1725.1 Recoveries through Court

Beginning July 1, 1992, the agency is allowed to establish a legal claim for medical assistance provided after June 30, 1992, to persons who, prior to their death:

were 55 years of age or older (except for recipients of QMB, LMB, or QWD only); or

were receiving long-term institutional care, including when provided through a PACE program at the time of death.

The claim would normally be filed against the client's decedent's, conservatorship’s, and guardianship's estate. These estates consist of the property owned solely by the deceased medical assistance recipient.

Expanded Estate - For medical assistance provided on or before June 30, 2004, the agency's claim applies to the aforementioned estate. However, for medical assistance provided after June 30, 2004, the agency may establish a claim on any property interest owned by the deceased medical assistance recipient. The agency’s claim will apply to the deceased recipient’s 'medical assistance estate' (K.S.A. 39-709). This estate will include all real and personal property in which the deceased individual had any legal title or interest immediately before or at the time of death to the extent of that interest or title. The medical assistance estate includes, without limitation, assets conveyed to a survivor, heir or assign of the deceased recipient through joint tenancy, tenancy-in-common, survivorship, transfer-on-death deed, pay-on-death contract, life estate, trust, annuity, life insurance policy (whole or term life) or similar arrangement. The medical assistance estate is limited to the recipient’s interest in the property. The expanded definition also applies to the surviving spouse of a recipient. Example : A medical assistance recipient has an interest in a house valued at $100,000. He added his daughter’s name to the deed 7 years earlier when his wife died. The deed is a joint tenancy deed with rights of survivorship. He received medical assistance for the period of July 2003 through June 2005 with a total claim amount of $60,000. He received $30,000 in benefits in the period of July 1, 2004, to June 30, 2005, when he died. The house is the only asset. The state has a claim for $30,000 (July 1, 2004 - June 30, 2005) against his half - interest ($50,000) in his house. Assistance provided prior to July 1, 2004, cannot be used as a claim against his interest in the house.

Exceptions to Claims through Courts - If there is a surviving spouse, no probate would be started, and no claim would be filed at the time of the individual’s death. A claim will not be established if the surviving children are under the age of 21 years or are blind or permanently disabled according to Social Security criteria. No claim will be established for those who solely received coverage under QMB, LMB, or QWD.

Priority of Claims in Courts - In cases involving a decedent’s estate, the claim will be a first class claim against the estate of the deceased person. Payment of reasonable funeral expenses will be the only allowable claim prior to a medical assistance claim. In cases involving a guardianship or conservatorship, the claim is discretionary with the court and is payable in the amount determined by the court.