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COMAR 10.09.24.01-.16 1734 State of Maryland Medical Assistance Manual Revised July 2012

A-1. The Department shall make a claim against income or resources, or both, of a recipient for benefits correctly paid, or to be paid, under the following circumstances:

(1) Under a court order;

(2) In any situation in which a recipient has a cause of action against any person for medical expenses arising from that cause of action; or

(3) As a result of payment by the Department for services for which health care coverage was available to a recipient.

A-2. Liens.

(1) Incorrect Payments. Following a court judgment which has determined that benefits were incorrectly paid for a person, the Department shall impose a lien against the person's property, both personal and real, before the person's death, on account of Medical Assistance claims paid or to be paid on the person's behalf.

(2) Correct Payments. Except as provided under §A-2(3) of this regulation, the Department shall impose a lien against the real property of a person, before the person's death, on account of Medical Assistance claims paid or to be paid on that person's behalf under the following circumstances:

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Page 134

Official source

COMAR 10.09.24.01-.16 1734 State of Maryland Medical Assistance Manual Revised July 2012

A-1. The Department shall make a claim against income or resources, or both, of a recipient for benefits correctly paid, or to be paid, under the following circumstances:

(1) Under a court order;

(2) In any situation in which a recipient has a cause of action against any person for medical expenses arising from that cause of action; or

(3) As a result of payment by the Department for services for which health care coverage was available to a recipient.

A-2. Liens.

(1) Incorrect Payments. Following a court judgment which has determined that benefits were incorrectly paid for a person, the Department shall impose a lien against the person's property, both personal and real, before the person's death, on account of Medical Assistance claims paid or to be paid on the person's behalf.

(2) Correct Payments. Except as provided under §A-2(3) of this regulation, the Department shall impose a lien against the real property of a person, before the person's death, on account of Medical Assistance claims paid or to be paid on that person's behalf under the following circumstances:

(a)The person owns real property, is a patient in a…#

(a) The person owns real property, is a patient in a long-term care facility, and is required, as a condition of receiving Medical Assistance services, to spend for costs of medical care all but a minimal amount of his income required for personal needs; and

(b)The Department has determined, after notice and…#

(b) The Department has determined, after notice and opportunity for a hearing, that there is no reasonable expectation that the person can be discharged from the long-term care facility and return home.

(3) Restrictions on Placing a Lien. The Department may not impose a lien on the home of an institutionalized individual under §A-2(2) of this regulation if any of the following individuals lawfully reside in the home. The institutionalized individual's:

(a) Spouse;

(b) Child as defined in Regulation .02B of this chapter;

(c)Son or daughter who is blind or disabled as defined in…#

(c) Son or daughter who is blind or disabled as defined in Regulation .05D and E of this chapter; or

(d)Sibling, who has an equity interest in the home and who…#

(d) Sibling, who has an equity interest in the home and who was residing in the home for a period of at least 1 year immediately before the date of the institutionalized person's admission to a long-term care facility.