{ "name": "Medicaid Estate Recovery Rules by State", "description": "State-by-state Medicaid estate recovery rules, taken from each state's own statute or administrative code: what the state counts as the 'estate' it may recover from (the single biggest difference between states \u2014 a probate-only state cannot reach jointly held property, a life estate or a living trust, an expanded state can), when recovery is barred or deferred because a spouse or a minor, blind or disabled child survives, the undue-hardship waiver the state offers, and any home equity limit the provision states. Answers 'can Medicaid take the house', 'does my state recover from non-probate assets', and 'what stops recovery while a survivor is alive'. Each value is a verbatim span of the state's own provision, quoted alongside it.", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/", "licence": "public-domain-facts", "last_verified": "2026-09-01", "stale_after": "2027-09-01", "sources": [ "https://www.azleg.gov/ars/36/02935.htm", "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14009.5", "https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-25.5.pdf", "https://www.cga.ct.gov/current/pub/chap_319s.htm", "http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0409/Sections/0409.9101.html", "https://www.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0037.htm", "https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-218/", "https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=030500050K5-13", "https://www.legis.iowa.gov/docs/code/249A.53.pdf", "https://www.ksrevisor.gov/statutes/chapters/ch39/039_007_0009.html", "https://apps.legislature.ky.gov/law/kar/titles/907/001/585/", "https://legislature.maine.gov/statutes/22/title22sec14.html", "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter118E/Section31", "https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-400-112g", "https://www.revisor.mn.gov/statutes/cite/256B.15", "https://revisor.mo.gov/main/OneSection.aspx?section=473.398", "https://leg.mt.gov/bills/mca/title_0530/chapter_0060/part_0010/section_0670/0530-0060-0010-0670.html", "https://nebraskalegislature.gov/laws/statutes.php?statute=68-919", "https://www.leg.state.nv.us/NRS/NRS-422.html", "https://www.gencourt.state.nh.us/rsa/html/XII/167/167-14-a.htm", "https://www.srca.nm.gov/parts/title08/08.200.0430.html", "https://www.nysenate.gov/legislation/laws/SOS/369", "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_108A/GS_108A-70.5.html", "https://ndlegis.gov/cencode/t50c24-1.pdf", "https://codes.ohio.gov/ohio-revised-code/section-5162.21", "https://www.oregonlegislature.gov/bills_laws/ors/ors416.html", "https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter258/chap258toc.html", "https://webserver.rilegislature.gov/Statutes/TITLE40/40-8/40-8-15.htm", "https://www.scstatehouse.gov/code/t43c007.php", "https://legislature.vermont.gov/statutes/section/33/019/01906a", "https://law.lis.virginia.gov/admincode/title12/agency30/chapter20/section141/", "https://app.leg.wa.gov/RCW/default.aspx?cite=43.20B.080", "https://code.wvlegislature.gov/9-5-11c/", "https://docs.legis.wisconsin.gov/document/statutes/49.496", "https://www.wyoleg.gov/statutes/compress/title42.pdf" ], "records": [ { "state": "Arizona", "estate_definition": "A. The director shall adopt rules in accordance with state and federal law to allow the administration to file a claim against a member's estate to recover paid assistance. The administration is also entitled to a lien on a member's property to recover paid assistance the member receives.", "statute_citation": "36-2935", "id": "arizona", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/arizona/", "source": "https://www.azleg.gov/ars/36/02935.htm", "source_quote": "A. The director shall adopt rules in accordance with state and federal law to allow the administration to file a claim against a member's estate to recover paid assistance. The administration is also entitled to a lien on a member's property to recover paid assistance the member receives.", "verified_fields": [ "estate_definition" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "California", "estate_definition": "the department shall claim against the estate of the decedent, or against any recipient of the property of that decedent by distribution, an amount equal to the payments for the health care services received or the value of the property received by any recipient from the decedent by distribution, whichever is less", "surviving_spouse_protection": "The department shall not claim under this paragraph when there is any of the following: (i) A surviving spouse or surviving registered domestic partner. (ii) A surviving child who is under 21 years of age. (iii) A surviving child who is blind or disabled, within the meaning of Section 1614 of the federal Social Security Act (42 U.S.C. Sec. 1382c).", "hardship_waiver": "The department shall waive its claim, in whole or in part, if it determines that enforcement of the claim would result in substantial hardship to other dependents, heirs, or survivors of the individual against whose estate the claim exists.", "statute_citation": "WIC 14009.5", "id": "california", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/california/", "source": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14009.5", "source_quote": "(b) Notwithstanding any other provision of this chapter, the department shall claim against the estate of the decedent, or against any recipient of the property of that decedent by distribution, an amount equal to the payments for the health care services received or the value of the property received by any recipient from the decedent by distribution, whichever is less, only in either of the following circumstances: (1) Against the real property of a Medi-Cal member of any age who meets the criteria in Section 1396p(a)(1)(B) of Title 42 of the United States Code and who was or is an inpatient in a nursing facility in accordance with Section 1396p(b)(1)(A) of Title 42 of the United States Code.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Colorado", "estate_definition": "Medical assistance paid on behalf of any individual who was fifty-five years of age or older when the individual received such assistance may be recovered by the state department from the estate of such individual in accordance with paragraph (c) of this subsection (2).", "statute_citation": "Colo. Rev. Stat. \u00a7 25.5-4-302", "id": "colorado", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/colorado/", "source": "https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-25.5.pdf", "source_quote": "25.5-4-302. Recovery of assets.", "verified_fields": [ "estate_definition" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Connecticut", "estate_definition": "all sums due on or after July 1, 2003, to any individual after the death of a Medicaid beneficiary pursuant to the terms of an annuity contract purchased at any time with assets of a Medicaid beneficiary, shall be deemed to be part of the estate of the deceased beneficiary", "surviving_spouse_protection": "The claim of the state shall only be to the extent that the amount which the surviving spouse, parent or dependent children of the decedent would otherwise take from such estate is not needed for their support.", "statute_citation": "Conn. Gen. Stat. \u00a7 17b-95", "id": "connecticut", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/connecticut/", "source": "https://www.cga.ct.gov/current/pub/chap_319s.htm", "source_quote": "(a) Upon the death of any person who has at any time been a beneficiary of the Medicaid program, the state shall have a claim against such person's estate for all amounts paid on behalf of such person under the Medicaid program for which the state has not been reimbursed and that the state is required to recover under federal law", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Florida", "estate_definition": "Medicaid estate recovery shall be accomplished by the agency filing a statement of claim against the estate of a deceased Medicaid recipient as provided in part VII of chapter 733.", "surviving_spouse_protection": "The debt created under this section shall not be enforced if the recipient is survived by: (a) A spouse; (b) A child or children under 21 years of age; or (c) A child or children who are blind or permanently and totally disabled pursuant to the eligibility requirements of Title XIX of the Social Security Act.", "hardship_waiver": "The agency shall not recover from an estate if doing so would cause undue hardship for the qualified heirs, as defined in s. 731.201 . The personal representative of an estate and any heir may request that the agency waive recovery of any or all of the debt when recovery would create a hardship. A hardship does not exist solely because recovery will prevent any heirs from receiving an anticipated inheritance.", "statute_citation": "409.9101", "id": "florida", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/florida/", "source": "http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0409/Sections/0409.9101.html", "source_quote": "409.9101 Recovery for payments made on behalf of Medicaid-eligible persons. \u2014 (1) This section may be cited as the \u201cMedicaid Estate Recovery Act.\u201d (2) It is the intent of the Legislature by this section to supplement Medicaid funds that are used to provide medical services to eligible persons. Medicaid estate recovery shall be accomplished by the agency filing a statement of claim against the estate of a deceased Medicaid recipient as provided in part VII of chapter 733. Recovery shall be made pursuant to federal authority in s. 13612 of the Omnibus Budget Reconciliation Act of 1993, which amends s. 1917(b)(1) of the Social Security Act, 42 U.S.C. s. 1396p(b)(1).", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Hawaii", "surviving_spouse_protection": "The department shall file a claim against the estate of a deceased recipient of medical assistance for the amount of medical assistance granted, only if the recipient was age fifty-five or over when such medical assistance was received and there is no surviving spouse, or surviving child who is under twenty-one years of age, or blind, or disabled.", "statute_citation": "Haw. Rev. Stat. \u00a7 346-37", "id": "hawaii", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/hawaii/", "source": "https://www.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0037.htm", "source_quote": "\u00a7346-37 Recovery of payments and costs of medical assistance.", "verified_fields": [ "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Idaho", "estate_definition": "(a) All real and personal property and other assets included within the individual\u2019s estate, as defined for purposes of state probate law; and (b) Any other real and personal property and other assets in which the individual had any legal title or interest at the time of death, to the extent of such interest, including such assets conveyed to a survivor, heir, or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement.", "surviving_spouse_protection": "There shall be no adjustment or recovery until after the death of both the individual and the spouse, if any, and only at a time when the individual has no surviving child who is under twenty-one (21) years of age or is blind or permanently and totally disabled as defined in 42 U.S.C. 1382c.", "hardship_waiver": "rules establishing undue hardship waivers for the following circumstances: (a) The estate subject to recovery is income-producing property that provides the primary source of support for other family members; or (b) The estate has a value below an amount specified in the rules; or (c) Recovery by the department will cause the heirs of the deceased individual to be eligible for public assistance.", "statute_citation": "56-218", "id": "idaho", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/idaho/", "source": "https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-218/", "source_quote": "56-218. Recovery of certain medical assistance. (1) Except where exempted or waived in accordance with federal law medical assistance pursuant to this chapter paid on behalf of an individual who was fifty-five (55) years of age or older when the individual received such assistance may be recovered from the individual\u2019s estate, and the estate of the spouse, if any, for such aid paid to either or both:", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Illinois", "estate_definition": "The term \"estate\", as used in this Section, with respect to a deceased person, means all real and personal property and other assets included within the person's estate, as that term is used in the Probate Act of 1975; however, in the case of a deceased person who has received (or is entitled to receive) benefits under a long-term care insurance policy in connection with which assets or resources are disregarded to the extent that payments are made or because the deceased person received (or was entitled to receive) benefits under a long-term care insurance policy, \"estate\" also includes any other real and personal property and other assets in which the deceased person had any legal title or interest at the time of his or her death (to the extent of that interest), including assets conveyed to a survivor, heir, or assignee of the deceased person through joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement.", "surviving_spouse_protection": "but no recovery may be had thereon until after the death of the surviving spouse, if any, and then only at such time when there is no surviving child who is under age 21, or blind, or is a child with a permanent total disability.", "statute_citation": "305 ILCS 5/5-13", "id": "illinois", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/illinois/", "source": "https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=030500050K5-13", "source_quote": "Sec. 5-13. Claim against estate of recipients. To the extent permitted under the federal Social Security Act, the amount expended under this Article (1) for a person of any age who is an inpatient in a nursing facility, an intermediate care facility for persons with intellectual disabilities, or other medical institution, or (2) for a person aged 55 or more, shall be a claim against the person's estate or a claim against the estate of the person's spouse, regardless of the order of death", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Iowa", "estate_definition": "For purposes of this section, the estate of a medical assistance recipient, surviving spouse, or surviving child includes any real property, personal property, or other asset in which the recipient, spouse, or child had any legal title or interest at the time of the recipient\u2019s, spouse\u2019s, or child\u2019s death, to the extent of such interests, including but not limited to interests in jointly held property, retained life estates, and interests in trusts.", "surviving_spouse_protection": "The department shall waive the collection of the debt created under this subsection from the estate of a recipient of medical assistance to the extent that collection of the debt would result in either of the following: (1) Reduction in the amount received from the recipient\u2019s estate by a surviving spouse, or by a surviving child who was under age twenty-one, blind, or permanently and totally disabled at the time of the individual\u2019s death.", "hardship_waiver": "The department shall waive the collection of the debt created under this subsection from the estate of a recipient of medical assistance to the extent that collection of the debt would result in either of the following: (1) Reduction in the amount received from the recipient\u2019s estate by a surviving spouse, or by a surviving child who was under age twenty-one, blind, or permanently and totally disabled at the time of the individual\u2019s death. (2) Otherwise work an undue hardship as determined on the basis of criteria established pursuant to 42 U.S.C. \u00a71396p(b)(3).", "statute_citation": "\u00a7249A.53", "id": "iowa", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/iowa/", "source": "https://www.legis.iowa.gov/docs/code/249A.53.pdf", "source_quote": "2. The provision of medical assistance to an individual who is fifty-five years of age or older, or who is a resident of a nursing facility, intermediate care facility for persons with an intellectual disability, or mental health institute, who cannot reasonably be expected to be discharged and return to the individual\u2019s home, creates a debt due the department from the individual\u2019s estate for all medical assistance provided on the individual\u2019s behalf, upon the individual\u2019s death.