Effective July 1, 1994, Medicaid will seek recovery from the estate of deceased
Medicaid recipients who are age 55 or older and in a nursing facility, or enrolled
in a Home and Community Based Ser-vices Waiver Program at the time of death. Recovery
will be made from any real or personal property in the estate of the recipient up
to the value of payments made by Medicaid for nursing facility, hospital and drug
services. Estate recovery will not apply to recipients who have a surviving spouse
or dependant or disabled child.
Federal Law on Medicaid Estate Recovery
Copyright(c) West Publishing Co. 1995 No claim to original U.S. Govt. works.
42 USC 1396p
(b) Adjustment or recovery of medical assistance correctly paid under State plan
(1) No adjustment or recovery of any medical assistance correctly paid on behalf
of an individual under the State plan may be made, except that the State shall seek
adjustment or recovery of any medical assistance correctly paid on behalf of an
individual under the State plan in the case of the following individuals:
(A) In the case of an individual described in subsection (a)(1)(B) of this section,
the State shall seek adjustment or recovery from the individual's estate or upon
sale of the property subject to a lien imposed on account of medical assistance
paid on behalf of the individual.
(B) In the case of an individual who was 55 years of age or older when the individual
received such medical assistance, the State shall seek adjustment or recovery from
the individual's estate, but only for medical assistance consisting of--
(i) nursing facility services, home and community-based services, and related hospital
and prescription drug services, or
(ii) at the option of the State, any items or services under the State plan.
(C)(i) In the case of an individual who has received (or is entitled to receive)
benefits under a long-term care insurance policy in connection with which assets
or resources are disregarded in the manner described in clause (ii), except as provided
in such clause, the State shall seek adjustment or recovery from the individual's
estate on account of medical assistance paid on behalf of the individual for nursing
facility and other long-term care services.
(ii) Clause (i) shall not apply in the case of an individual who received medical
assistance under a State plan of a State which had a State plan amendment approved
as of May 14, 1993, which provided for the disregard of any assets or resources--
(I) to the extent that payments are made under a long-term care insurance policy;
(II) because an individual has received (or is entitled to receive) benefits under
a long-term care insurance policy.
(2) Any adjustment or recovery under paragraph (1) may be made only after the death
of the individual's surviving spouse, if any, and only at a time--
(A) when he has no surviving child who is under age 21, or (with respect to States
eligible to participate in the State program established under subchapter XVI of
this chapter) is blind or permanently and totally disabled, or (with respect to
States which are not eligible to participate in such program) is blind or disabled
as defined in section 1382c of this title; and
(B) in the case of a lien on an individual's home under subsection (a)(1)(B) of
this section, when--
(i) no sibling of the individual (who was residing in the individual's home for
a period of at least one year immediately before the date of the individual's admission
to the medical institution), and
(ii) no son or daughter of the individual (who was residing in the individual's
home for a period of at least two years immediately before the date of the individual's
admission to the medical institution, and who establishes to the satisfaction of
the State that he or she provided care to such individual which permitted such individual
to reside at home rather than in an institution),
is lawfully residing in such home who has lawfully resided in such home on a continuous
basis since the date of the individual's admission to the medical institution.
(3) The State agency shall establish procedures (in accordance with standards specified
by the Secretary) under which the agency shall waive the application of this subsection
(other than paragraph (1)(C)) if such application would work an undue hardship as
determined on the basis of criteria established by the Secretary.
(4) For purposes of this subsection, the term "estate", with respect to a deceased
(A) shall include all real and personal property and other assets included within
the individual's estate, as defined for purposes of State probate law; and
(B) may include, at the option of the State (and shall include, in the case of an
individual to whom paragraph (1)(C)(i) applies), 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.
Mississippi Medicaid Estate Recovery Law
Mississippi Code §43-13-317
(1) The division shall be noticed as an identified creditor against the estate of
any deceased Medicaid recipient underSection 91-7-145.
(2) In accordance with applicable federal law and rules and regulations, including
those under Title XIX of thefederal Social Security Act, the division may seek recovery
of payments for nursing facility services, home- and community-based services and
related hospital and prescription drug services from the estate of a deceased Medicaidrecipient
who was fifty-five (55) years of age or older when he or she received the assistance.
The claim shall bewaived by the division (a) if there is a surviving spouse; or
(b) if there is a surviving dependent who is under the ageof twenty-one (21) years
or who is blind or disabled; or (c) as provided by federal law and regulation, if
it isdetermined by the division or by court order that there is undue hardship.
Sources: Laws, 1994, ch. 649, §8; Laws, 2004, ch. 593, §7, eff from and after July
1, 2004. Sources: Laws, 1994, ch. 649, §8; Laws, 2004, ch. 593, §7, eff from and
after July 1, 2004.