States Becoming More Aggressive In Medicaid Estate Recovery Programs

January 4, 2007 – 12:49 pm | posted in Medical Malpractice, Medicare

The Christian Science Monitor last week examined how federally mandated Medicaid estate-recovery programs “have produced confusion, anger and even lawsuits.” According to the Monitor, some states are becoming more aggressive in claiming Medicaid beneficiaries’ estates after their deaths. States often “target the home because it’s all that’s left after beneficiaries have spent their assets to pay for nursing home care,” the Monitor reports. Families generally are notified about estate-recovery programs when a beneficiary applies for Medicaid coverage and again when the beneficiary dies, according to Wendy Fox-Grage, a policy adviser at the AARP Public Policy Institute. However, Fox-Grage said there is concern that “families are not being notified” of states’ policies. The Monitor reports that information about estate-recovery programs often is provided “as part of a long list of things a Medicaid applicant should know.” In addition, Fox-Grage said not all states tell families about available hardship waivers. An AARP report found that in fiscal year 2003, states recouped $347 million from estate-recovery programs and that eight states recovered more than 1% of Medicaid long-term care costs through the programs. The Monitor reports that some states “have tried to remove themselves from the process altogether on the grounds it could impoverish beneficiaries’ families.” West Virginia in 2001 challenged the constitutionality of the programs, but a U.S. circuit court upheld the rule, noting that states could lose federal Medicaid funding if they did not comply. Families are exempt from estate recovery if a spouse or a dependent younger than age 21 is still living. However, Tim Takacs, an attorney and elder law expert, said confusion surrounding estate-recovery programs may lead some seniors to avoid applying for health care benefits. Takacs said, “Our concern is that people will say, ‘I don’t want my husband to go to the nursing home because then the government will take my house.’” CMS spokesperson Mary Kahn said Medicaid is intended “for people with no alternative.” She added, “If the state is able to recover expenses that they put forth, then that money will be there for the next person down the line who desperately needs help” (Green, Christian Science Monitor, 12/26/06).

“Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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