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State of Maryland Medical Assistance Manual Revised July 2012 Attachment B Note of Potential MA Payment Recovery-DHMH 1169 Attachment C Referral for Investigation-DHMH 4243 Attachment D Explanation of Lien-DHMH 4244 Attachment E Physician Report-DHMH 4245 (LTC) Attachment F Lien Worksheet-DHMH 1159C (LTC) Attachment G Lien Memorandum- DHMH 4242 (LTC) Attachment H Home Exclusion-Statement of Intent DHMH 4255 (LTC) Attachment I Notice of Medical Review Decision-Home Property-DHMH 4255

1500.16 Lien Process Flow Chart for Institutionalized Persons

Frequently Asked Questions (FAQs) and Answers

Objectives for Section 1500

1. Define Liens, Adjustments and Recoveries; 2. Provide in detail Restrictions on the Imposition of a Lien; 3. Explain the Medical Review Process.