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Kansas", "estate_definition": "such claim shall apply to the individual's medical assistance estate. The medical assistance estate is defined as including all real and personal property and other assets in which the deceased individual had any legal title or interest immediately before or at the time of death to the extent of that interest or title. The medical assistance estate includes without limitation, assets conveyed to a survivor, heir or assign of the deceased recipient through joint tenancy, tenancy in common, survivorship, transfer-on-death deed, payable-on-death contract, life estate, trust, annuities or similar arrangement.", "surviving_spouse_protection": "There shall be no recovery of medical assistance correctly paid to or on behalf of an individual under subsection (i) except after the death of the surviving spouse of the individual, if any, and only at a time when the individual has no surviving child who is under 21 years of age or is blind or permanently and totally disabled.", "statute_citation": "K.S.A. 39-709", "id": "kansas", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/kansas/", "source": "https://www.ksrevisor.gov/statutes/chapters/ch39/039_007_0009.html", "source_quote": "(2) The amount of any medical assistance paid after June 30, 1992, under the provisions of subsection (i) is a claim against the property or any interest therein belonging to and a part of the estate of any deceased recipient", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Kentucky", "estate_definition": "All real and personal property or other assets owned by the deceased recipient that would be included as probate property under Kentucky law; and (b) All real and personal property or other assets in which the deceased recipient had legal title or interest at the time of death, to the extent of the recipient's interest, whether the asset was conveyed to a survivor, heir or assign of the deceased recipient through joint tenancy, tenancy in common survivorship, life estate, living trust or other arrangement.", "surviving_spouse_protection": "Recovery shall not be made from the estate if the estate representative can verify to the department's satisfaction that there is a: (a) Surviving spouse; or (b) Surviving child.", "hardship_waiver": "The department shall waive estate recovery to the extent the recovery would work an undue hardship. (a) Undue hardship shall exist if an asset subject to recovery is the sole income-producing asset, for example a family farm or business, conveyed to the surviving recipient family member. A sole income-producing asset shall not include residential real property producing income through a lease or rental arrangement.", "statute_citation": "907 KAR 1:585", "id": "kentucky", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/kentucky/", "source": "https://apps.legislature.ky.gov/law/kar/titles/907/001/585/", "source_quote": "907 KAR 1:585. Estate recovery. RELATES TO: KRS 205.520, 205.619, 304.14-640, 42 C.F.R. 430.10, 435.236, 42 U.S.C. 1396p(b)(1)-(4) STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 205.520(3), EO 2004-726 NECESSITY, FUNCTION, AND CONFORMITY: The Cabinet for Health and Family Services, Department for Medicaid Services has responsibility to administer the Medicaid Program. KRS 205.520(3) empowers the cabinet, by administrative regulation, to comply with any requirement that may be imposed or opportunity presented by federal law for the provision of medical assistance to Kentucky's indigent citizenry. 42 U.S.C. 1396p(b)(1)-(4) establishes minimum requirements for state plans for estate recovery actions. This administrative regulation establishes provisions relating to estate recovery.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Maine", "estate_definition": "All real and personal property and other assets included in the recipient's estate, as defined in Title 18\u2011C, section 1\u2011201 ; and (2) Any other real and personal property and other assets in which the recipient had any legal interest at the time of death, to the extent of that interest, including assets conveyed to a survivor, heir or assign of the deceased recipient through tenancy in common, survivorship, life estate, living trust, joint tenancy in personal property or other arrangement but not including joint tenancy in real property.", "surviving_spouse_protection": "a claim may not be made under paragraph A , subparagraph (2) or (3) until: (1) The recipient has no surviving spouse; and (2) The recipient has no surviving child who is under age 21 or who is blind or permanently and totally disabled as defined in 42 United States Code, Section 1382c.", "hardship_waiver": "A claim under paragraph A , subparagraph (2) must be waived if enforcement of the claim would create an undue hardship under criteria developed by the department or if the costs of collection are likely to exceed the amount recovered. A waiver may be granted in full or in part. A waiver may not be granted if the recipient or waiver applicant acted to lose, diminish, divest, encumber or otherwise transfer any value of or title to an asset for the purpose of preventing recovery under this subsection.", "statute_citation": "22 M.R.S. \u00a714, sub-\u00a72-I", "id": "maine", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/maine/", "source": "https://legislature.maine.gov/statutes/22/title22sec14.html", "source_quote": "2-I. Claims against estates of MaineCare recipients. Claims against the estates of MaineCare recipients are governed by this subsection. A. The department has a claim against the estate of a MaineCare recipient when, after the death of the recipient: (1) Property or other assets are discovered that existed and were owned by the recipient during the period when MaineCare benefits were paid for the recipient and disclosure of the property or assets at the time benefits were being paid would have rendered the recipient ineligible to receive the benefits; (2) It is determined that the recipient was 55 years of age or older when that person received MaineCare assistance; or (3) It is determined that the recipient has received or is entitled to receive benefits under a long-term care insurance policy in connection with which assets or resources are disregarded and medical assistance was paid on behalf of the recipient for nursing facility or other long-term care services.