26 See
A construction that would allow MassHealth to enforce a TEFRA lien after a member‘s death would
Further, a construction that would permit MassHealth to enforce a TEFRA lien after the member‘s death contravenes the Legislature‘s specific delineation of the relative priorities of various creditors, including MassHealth, in connection with the disposition of a probate estate. See
B. Limited post-death enforcement authority. Relying on
“If the personal representative wishes to sell or transfer any real property against which [MassHealth] has filed a lien or claim not yet enforceable because circumstances or conditions specified in [G. L. c. 118E, § 31,] continue to exist,28 [MassHealth] shall release the lien or claim if the personal
representative agrees to (1) either set aside sufficient assets to satisfy the lien or claim, or to give bond to [MassHealth] with sufficient surety or sureties and (2) repay [MassHealth] as soon as the circumstances or conditions which resulted in the lien or claim not yet being enforceable no longer exist. Notwithstanding the foregoing provision or any general or special law to the contrary, [MassHealth] and the parties to the sale may by agreement enter into an alternative resolution of [MassHealth]‘s lien or claim.” (Emphases added.)
While the interrelationship between
Instead, we construe
In such a circumstance, MassHealth may enforce the lien after the member‘s death as set forth in
b. Applicability of the MUPC time limit. We turn to the second question on appeal -- whether the “ultimate time limit” provision of the MUPC,
Absent a clear indication of legislative intent, a statute presumptively operates prospectively only. See Sliney v. Previte, 473 Mass. 283, 288 (2015); Federal Nat‘l Mtge. Ass‘n v. Nunez, 460 Mass. 511, 516 (2011) (“As a general matter, all statutes are prospective in their operation . . . and [have] no retroactive effect” [quotation and citation omitted]). This presumption applies to statutes of repose such as
Here, the Legislature expressed its intent that the current version of the ultimate time limit,
“If a right is acquired, extinguished or barred upon the expiration of a prescribed period that has commenced to run
under any other statute before the effective date of this act, that statute shall continue to apply to the right even if it has been superseded.”38
Similarly, St. 2008, c. 521, § 43 (4), which applies to the MUPC‘s original enabling act, and thus to the original version of the ultimate time limit, provides:
“[A]n act done before the effective date [of the MUPC] in any proceeding and any accrued right is not imрaired by this act. If a right is acquired, extinguished or barred upon the expiration of a prescribed period of time which has commenced to run by the provisions of any statute before the effective date, the provisions shall remain in force with respect to that right.”39
Because Mason died on August 18, 2008, prior to the July 8, 2012, effective date of
4. Conclusion. So much of the order of the Probate and Family Court judge as dismissed MassHealth‘s claim against the decedent‘s estate is reversed; the order is otherwise affirmed, and the matter is remanded for further proceedings consistent with this opinion.
So ordered.
Notes
As discussed in part 3.a.ii, supra,
“any other real and personal property and other assets in which the individual had any legal title or interest at the time of death (to the extent of such interest), including such assets conveyed to a survivor, heir, or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement.”
“(1) a sibling who had been residing in the property for at least one year immediately prior to the individual being admitted to a nursing facility or other medical institution; or (2) a child who (i) had been residing in the property for at least two years immediately prior to the parent being admitted to a nursing facility or other medical institution; and (ii) establishes to the satisfaction of [MassHealth] that he provided care which permitted the parent to reside at home during that two year period rather than in an institution; and (iii) has lawfully resided in the property on a continuous basis while the parent has been in the medical institution.”
“If repayment is not yet required because a relative specified above is still lawfully residing in the property and the individual wishes to sell the property, the purchaser shall take possession subject to the lien or [MassHealth] shall release the lien if the [permanently institutionalized member] agrees to (1) either set aside sufficient assets to satisfy the lien or give bond to the division with sufficient sureties and (2) repay [MassHealth] as soon as the specified relative is no longer lawfully residing in the property. Notwithstanding the foregoing or any general or special law to the contrary, [MassHealth] and the parties to the sale may by agreement enter into an alternative resolution of [MassHealth‘s] lien.”
“No informal probate or appointment proceeding or formal testacy or appointment рroceeding . . . may be commenced more than [three] years after the decedent‘s death, except that: . . . (4) an informal appointment or a formal testacy or appointment proceeding may be commenced thereafter if no proceedings relative to the succession or estate administration has occurred within the [three] year period after the decedent‘s death, but the personal representative shall have no right to possess estate assets as provided in
[§] 3-709 beyond that necessary to confirm title thereto in the successors to the estate and claims other than expenses of administration shall not be presented against the estate” (emphases added).
