On February 22, 2011, the Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) issued a letter to Secretary of Health and Human Services, JudyAnn Bigby, indicating that MassHealth must allow a MassHealth recipient to use their Patient Pay Amount (PPA) to pay for medical expenses incurred prior to eligibility. The policy change essentially allows the individual to use their income that would otherwise be included in the monthly PPA, in order to satisfy outstanding medical bills which were incurred prior to the date of eligibility. Although this letter was issued last winter, it is only in recent months that practitioners have been successful in forcing MassHealth to comply with the CMS directive.

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Should a husband and wife who are competent and confident regarding their end of life decisions be obstructed for choosing to die? Recently, The New York Times discussed a couple’s plan for death in an article entitled “Deciding to Die, Then Shown the Door.” The article highlighted an elderly couple who had implemented a plan for their death after discussing the various options for over a decade.

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