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Medical Services Policy Manual, Section H

H 600 Estate Recovery

H-600 Estate Recovery MS Manual 08/29/22 The Omnibus Budget Reconciliation Act of 1993 and Arkansas Act 415 of 1993 mandate recovery of medical payments correctly made from August 13, 1993 and later from the estates of: ● Individuals of any age who were considered to be permanently institutionalized, who receivedmedical services in a nursing or ICF/IID facility, and who were required to pay all but a minimal amount of income for their care, and ● Individuals fifty-five (55) years of age and older who received medical services in a nursing or ICF/IID facility or in a home and community based waiver program, whether or not they were considered to be permanently institutionalized. Estate recovery will not be made from the estate of deceased individuals when: ● There is a surviving spouse, dependent children under twenty-one (21) years of age, or children who are blind or have a disability (as determined by SSA disability guidelines), ● Recovery will create an undue hardship for other surviving family members, or ● Recovery is not cost effective. Estate recovery will not be made from resources that were protected as a result of the individual having a Qualified Long Term Care Insurance Partnership Policy. The maximum amount protected at estate recovery will be the amount protected when eligibility was established. If any of the protected resources have been spent or given away, only the amount remaining will be protected at estate recovery. Estate recovery will not be made from interests acquired through grant of a beneficiary deed, per Arkansas Act 570 of 2021 when: • The beneficiary deed was properly executed and recorded; and • Documentation has been provided to the entity seeking recovery. H-620 County Office Responsibilities MS Manual 07/13/15 During the application process for nursing facility, ICF/IID, or waiver services, the caseworker will review the initial estate recovery notice on the back of the DCO-777 with the applicant or representative. The MS H-600-650 section can be used as the basis to provide additional information if needed. If the applicant or representative has questions which the caseworker cannot answer, a suggestion may be made to make further inquiries of an attorney. The determination that an individual under age 55 is considered permanently institutionalized will be made based on the medical information submitted on the DHS-703 for nursing facility residents, or on the DHS-703A for ICF/IID residents.