Estate property includes all real and personal property of a decedent which is subject to administration by a decedents personal representative, whether actually administered or not administered. Medicaid Estate Recovery claims are filed according to the states' probate . The date on the statement of claim shall establish the Departments issuance date of the statement of claim. Pennsylvania is one such state, as it allows the exclusion of cash value up to $1,000 if an applicant's . (b)The Departments claim against deposit accounts and patient care accounts subject to 20 Pa.C.S. (c)The personal representative will be deemed to have complied with his responsibilities to protect the Departments claim during the postponement period if, after liquidating the assets as appropriate and paying all expenses of administration and superior claims of creditors against the estate, the personal representative takes one or more of the following actions until the Departments claim is fully protected, or until all protectable assets are protected. You might not be able to collect the benefits you need for many years. The state will also postpone collection of its estate recovery claim until: In addition to a probate estate, the state can recover its Medicaid costs from: Pennsylvanias regulations provide that certain additional items are not subject to, or are specifically exempt from, estate recovery: As you can see, Pennsylvania may be able to recoup Medicaid costs from Aunt Marthas estate. Box 8486 Harrisburg, PA 17105-8486 Facsimile # (717)772-6553 . Pennsylvanias Estate Recovery Program can only reach Applicable law reads that With the approval of the Governor, the Department may expand the estate recovery by regulation to include medical assistance for services other than those listed in this section and to recover against other real and personal property in which an individual had any legal title or interest at the time of death. In other words, the law can change such that estate recovery may in the future apply tonon-probate property such as jointly owned property. The limits increase for married couples. Improper transfer or sale of such protected assets will also result in personal liability for the personal representative. (2)The court records show that the personal representative made the inquiry required by 258.4 (relating to request for statement of claim) and obtained a statement of claim, if appropriate. TransfereeAn individual or entity, other than a personal representative, possessing or receiving property subject to the Departments claim. This section cited in 55 Pa. Code 258.8 (relating to liability of personal representative). Response periodThe period during which the Department will respond to a notice requesting a statement of claim. If the estates personal representative determines that benefits were received within that five-year window, then the executor or administrator is required to give notice to the department in an effort to obtain a statement of the departments claim. Necessary and reasonable expenses for maintaining the home include real estate taxes, utility bills, home repairs and home maintenance such as lawn care and snow removal necessary to keep the property in condition for the decedent to return home or to sell at fair market value. provides healthcare for people with limited income and assets. Division of Third Party Liability. such as nursing home care and personal care services. (d)The Bureau of Hearings and Appeals has concurrent jurisdiction with the courts of common pleas over disputes involving the computation of the Departments claim or assessment of liability against a personal representative or transferee. We have represented clients dealing with Pennsylvania's Estate Recovery Program since it began in 1995. Your house must be their main and only place to live. 3121 (relating to when available). WARNING: IT IS STRONGLY RECOMMENDED THAT YOU MEET WITH AN ELDER LAW ATTORNEY BEFORE REQUESTING A STATEMENT OF CLAIM FROM THE ESTATE RECOVERY PROGRAM. The Estate Recovery statute in Pennsylvania is set forth at 62 P.S. For states that do have a a statute of limitations for their MERP, its usually one year, as is the case in Florida. If there is one or more surviving owner, and the deed shows that the property is owned jointly with rights of survivorship, the house will not be subject to estate recovery. No part of the information on this site may be reproduced forprofit or sold for profit. The Departments claim will also be waived on a hardship basis for a spouse, child, sibling, or grandchild with respect to income-producing property if the asset is used to generate the primary source of income for the household, and the family would have income below 250% of the federal poverty guidelines without use of the asset. The best practice for the personal representative in this circumstance, other than selling the property to an unrelated third party, is to adequately document the fair market of the asset by way of a professional appraisal. MEDICAL ASSISTANCE ESTATE RECOVERY Sec. Second, the state can recover from a Medicaid recipients probate estate. (i)Waiver requests shall be submitted to the following address: Estate Recovery Program, Post Office Box 8486, Harrisburg, Pennsylvania 