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Massachusetts", "estate_definition": "''estate'' shall mean all real and personal property and other assets includable in the decedent's probate estate under the General Laws.", "surviving_spouse_protection": "Any recovery may be made only after the death of the surviving spouse, if any, and only at a time when the individual has no surviving child who is: (i) under the age of 21; or (ii) an individual who is blind or an individual with a disability.", "statute_citation": "Chapter 118E, Section 31", "id": "massachusetts", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/massachusetts/", "source": "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter118E/Section31", "source_quote": "(b1/2) This subsection shall apply to estates of individuals dying on or after August 1, 2024. There shall be no adjustments or recovery of medical assistance correctly paid except for recovery from the estate of an individual who was: (i) regardless of age, a resident in a nursing facility or other medical institution within the meaning of 42 U.S.C. 1396p(a)(1)(B)(i) when the individual received such assistance; provided, however, that recovery of such assistance shall be limited to assistance provided on or after March 22, 1991; or (ii) 55 years of age or older when the individual received such assistance, where such assistance was for services provided on or after October 1, 1993, but only for medical assistance consisting of nursing facility services, home and community-based services and related hospital and prescription drug services for which estate recovery is mandated under 42 U.S.C. 1396p(b)(1)(B)(i) or other federal law.", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Michigan", "surviving_spouse_protection": "The department of community health shall not recover assets from the home of a medical assistance recipient if 1 or more of the following individuals are lawfully residing in that home: (a) The medical assistance recipient's spouse. (b) The medical assistance recipient's child who is under the age of 21 years, or is blind or permanently and totally disabled as defined in section 1614 of the social security act, 42 USC 1382c.", "hardship_waiver": "The department of community health shall develop a definition of hardship according to section 1917(b)(3) of title XIX that includes, but is not limited to, the following: (i) An exemption for the portion of the value of the medical assistance recipient's homestead that is equal to or less than 50% of the average price of a home in the county in which the medicaid recipient's homestead is located as of the date of the medical assistance recipient's death. (ii) An exemption for the portion of an estate that is the primary income-producing asset of survivors, including, but not limited to, a family farm or business. (iii) A rebuttable presumption that no hardship exists if the hardship resulted from estate planning methods under which assets were diverted in order to avoid estate recovery.", "statute_citation": "MCL 400.112g", "id": "michigan", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/michigan/", "source": "https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-400-112g", "source_quote": "Sec. 112g. (1) Subject to section 112c(5), the department of community health shall establish and operate the Michigan medicaid estate recovery program to comply with requirements contained in section 1917 of title XIX.", "verified_fields": [ "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Minnesota", "estate_definition": "(1) the person's probate estate; (2) all of the person's interests or proceeds of those interests in real property the person owned as a life tenant or as a joint tenant with a right of survivorship at the time of the person's death; (3) all of the person's interests or proceeds of those interests in securities the person owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time of the person's death, to the extent the interests or proceeds of those interests become part of the probate estate under section 524.6-307 ; (4) all of the person's interests in joint accounts, multiple-party accounts, and pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent the interests become part of the probate estate under section 524.6-207 ; and (5) assets conveyed to a survivor, heir, or assign of the person through survivorship, living trust, transfer-on-death of title or deed, or other arrangements.", "surviving_spouse_protection": "If a decedent is survived by a spouse, or was single or the surviving spouse of a married couple and is survived by a child who is under age 21 or blind or permanently and totally disabled according to the Supplemental Security Income program criteria, a claim shall be filed against the estate according to this section.", "hardship_waiver": "Any person entitled to notice in subdivision 1a has a right to apply for waiver of the claim based upon undue hardship. Any claim pursuant to this section may be fully or partially waived because of undue hardship. Undue hardship does not include action taken by the decedent which divested or diverted assets in order to avoid estate recovery.", "statute_citation": "256B.15", "id": "minnesota", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/minnesota/", "source": "https://www.revisor.mn.gov/statutes/cite/256B.15", "source_quote": "(b) For the purposes of this section, the person's estate must consist of: (1) the person's probate estate; (2) all of the person's interests or proceeds of those interests in real property the person owned as a life tenant or as a joint tenant with a right of survivorship at the time of the person's death; (3) all of the person's interests or proceeds of those interests in securities the person owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time of the person's death, to the extent the interests or proceeds of those interests become part of the probate estate under section 524.6-307 ; (4) all of the person's interests in joint accounts, multiple-party accounts, and pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent the interests become part of the probate estate under section 524.6-207 ; and (5) assets conveyed to a survivor, heir, or assign of the person through survivorship, living trust, transfer-on-death of title or deed, or other arrangements.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Missouri", "estate_definition": "1. Upon the death of a person, who has been a participant of aid, assistance, care, services, or who has had moneys expended on his behalf by the department of health and senior services, department of social services, or the department of mental health, or by a county commission, the total amount paid to the decedent or expended upon his behalf after January 1, 1978, shall be a debt due the state or county, as the case may be, from the estate of the decedent. The debt shall be collected as provided by the probate code of Missouri, chapters 472 , 473 , 474 and 475 .", "surviving_spouse_protection": "The collection of the claim will adversely affect the need of the surviving spouse or dependents of the decedent to reasonable care and support from the estate.", "hardship_waiver": "Such claim shall not be filed or allowed if it is determined that: (1) The cost of collection will exceed the amount of the claim;", "statute_citation": "473.398", "id": "missouri", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/missouri/", "source": "https://revisor.mo.gov/main/OneSection.aspx?section=473.398", "source_quote": "1. Upon the death of a person, who has been a participant of aid, assistance, care, services, or who has had moneys expended on his behalf by the department of health and senior services, department of social services, or the department of mental health, or by a county commission, the total amount paid to the decedent or expended upon his behalf after January 1, 1978, shall be a debt due the state or county, as the case may be, from the estate of the decedent. The debt shall be collected as provided by the probate code of Missouri, chapters 472 , 473 , 474 and 475 .", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Montana", "estate_definition": "(1) Except as provided in subsection (7) or (9)(b), after the death of a recipient, the department shall execute and present a claim against the recipient's estate, within the time specified in the published notice to creditors in the estate proceeding, for the total amount of recoverable medical assistance paid to or on behalf of the recipient. The department is not required to initiate probate proceedings in order to present a claim in a case in which no proceeding has been commenced to probate the estate of the deceased recipient. (2) Except as prohibited by subsection (9)(b), after the death of a recipient, the department may execute and present a claim against a person who has received property of the recipient by distribution or survival for an amount equal to the recoverable medical assistance paid on behalf of the recipient or the value of the property received by the person from the recipient by distribution or survival, whichever is less.", "surviving_spouse_protection": "The department may not recover under this section while there is a surviving spouse of the recipient or while there is a surviving child of the recipient who is under 21 years of age, blind, or permanently and totally disabled. This subsection (9)(b) does not preclude the department from recovering from the recipient's estate after the death of the surviving spouse or child.", "hardship_waiver": "Upon presentation or assertion of a claim by the department under this section, the personal representative of the estate or another affected person may apply to the department, in accordance with procedures established by department rule, for a waiver of recovery based on undue hardship. The department shall waive its recovery under this section in whole or in part if it determines that recovery would result in undue hardship as defined by department rule.", "statute_citation": "MCA 53-6-167", "id": "montana", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/montana/", "source": "https://leg.mt.gov/bills/mca/title_0530/chapter_0060/part_0010/section_0670/0530-0060-0010-0670.html", "source_quote": "53-6-167. Recovery of medicaid benefits after recipient's death. (1) Except as provided in subsection (7) or (9)(b), after the death of a recipient, the department shall execute and present a claim against the recipient's estate, within the time specified in the published notice to creditors in the estate proceeding, for the total amount of recoverable medical assistance paid to or on behalf of the recipient.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Nebraska", "estate_definition": "Estate of a recipient of medical assistance means any real estate, personal property, or other asset in which the recipient had any legal title or interest at or immediately preceding the time of the recipient's death, to the extent of such interests. In furtherance and not in limitation of the foregoing, the estate of a recipient of medical assistance also includes: (A) Assets to be transferred to a beneficiary described in section 77-2004 or 77-2005 in relation to the recipient through a revocable trust or other similar arrangement which has become irrevocable by reason of the recipient's death; and (B) Notwithstanding anything to the contrary in subdivision (3) or (4) of section 68-923 , assets conveyed or otherwise transferred to a survivor, an heir, an assignee, a beneficiary, or a devisee of the recipient of medical assistance through joint tenancy, tenancy in common, transfer on death deed, survivorship, conveyance of a remainder interest, retention of a life estate or of an estate for a period of time, living trust, or other arrangement by which value or possession is transferred to or realized by the beneficiary of the conveyance or transfer at or as a result of the recipient's death.", "surviving_spouse_protection": "Any such debt to the department that exists when the recipient dies shall be recovered only after the death of the recipient's spouse, if any, and only after the recipient is not survived by a child who either is under twenty-one years of age or is blind or totally and permanently disabled as defined by the Supplemental Security Income criteria.", "hardship_waiver": "The department may waive or compromise its claim, in whole or in part, if the department determines that enforcement of the claim would not be in the best interests of the state or would result in undue hardship as provided in rules and regulations of the department.", "statute_citation": "68-919", "id": "nebraska", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/nebraska/", "source": "https://nebraskalegislature.gov/laws/statutes.php?statute=68-919", "source_quote": "(1) The recipient of medical assistance under the medical assistance program shall be indebted to the department for the total amount paid for medical assistance on behalf of the recipient if: (a) The recipient was fifty-five years of age or older at the time the medical assistance was provided; or (b) The recipient resided in a medical institution and, at the time of institutionalization or application for medical assistance, whichever is later, the department determines that the recipient could not have reasonably been expected to be discharged and resume living at home.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Nevada", "estate_definition": "\u201cUndivided estate\u201d means all real and personal property and other assets included in the estate of a deceased recipient of Medicaid and any other real and personal property and other assets in or to which the deceased recipient had an interest or legal title immediately before or at the time of his or her death, to the extent of that interest or title. The term includes, without limitation, assets conveyed to a survivor, heir or assign of the deceased recipient through or as the result of any joint tenancy, tenancy in common, survivorship, life estate, living trust, annuity, declaration of homestead or other arrangement.", "surviving_spouse_protection": "The amount of Medicaid paid to or on behalf of a person is a claim against the estate in any probate proceeding only at a time when there is no surviving spouse or surviving child who is under 21 years of age, blind or disabled.", "hardship_waiver": "The Director may elect not to file a claim against the estate of a recipient of Medicaid or the spouse of the recipient if the Director determines that the filing of the claim will cause an undue hardship for the spouse or other survivors of the recipient. The Director shall adopt regulations defining the circumstances that constitute an undue hardship.", "statute_citation": "NRS 422.054; NRS 422.29302", "id": "nevada", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/nevada/", "source": "https://www.leg.state.nv.us/NRS/NRS-422.html", "source_quote": "1. Except as otherwise provided in this section and to the extent it is not prohibited by federal law and when circumstances allow, the Authority shall recover benefits correctly paid for Medicaid from: (a) The undivided estate of the person who received those benefits; and (b) Any recipient of money or property from the undivided estate of the person who received those benefits.