B-2610 Types of MEPD Groups Subject to MERP

Revision 18-1; Effective March 1, 2018

On March 1, 2005, Texas implemented MERP in compliance with federal Medicaid and state laws. The program is managed by HHSC. Under this program, the state may file a claim against the estate of a deceased Medicaid recipient who: 1) was age 55 or older when Medicaid services were received; and 2) first applied for certain long-term care services and supports on or after March 1, 2005. The most complete, current and accurate source of information regarding MERP is the HHS website: Medicaid Estate Recovery Program . MERP Claims include the cost of Medicaid assistance paid for the following services:

nursing facilities;

intermediate care facilities for individuals with an intellectual disability or related conditions (ICF/IID), which include state supported living centers;

Home and Community-Based Services waiver programs. See Chapter O , Waiver Programs, Demonstration Projects and All-Inclusive Care;

Community Attendant Services; and

related hospital and prescription drug services.

Notes :

A person who is placed on an interest list for a Home and Community-Based Services waiver program is not considered to be an applicant.

As of Jan. 1, 2010, states are prohibited from recovering the value of Medicare cost-sharing paid under Medicare savings programs as a result of the Medicare Improvements for Patients and Providers Act (MIPPA) signed into law on July 15, 2008.