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Title 8: Medicaid Page 26 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Estate Recovery Revised July 10, 2026 Establishing Whether a Member Under Age 55… If the Medical Services Unit determines that the member cannot reasonably expect to return home, the Unit will provide information to the member and to you about whether the member was ever able to return home within the first six months of institutionalization and the date the expectation and ability to return home ceased. File a copy of the determination in the case record. A member may appeal an adverse decision. The member first appeals through the IME Medical Services Unit for reconsideration. If the member disagrees with the reconsideration decision, the member or someone acting responsibly for the member can appeal an adverse reconsideration decision by IME Medical Services Unit though normal DHS appeal procedures. Requests for the IME Medical Services Unit determination are timely when filed within 30 calendar days from the date form 470-3209, Estate Recovery Six- Month Follow-Up is issued. The member may still make a request later. However, if the decision then is that the member is reasonably able to return home, assistance received before the date the request was submitted to DHS is still subject to estate recovery. Estate Recovery Agent Estate recovery activities are conducted by the Revenue Collection Unit at the Iowa Medicaid. The Revenue Collection Unit may request a copy of the member’s first and last application or review form to determine if there are resources that could be subject to estate recovery. When sending a copy of the requested forms, record the member’s name, state identification number, social security number, and case number on each sheet. Additionally, the Revenue Collection Unit compares monthly Medicaid eligibility files against Vital Statistics records on reported deaths in Iowa to determine when estate recovery can be initiated for an individual.