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "New Hampshire", "estate_definition": "the estate of a recipient shall include all property, real or personal, which at the time of a recipient's death was held by the recipient in joint tenancy with rights of survivorship, or life estate for all such title or interest established on or after July 1, 2005. Recovery shall be limited to the value of the recipient's ownership interest and in no case shall such amount exceed the total amount of medical assistance provided to the deceased recipient, nor shall recovery extend to any interest in property, real or personal, for which a non-recipient owner paid fair market value at the time said ownership interest was acquired.", "surviving_spouse_protection": "Nothing in this paragraph shall be interpreted or applied so as to violate RSA 167:16-a or 42 U.S.C. section 1396p(b)(2)(A) and (B) prohibiting recovery when the recipient is survived by a spouse, minor children, or disabled children or when the recipient is survived by either siblings or children under certain circumstances.", "hardship_waiver": "Written notice shall include a description of all categories of individuals exempt from recovery by reason of familial status as allowed under 42 U.S.C. section 1396p(b)(2) and RSA 167:16-a, IV, as well as the availability and method of requesting a hardship waiver.", "statute_citation": "RSA 167:14-a", "id": "new-hampshire", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/new-hampshire/", "source": "https://www.gencourt.state.nh.us/rsa/html/XII/167/167-14-a.htm", "source_quote": "VI. (a) For purposes of recovering the costs of medical assistance, the estate of a recipient shall include all property, real or personal, which at the time of a recipient's death was held by the recipient in joint tenancy with rights of survivorship, or life estate for all such title or interest established on or after July 1, 2005.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "New Mexico", "estate_definition": "Real and personal property and other assets of an individual subject to probate or administration pursuant to the New Mexico Uniform Probate Code.", "surviving_spouse_protection": "Recovery from an eligible recipient's estate will be made only after the death of the eligible recipient's surviving spouse, if any, and only at a time that the eligible recipient does not have surviving child who is less than 21 years of age, blind, or who meet the SSA definition of disability.", "hardship_waiver": "Hardship provision: HCA, or its designee, may waive recovery because recovery would work an undue hardship on the heirs. The following are deemed to be causes for hardship: (a) the deceased recipient's heir would become eligible for a needs-based assistance program such as medicaid or temporary assistance to needy families (TANF) or be put at risk of serious deprivation without the receipt of the proceeds of the estate; (b) the deceased eligible recipient's heir would be able to discontinue reliance on a needs-based program (such as medicaid or TANF) if they received the inheritance from the estate; (c) the deceased recipient\u2019s assets which are subject to recovery are the sole income source for the heir; (d) the homestead is worth 50 percent or less than the average price of a home in the county where the home is located based on census data compared to the property tax value of the home; or (e) there are other compelling circumstances as determined by HCA or its designee.", "statute_citation": "8.200.430.19 NMAC", "id": "new-mexico", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/new-mexico/", "source": "https://www.srca.nm.gov/parts/title08/08.200.0430.html", "source_quote": "8.200.430.19 MAD ESTATE RECOVERY: HCA is mandated to seek recovery from the estates of certain individuals up to the amount of medical assistance payments made by the HCA on behalf of the individual. See Social Security Act Section 1917 (42 USC 1396p(b) and Section 27-2A-1 et seq., NMSA 1978 \"Medicaid Estate Recovery Act\").", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "New York", "estate_definition": "all real and personal property and other assets included within the individual's estate and passing under the terms of a valid will or by intestacy", "surviving_spouse_protection": "Any such adjustment or recovery shall be made only after the death of the individual's surviving spouse, if any, and only at a time when the individual has no surviving child who is under twenty-one years of age or is blind or permanently and totally disabled", "hardship_waiver": "waived in cases of undue hardship, as determined pursuant to the regulations of the department in accordance with criteria established by the secretary of the federal department of health and human services", "statute_citation": "N.Y. Soc. Serv. Law \u00a7 369", "id": "new-york", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/new-york/", "source": "https://www.nysenate.gov/legislation/laws/SOS/369", "source_quote": "(B) from the estate of an individual who was fifty-five years of age or older when he or she received such assistance, provided that for individuals whose eligibility for medical assistance was based on paragraph (b) of subdivision one of section three hundred sixty-six of this title, recovery shall be limited to medical assistance consisting of nursing facility services, home and community-based services, and related hospital and prescription drug services.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "North Carolina", "estate_definition": "Estate. - All the real and personal property considered assets of the estate available for the discharge of debt pursuant to G.S. 28A-15-1. The Department has all rights available to estate creditors, including the right to qualify as personal representative or collector of an estate. For individuals who have received benefits under a qualified long-term care partnership policy as described in G.S. 108A-70.4, this term also includes any other real and personal property and other assets in which the individual had any legal title or interest at the time of death (to the extent of the interest), including assets conveyed to a survivor, heir, or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement.", "hardship_waiver": "rules to waive whole or partial recovery when this recovery would be inequitable because it would work an undue hardship or because it would not be administratively cost-effective", "statute_citation": "G.S. 108A-70.5", "id": "north-carolina", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/north-carolina/", "source": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_108A/GS_108A-70.5.html", "source_quote": "(a) There is established in the Department of Health and Human Services, the Medicaid Estate Recovery Plan, as required by the Omnibus Budget Reconciliation Act of 1993, to recover from the estates of recipients of medical assistance an equitable amount of the State and federal shares of the cost paid for the recipient. The Department shall administer the program in accordance with applicable federal law and regulations, including those under Title XIX of the Social Security Act, 42 U.S.C. \u00a7 1396(p).", "verified_fields": [ "estate_definition", "hardship_waiver" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "North Dakota", "estate_definition": "All assets in the decedent's estate of the spouse of a deceased medical assistance recipient are presumed to be assets in which that recipient had an interest at the time of the recipient's death.", "surviving_spouse_protection": "A claim may not be required to be paid nor may interest begin to accrue during the lifetime of the decedent's surviving spouse, if any, nor while there is a surviving child who is under the age of twenty-one years or is blind or permanently and totally disabled", "statute_citation": "N.D.C.C. \u00a7 50-24.1-07", "id": "north-dakota", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/north-dakota/", "source": "https://ndlegis.gov/cencode/t50c24-1.pdf", "source_quote": "the total amount of medical assistance paid on behalf of the recipient following the institutionalization of the recipient who cannot reasonably be expected to be discharged from the medical institution, or following the recipient's fifty-fifth birthday, as the case may be, must be allowed as a preferred claim against the decedent's estate after payment, in the following order, of:", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Ohio", "estate_definition": "\"Estate\" includes both of the