317.03 Reimbursement - Medical Assistance for Non-Institutionalized Individuals (AAM)

317.03 Reimbursement - Medical Assistance for Non-Institutionalized Individuals (AAM)

SR 11-43 Dated 11/11 Previous Policy

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Inform all non-institutionalized applicants for medical assistance under the OAA, ANB, MEAD, BCCP, and APTD programs:

. of DHHS ' s obligation to recover from their estate for medical assistance received by recipients age 55 and older;

. that for the purposes of recovery of medical assistance, a recipient ' s "estate" includes:

- all property, real or personal, in which the recipient holds an interest on the date of the recipient ' s death. Such interests include joint tenancy with rights of survivorship, tenancy in common, life estates, and living trusts, without regard to the date that such title or interest was established; and

- both assets that pass through probate and assets that pass outside the probate process, such as certain trust assets, assets held jointly, and unpaid annuity balances that benefit the recipient;

. that DHHS will only pursue recovery from the recipient ' s assets;

. that DHHS will only pursue recovery after the recipient ' s death, unless the property is voluntarily sold or refinanced while a lien is in place;

. that if DHHS ' s pursuit of recovery would cause undue hardship to the recipient ' s heirs, a waiver is available when recovery action begins;

. that DHHS will pursue recovery from the recipient ' s estate, but only if the recipient has no surviving spouse, child who is under age 21 years, or child who is blind or permanently and totally disabled; and

. that recovery is limited to the actual amount paid on behalf of the recipient from age 55 and older.

Exception : If benefits were incorrectly paid, recoupment of the erroneous payment can be required while the recipient is alive or regardless of the above criteria for recovery. See PART 633 , RECOUPMENT OF MEDICAL ASSISTANCE .

Inform the individual or the ANB child ' s parents of DHHS ' s recovery obligations and the recipient ' s rights and responsibilities with DFA Form 770, Reimbursement Agreement and Acknowledgment . Failure or refusal to complete the medical assistance portion of DFA Form 770 does not result in denial or termination from assistance.

*Scan the original signed DFA Form 770 *into the individual ' s electronic case record.