17105-8486. The deceased has a blind or disabled child. A facility of payment clause is a contract provision which enables an insurance company to pay policy proceeds directly to certain family members, not to the estate, even where there is no designated beneficiary. (a)A personal representative, transferee or family member adversely affected by a decision of the Department under this chapter may appeal to the Departments Bureau of Hearing and Appeals in accordance with Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings), within 30 days of the date the affected person is notified of the decision. Not every state has a statute of limitations for its MERP. If the house is owned with a surviving spouse, the answer is no. In 27 states, Medicaid Estate Recovery Programs only seek reimbursement from the deceased beneficiarys probate estate. These are known as probate-only states. 91019507 (relating to the Uniform Commercial Code), have been taken to make the lien valid and enforceable against all third parties. 1396p(b)(1)), which mandate that each state operate an estate recovery program. Kaune, Esquire at (610) 933-8069 or email him atdkaune@utbf.com. Section 223 Demonstration Program to Improve Community Mental Health Services. For Medicaid qualification purposes, some assets are (b)The Department will submit a statement of claim to the personal representative within the response period of 45-calendar days in accordance with section 1412(b) of the Public Welfare Code (62 P. S. 1412(b)) relating to repayment from probate estates. A qualified Medicare beneficiary is an individual whose Medicare copayments, premiums or deductibles only are paid by the MA program. Lets deal with the easiest question first. 258.5. 1382. In the many powers of attorney I see in my line of work, one problem recurs over and over again. If she owned her house jointly with another person with rights of survivorship, then the house would not be subject to estate recovery because it would not be part of her probate estate. Fiscal year 2020 2021 (Not yet available). There are certain exceptions to the program. But, there is a big loophole. Medicaid Estate Recovery in PA: How It Works, Estate recovery is Pennsylvanias program, Medicaid estate recovery: dont lose assets on the Back 9.. (b)The personal representative has a duty to insure protection of the Departments claim during the postponement period. He is a Certified Elder Law Attorney with over 20 years of experience helping clients with estate planning, estate administration, and Medicaid planning. Policy. To date, Pennsylvania's Estate Recovery has been limited to a decedent's probate assets. MACBIS. Provided that there is an heir to claim his or her beneficial interest in the estate, the Department will find undue hardship and will permanently waive its claim for administered estates with a gross value of $2,400 or less. The DHS will wait to collect a claim until: There are other reasons the DHS will wait to collect, but these are the most important ones. The term includes: (i)Real estate and all improvements thereto. As a practical matter, the Office of Legal Counsel for the Department has limited resources to allocate to the task of administering these estates and anticipates that it will only rarely do so. If thats not an option, or if no planning was done, a Certified Medicaid Planner can help the Medicaid beneficiary implement strategies to spend their new inheritance on Medicaid-allowed goods and services so they can avoid gaps in coverage and eventually return to Medicaid eligibility. In postponement cases, the executor also has a duty to protect the Commonwealths interest in certain estate protectable assets. For married couples with one Medicaid beneficiary and one non-beneficiary (commonly known as the Community Spouse) where the Medicaid beneficiary dies first, states can not seek reimbursement while the Community Spouse is living. If there is an estate claim, the Department must submit its claim to the executor or administrator within forty-five (45) days of receipt of the notice or the claim is forfeited. State Budget & Expenditure Reporting for Medicaid and CHIP. More details on how Medicaid payback rules handle beneficiarys homes and expanded recovery states can be found below. Another big exception to the Estate Recovery Program has to do with your caregivers. 01. You may have heard the term "estate recovery" before and wondered what it meant. Typically, the recovery program is not concerned with your personal possessions. Edit your pa department of public welfare statement of claim request form online Type text, add images, blackout confidential details, add comments, highlights and more. This is a process that can occur after a Medicaid recipient dies. *It is recommended that you have Robert C. Gerhard, III, Esq. and help you figure out how to protect your legacy from Pennsylvanias Medicaid This hearing is known as a fair hearing. The determination made by the administrative law judge at the fair hearing is subject to reconsideration by the Secretary of the Department ofHuman Servicesand appellate review in Commonwealth Court. Assistance payments made for the decedents nursing home services, home, community-based Estate Recovery What Happens After Death?