Page 2007

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 82 Chapter 24 Long Term Care

24.11 BENEFIT REPAYMENT 24.11.1 CLIENT REPAYMENT When payment for nursing care services is made for a client who is ineligible for such payment, for a lower amount, or for Medicaid, repayment is pursued as specified in Chapter 11. 24.11.2 PROVIDER FRAUD When fraud on the part of a nursing facility or other Medicaid provider is suspected, the procedures in Chapter 11 are followed. 24.11.3 ESTATE RECOVERY West Virginia has the authority to place liens on the estate or property of a Medicaid client who is either in a nursing facility or who receives benefits under a Home and Community-Based Waiver program, and who is age 55 or older, or who is determined to be permanently institutionalized. These liens cannot force the sale of real property during a person's lifetime. The state will not impose a lien or will defer recovery from the estate when the individual qualifies for Medicaid under the Adult Group expansion provisions of the Affordable Care Act (ACA). The Bureau for Medical Services (BMS) contracts with an agency to accomplish the recovery and to answer questions from interested persons. When the Worker receives inquiries about Estate Recovery, the Worker must refer the client to the current contract agency. Information about this agency is found in Appendix E. The Worker must not contact the contract agency on behalf of the client. See Section 24.6 regarding the Long Term Care Insurance Partnership (LTCIP) Asset Disregard and its relation to Estate Recovery.

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Page 2007

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 82 Chapter 24 Long Term Care

24.11 BENEFIT REPAYMENT 24.11.1 CLIENT REPAYMENT When payment for nursing care services is made for a client who is ineligible for such payment, for a lower amount, or for Medicaid, repayment is pursued as specified in Chapter 11. 24.11.2 PROVIDER FRAUD When fraud on the part of a nursing facility or other Medicaid provider is suspected, the procedures in Chapter 11 are followed. 24.11.3 ESTATE RECOVERY West Virginia has the authority to place liens on the estate or property of a Medicaid client who is either in a nursing facility or who receives benefits under a Home and Community-Based Waiver program, and who is age 55 or older, or who is determined to be permanently institutionalized. These liens cannot force the sale of real property during a person's lifetime. The state will not impose a lien or will defer recovery from the estate when the individual qualifies for Medicaid under the Adult Group expansion provisions of the Affordable Care Act (ACA). The Bureau for Medical Services (BMS) contracts with an agency to accomplish the recovery and to answer questions from interested persons. When the Worker receives inquiries about Estate Recovery, the Worker must refer the client to the current contract agency. Information about this agency is found in Appendix E. The Worker must not contact the contract agency on behalf of the client. See Section 24.6 regarding the Long Term Care Insurance Partnership (LTCIP) Asset Disregard and its relation to Estate Recovery.