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COMAR 10.09.24.15

1502

State of Maryland Medical Assistance Manual Revised July 2012

1500.1 Introduction- Liens, Adjustment and Recoveries

The Department has the right to make a claim against a recipient‟s income and/or resources under several circumstances. These circumstances are: A court order exists which permits the Department to take such action. MA benefits have been paid pending an appeal hearing. A third party may be responsible for medical expenses as a result of a lawsuit or other legal action. The recipient is deceased and received MA benefits at 55 or over. A recipient voluntarily reimburses the Program for expenditures. Health insurance coverage is available to cover expenses paid by the Department. An institutionalized person owns real property against which a lien may be placed.

The Department may not seek recovery from the estate of the deceased individual for Medical Assistance payments of Medicare premiums, co-payments, or deductibles as a Qualified Medicare Beneficiary (QMB) or Specified Low Income Medicare Beneficiary (SLMB).

Claims against a recipient‟s income and/or resources are made by the Division of Recoveries and Financial Services (Recoveries). This unit is responsible for carrying out all activities to make claims and recoveries on behalf of the Department; however, the activities of Recoveries must be coordinated with those of the LDSS. The LDSS is responsible for reporting complete information to Recoveries to enable that unit to pursue claims and recoveries. The extent to which claims and recoveries are made and the appropriateness of certain legal actions are the responsibility of Recoveries.

Address:

Medical Care Compliance Administration, Division of Medical Assistance Recoveries, 201 West Preston Street Rm 204 Baltimore, MD 21201

Phone number: 410-767-6614

1500.2 Court Order