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COMAR 10.09.24.15

1509

State of Maryland Medical Assistance Manual Revised July 2012 That a lien is a claim against a person‟s property as security for payment of a debt. For MA recipients, this means, when the property is sold, the Program will be entitled to an amount up to that which has been expended on recipient‟s behalf. That a lien does not affect ownership interest in a property until it is sold, at which time the Program will be entitled to reimbursement for expenditures paid on behalf of the recipient. That if the home is occupied by a “specified relative”, the lien will not be imposed. (Refer to Restriction on the Imposition of a Lien).

NOTE: The fact that a “dependent relative” lives in the home which may result in the exclusion of the home as a resource, does not preclude imposition of a lien. (Refer to Chapter 8, Evaluation of the Home Property of an Institutionalized Person for a listing of “dependent relatives).

That a medical review will be conducted to determine if there is a reasonable expectation that the person will be able to return to live in his/her home property. If the person is expected to return, the lien will not be imposed. If the person is not expected to return, the lien will be imposed. That if a lien is imposed and the person is discharged from the LTCF and resumes living in his/her home property, the lien will be lifted. If the person is discharged but does not resume living in the home property, the lien may not be lifted. That disposal of the home property for less than fair market value within 60 months prior to or subsequent to the month of application may result in ineligibility. This applies even if the institutionalized person was living in the home at the time of disposal. Transfer of the home to the spouse, unmarried child under 21, or a blind or disabled son or daughter of any age will not affect eligibility. (Refer to Chapter 8, Disposal of Resources).

STEP 3

Determine if the home property is occupied by the person‟s spouse, unmarried child under 21, blind or disabled son or daughter of any age, or brother or sister, who satisfy the conditions specified under the section Restrictions on the Imposition of a Lien. a. If the home is occupied by anyone of these “specified relatives listed above, the lien will not be imposed. Inform the representative that any change in occupancy must be reported. GO TO STEP 4a b. If the home is not occupied by anyone of these “specified relatives”, the home and other real property may be subject to a lien. GO TO STEP 4b

STEP 4

Is the Physician Report (DHMH Form 4245 LTC) required? a. The Physician Report is not required when the home is occupied by “specified relatives”, (Step 3 a). File the Explanation of Lien and Lien Worksheet in the case