following: (a) All real and personal property and other assets to be administered under Title XXI of the Revised Code and property that would be administered under that title if not for section 2113.03 or 2113.031 of the Revised Code; (b) Any other real and personal property and other assets in which an individual had any legal title or interest at the time of death (to the extent of the interest), including assets conveyed to a survivor, heir, or assign of the individual through joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement.", "surviving_spouse_protection": "No adjustment or recovery may be made under division (B)(1) of this section from a permanently institutionalized individual's estate or on the sale of property of a permanently institutionalized individual that is subject to a lien imposed under section 5162.211 of the Revised Code or under division (B)(2) or (3) of this section from an individual's estate while either of the following are alive: (a) The spouse of the permanently institutionalized individual or individual; (b) The son or daughter of a permanently institutionalized individual or individual if the son or daughter is under age twenty-one or, under the \"Social Security Act,\" section 1614, 42 U.S.C. 1382c, is considered blind or disabled.", "hardship_waiver": "The department shall, in accordance with procedures and criteria established in rules authorized by division (G) of this section, waive seeking an adjustment or recovery otherwise required by this section if the medicaid director determines that adjustment or recovery would work an undue hardship. The department may limit the duration of the waiver to the period during which the undue hardship exists.", "statute_citation": "Section 5162.21", "id": "ohio", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/ohio/", "source": "https://codes.ohio.gov/ohio-revised-code/section-5162.21", "source_quote": "(B) To the extent permitted by federal law, the department of medicaid shall institute a medicaid estate recovery program under which the department shall, except as provided in divisions (C) and (E) of this section, and subject to division (D) of this section, do all of the following: (1) For the costs of medicaid services the medicaid program correctly paid or will pay on behalf of a permanently institutionalized individual of any age, seek adjustment or recovery from the individual's estate or on the sale of property of the individual or spouse that is subject to a lien imposed under section 5162.211 of the Revised Code; (2) For the costs of medicaid services the medicaid program correctly paid or will pay on behalf of an individual fifty-five years of age or older who is not a permanently institutionalized individual, seek adjustment or recovery from the individual's estate;", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Oregon", "estate_definition": "\u201cEstate\u201d includes all real and personal property and other assets in which the deceased individual had any legal title or interest at the time of death including assets conveyed to a survivor, heir or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust or other similar arrangement.", "surviving_spouse_protection": "Claim for such medical assistance correctly paid to or on behalf of the individual may be established against the estate, but the claim may not be adjusted or recovered until after the death of the surviving spouse, if any, and only at a time when the individual has no surviving child who is under 21 years of age or who is blind or permanently and totally disabled.", "statute_citation": "ORS 416.350", "id": "oregon", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/oregon/", "source": "https://www.oregonlegislature.gov/bills_laws/ors/ors416.html", "source_quote": "416.350 Recovery of medical assistance; estate claims; transfer of assets. (1) The Department of Human Services or the Oregon Health Authority may recover from any person the amounts of medical assistance the department or the authority incorrectly paid to or on behalf of the person. (2) Except as prohibited by ORS 178.380, medical assistance pursuant to ORS chapter 414 paid to or on behalf of an individual who was 55 years of age or older when the individual received the assistance, or paid to or on behalf of a person of any age who was a permanently institutionalized inpatient in a nursing facility, intermediate care facility for persons with intellectual disabilities or other medical institution, may be recovered from the estate of the individual or from any recipient of property or other assets held by the individual at the time of death including the estate of the surviving spouse.", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Pennsylvania", "estate_definition": "(a) All estate property is subject to the Department\u2019s claim. Estate property includes all real and personal property of a decedent which is subject to administration by a decedent\u2019s personal representative, whether actually administered or not administered. (b) Property held by a decedent and another at the time of death as joint tenants with rights of survivorship, or as tenants by the entireties, is not subject to the Department\u2019s claim.", "surviving_spouse_protection": "(a) The Department will postpone collection of its claim until the last of one of the following occurs: (1) The death of any surviving spouse. (2) The death of any child who is blind or totally and permanently disabled, as determined under the standards of the Supplemental Security Income (SSI) program in the Social Security Act. See 42 U.S.C.A. \u00a7 1382. (3) The date any surviving child is 21 years of age. (4) The death of, property transfer by or vacating of the property by a sibling who has an equity interest in the property and who has been living in the home for at least 1 year prior to the death of the decedent.", "hardship_waiver": "(a) The Department will waive its claim in cases of undue hardship. (b) The Department will find undue hardship and will permanently waive its claim with respect to the primary residence of a decedent if the person requesting the undue hardship waiver meets all of the following conditions: (1) The person has continuously resided in the primary residence of the decedent for at least 2 years immediately preceding the decedent\u2019s receipt of nursing facility services, or, for at least 2 years during the period of time which Medicaid-funded home and community based services were received. (2) The person has no other alternative permanent residence. (3) The person has provided care or support to the decedent for at least 2 years during the period of time that Medicaid-funded home and community based services were received by the decedent, or for at least 2 years prior to the decedent\u2019s receipt of nursing home services during which time the decedent needed care or support to remain at home", "statute_citation": "55 Pa. Code Chapter 258", "id": "pennsylvania", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/pennsylvania/", "source": "https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter258/chap258toc.html", "source_quote": "(b) The estate of a an individual who was 55 years or older at the time that MA was received is liable to repay the Department for the amount of MA paid for all nursing facility services, home and community based services and related hospital and prescription drug services provided from the time the individual was 55 years of age and thereafter. Only MA services provided on or after August 15, 1994, are subject to estate recovery.