Page 318

1. Documentation that the payment is voluntary. 2. The member’s name and Medicaid ID number. 3. Name and address of the person who should receive the receipt. These refunds will be credited to the member and will be used to offset any claim that may be filed in the member’s estate. Incentive payments of five percent will be paid to the IM agency for refunds. Advise heirs and beneficiaries of deceased members who wish to make a voluntary refund to call ERP staff. 22.1.6 Match System ERP maintains the Estate Recovery Database. Information you submit on the Estate Recovery Disclosure Form and data received through the SSA State Data Exchange (SDX) tape (for SSI/Medicaid members) is on the database. The database is compared to the death record files of the DMS, Vital Records and State Registrar Section. When a match shows a Medicaid member or his or her surviving spouse has died, a report record is produced. ERP staff checks the report against new probate proceedings listed on the Wisconsin Circuit Court Access website. This is a back up to the requirement that DHS be notified of the last date for filing claims. 22.1.7 Notify Members A copy of the Wisconsin Medicaid Estate Recovery Program Handbook (P-13032) must be provided to every Medicaid member who is 54 1/2 years old or older or institutionalized at application, except people who are only applying for are enrolled in one of the MSPs. CARES will send this documentation automatically. The applicant or member or their representative should read the notice of liability on the application form ("Estate Recovery”). The member acknowledges understanding of this notice when signing the application. 22.1.8 Estate Recovery Program Contacts The ERP address is: Estate Recovery Program Section Division of Medicaid Services P.O. Box 309 Madison, WI 53701-0309 For general information regarding ERP, refer members to Member Services at 1-800-362-3002. 22.1.9 Voluntary Recovery (Not Estate Recovery Program) Accept payments from a member under age 55 made for purposes of Medicaid eligibility or prepaying a Medicaid deductible. Instruct the member to make the payment payable to your IM agency. Report the receipt on the Community Aids Reporting System (CARS) labeled as a Medical Refund.