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UPDATED: JANUARY 2012

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OTHER ELIGIBILITY REQUIREMENTS RECOVERIES

LIENS

Description: A lien is a legally filed claim against property as security for the payment of a debt.

Policy: Generally a lien may be placed against a recipient's:

• exempt real property if the individual is permanently institutionalized; and • personal injury claim or suit for Medicaid expenditures related to the injury. A claim may be placed against a recipient's:

• estate including non-probate assets, if the deceased recipient was 55 years of age or older when he or she received Medicaid; and • estate including non-probate assets, if the deceased recipient of any age was permanently institutionalized.

References: SSL Sect. 104

106

366.3(a)

369

Dept. Reg. 360-7.11

ADMs 11 OHIP/ADM-8

09 OHIP/ADM-3

02 ADM-03

92 ADM-53

Interpretation: When a recipient is permanently institutionalized and has an interest in real property that is exempt for purposes of Medicaid eligibility, is anticipating a court award, settlement, or claim that resulted from a personal injury or has died and left an estate, a lien is placed against the exempt real property, award, settlement, claim or estate. An award, settlement or claim may result from, but is not limited to insurance payments and lawsuits. Generally, liens against real property and estates are for the amount of Medicaid correctly paid on behalf of the individual, while liens for personal injury are for the cost of medical care provided to treat the personal injury.

Incorrectly paid Medicaid is any Medicaid furnished to a recipient at a MRG