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Administrative Manual Section: General Administrative Procedures and Compliance Policy Manual Number: 200.010 Chapter: Rights and Responsibilities
February 1, 2024 Division of TennCare 7
a. Estate recovery applies to:
i. TennCare Medicaid-covered services received by individuals permanently confined to a long-term care facility, regardless of age; ii. TennCare Medicaid-covered services received in a long-term care facility or in a home and community-based services setting and related hospital and prescription drug services, by individuals age 55 or older.
b. Adjustment or recovery from the recipient’s estate may be pursued only:
i. After the death of the individual’s surviving spouse, if any; and ii. Only at a time when the individual has no surviving child who is under eighteen (18) years of age or no surviving child, as defined in § 1614 of the Social Security Act, who is blind or permanently and totally disabled, or a child who became blind or permanently and totally disabled after reaching majority, if TennCare and the personal representative agree, or, in the event of a disagreement, the court, after de novo review, finds that repayment would constitute an undue hardship to the blind or disabled child. See Tenn. Code Ann. § 71-5- 116(c)(1).
TennCare Member Services is required to inform the responsible party of individuals in long- term care facilities about the estate recovery provisions. Information about estate recovery is available in the TennCare application. The State cannot impose a lien on real property which is occupied by an applicant for TennCare Medicaid.
a. Estate Recovery Unit
The Estate Recovery Unit is responsible for the estate recovery program. The TennCare Reform Act of 2002 requires a release to be obtained from TennCare indicating that no money is owed by a former Medicaid recipient before an estate can be settled. For further information, attorneys or relatives may contact:
Bureau of TennCare Estate Recovery Unit 310 Great Circle Road Nashville, TN 37243 Telephone: 1-866-389-8444 Fax: 615-413-1941