Opinion
No. 11–P–1037.
2012-07-16
Stephen P. KNIGHT v. DIVISION OF MEDICAL ASSISTANCE.
By the Court (BERRY, MILKEY & SULLIVAN, JJ.).
MEMORANDUM AND ORDER PURSUANT TO RULE 1:28
The plaintiff appeals from a judgment affirming the Division of Medical Assistance's (DMA) determination that he is ineligible to receive Medicare Part B premiums because his income exceeds the allowable maximum.
The plaintiff filed a motion to stay the judgment of the Superior Court pending the outcome of this appeal. That motion was denied by a single justice of this court. The plaintiff filed a notice of appeal from that denial. That appeal has been consolidated with the present appeal. In light of our disposition, the requested relief—allowing the plaintiff's motion to stay the judgment of the Superior Court—is moot.
The plaintiff is under the age of sixty-five, disabled, living in a one-person household, and began receiving State assistance for his Medicare Part B premiums in 1999. In July, 2005, the DMA switched the plaintiff's coverage from MassHealth Standard, a form of coverage that includes Medicare Part B coverage, to MassHealth CommonHealth, a type of coverage that does not include Medicare Part B coverage. DMA changed the plaintiff's coverage because his income rose above the maximum level permitted under MassHealth Standard. The plaintiff challenged the switch and a hearing took place. DMA affirmed the change in coverage and a Superior Court judge affirmed DMA's decision. The plaintiff filed an untimely notice of appeal and a panel of this court dismissed the appeal in a memorandum and order pursuant to rule 1:28.
Knight v. Division of Med. Assistance, 71 Mass.App.Ct. 1114 (2008).
Notwithstanding that result, DMA continued to pay the plaintiff's Medicare Part B coverage. DMA contends that this continued payment was the result of a “computer error.” DMA discovered its error in July, 2009, and notified the plaintiff at that time that his Medicare Part B coverage would be discontinued.
The plaintiff again protested, citing numerous grounds for his belief that DMA ought to be estopped from discontinuing his Medicare Part B coverage. Following a hearing, DMA concluded that the plaintiff's income exceeded the maximum allowable to receive Medicare Part B coverage and that, therefore, the plaintiff's coverage had been properly discontinued. A Superior Court judge affirmed that determination, finding that “[t]he record does not show a prejudicial error of law or a lack of substantial evidence to support the [b]oard decision.” The plaintiff filed numerous postjudgment motions, all of which the judge denied without substantive comment.
The plaintiff's appellate arguments focus on alleged procedural irregularities, which include, but are not limited to, that: there was a refusal to allow the plaintiff to cross-examine a particular witness; notice of the administrative hearing was defective; DMA's web page—by indicating that Medicare Part B coverage is available to persons over the age of sixty-five (the plaintiff is under that age)—prevents DMA from denying him coverage (or perhaps violates his due process rights); the Superior Court judge made numerous unspecified errors, failed to make separate findings of fact and rulings of law, and improperly denied various of the plaintiff's postjudgment motions.
Notwithstanding these host of purported irregularities, the plaintiff has repeatedly failed to address the dispositive fact that his monthly income is at least $1,744, an amount that exceeds the maximum allowable to receive coverage for Medicare Part B premiums. See 130 Code Mass. Regs. 505.002(F)(2)(b) and (G)(2009) (eligibility for MassHealth Standard and payment of Medicare Part B premiums requires gross income less than or equal to 133 percent of Federal poverty level). The plaintiff's income amounted to 193 percent of the 2009 Federal poverty level. In sum, the plaintiff fails to establish any error in DMA's decision. See G.L. c. 30A, § 14(7), and G.L. c. 118E, §§ 7, 9, and 12. See also Andrews v. Division of Med. Assistance, 68 Mass.App.Ct. 228, 231 (2007) (“the burden is on the appealing party to demonstrate the invalidity of the administrative determination”). Moreover, as noted in the plaintiff's 2006 appeal, “[o]ur review of the administrative record ... persuades us that the Superior Court did not violate [the plaintiff's] due process rights or commit any procedural impropriety warranting reversal.” Knight v. Division of Med. Assistance, 71 Mass.App.Ct. 1114 (2008).
Judgment affirmed.