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Rhode Island", "estate_definition": "For purposes of this section, the term \u201cestate\u201d with respect to a deceased individual shall include all real and personal property and other assets included or includable within the individual\u2019s probate estate.", "surviving_spouse_protection": "The lien shall not be effective and shall not attach as against the estate of a beneficiary who is survived by a spouse, or a child who is under the age of twenty-one (21), or a child who is blind or permanently and totally disabled as defined in Title XVI of the federal Social Security Act, 42 U.S.C. \u00a7 1381 et seq.", "hardship_waiver": "The executive office shall establish procedures, in accordance with the standards specified by the Secretary, United States Department of Health and Human Services, under which the executive office shall waive, in whole or in part, the lien and reimbursement established by this section if the lien and reimbursement would cause an undue hardship, as determined by the executive office, on the basis of the criteria established by the secretary in accordance with 42 U.S.C. \u00a7 1396p(b)(3).", "statute_citation": "R.I. Gen. Laws \u00a7 40-8-15", "id": "rhode-island", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/rhode-island/", "source": "https://webserver.rilegislature.gov/Statutes/TITLE40/40-8/40-8-15.htm", "source_quote": "\u00a7 40-8-15. Lien on deceased recipient\u2019s estate for assistance. (a)(1) Upon the death of a recipient of Medicaid under Title XIX of the federal Social Security Act (42 U.S.C. \u00a7 1396 et seq. and referred to hereinafter as the \u201cAct\u201d), the total sum for Medicaid benefits so paid on behalf of a beneficiary who was fifty-five (55) years of age or older at the time of receipt shall be and constitute a lien upon the estate, as defined in subsection (a)(2), of the beneficiary in favor of the executive office of health and human services", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "South Carolina", "estate_definition": "\"Estate\" means real property, personal property, and other assets included within the individual's estate as defined in Section 62-1-201(11).", "surviving_spouse_protection": "Recovery under this section may be made only after the death of the decedent's surviving spouse, if one exists, and only at a time when the decedent has no surviving child under age twenty-one or no child who is blind or permanently and totally disabled as defined in Title XVI of the Social Security Act.", "hardship_waiver": "Recovery under this section must be waived by the department upon proof of undue hardship, asserted by an heir or devisee of the property claimed pursuant to 42 U.S.C. 1396p(b)(3) and in accordance with the guidance issued by the Secretary of the United States Department of Health and Human Services in the State Medicaid Manual as incorporated into the state plan.", "statute_citation": "SECTION 43-7-460", "id": "south-carolina", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/south-carolina/", "source": "https://www.scstatehouse.gov/code/t43c007.php", "source_quote": "SECTION 43-7-460. Recovery of medical assistance paid from estates of certain individuals. (A) The department shall seek recovery of medical assistance paid under the Title XIX State Plan for Medical Assistance from the estate of an individual who: (1) at the time of death was an inpatient in a nursing facility, intermediate care facility for persons with intellectual disability, or other medical institution, if the individual is required, as a condition of receiving a service in the facility under the state plan, to spend for the cost of medical care all but a minimal amount of the person's income required for personal needs; or (2) was fifty-five years of age or older when the individual received medical assistance, but only for medical assistance consisting of a nursing facility service, home and community-based service, hospital or prescription drug service provided to an individual or a nursing facility, or receiving a home and community-based service.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Vermont", "surviving_spouse_protection": "No recovery of medical expenses shall be made under this subchapter against a homestead, provided that the homestead would pass to one or more lineal heirs or siblings of the decedent who either have income below 300 percent of the federal poverty level or who have contributed significantly, monetarily or otherwise, to the decedent so as to allow the decedent to delay or avoid nursing home placement.", "statute_citation": "33 V.S.A. \u00a7 1906a", "id": "vermont", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/vermont/", "source": "https://legislature.vermont.gov/statutes/section/33/019/01906a", "source_quote": "\u00a7 1906a. Recovery against estate; homestead exemptions No recovery of medical expenses shall be made under this subchapter against a homestead, provided that the homestead would pass to one or more lineal heirs or siblings of the decedent who either have income below 300 percent of the federal poverty level or who have contributed significantly, monetarily or otherwise, to the decedent so as to allow the decedent to delay or avoid nursing home placement. If a maximum homestead value exemption is allowed by federal law, then any recoveries due to the U.S. Department of Health and Human Services on homesteads valued between such maximum and $125,000.00 shall be paid through State general funds provided the caregiving or poverty standards set forth in this section are also met and the probate estate was opened after June 30, 2000.", "verified_fields": [ "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Virginia", "estate_definition": "(i) all real and personal property and other assets held by the individual at the time of death and (ii) any other real and personal property and other assets in which the individual had any legal title or interest (to the extent of such interest) at the time of his death.", "surviving_spouse_protection": "Adjustment or recovery can only be made after the death of the individual's surviving spouse, if any, and only at a time when the individual has no surviving child under age 21, or a blind or disabled child as defined in \u00a7 1614 of the Act.", "hardship_waiver": "Whenever estate recovery would work an undue hardship on the deceased individual's heirs, the Commonwealth shall waive adjustment or recovery. Recovery from deceased individuals' estates shall be waived when the heirs are themselves Medicaid eligible.", "statute_citation": "12VAC30-20-141", "id": "virginia", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/virginia/", "source": "https://law.lis.virginia.gov/admincode/title12/agency30/chapter20/section141/", "source_quote": "B. Under the authority and consistent with the requirements of the Social Security Act \u00a7 1917 (the Act), the Commonwealth shall recover applicable medical assistance payments when such payments have been correctly or incorrectly paid on behalf of certain individuals. The Department of Medical Assistance Services (DMAS) shall provide notice of the Commonwealth's Medicaid estate recovery program at the time of application for medical assistance.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Washington", "estate_definition": "the department shall seek adjustment or recovery from the individual's estate, and from nonprobate assets of the individual as defined by RCW 11.02.005 , but only for medical assistance consisting of nursing facility services, home and community-based services, other services that the department determines to be appropriate, and related hospital and prescription drug services.", "surviving_spouse_protection": "The department shall recognize an undue hardship for a surviving domestic partner whenever recovery would not have been permitted if he or she had been a surviving spouse. The department is not authorized to pursue recovery under such circumstances.", "hardship_waiver": "The department shall establish procedures consistent with standards established by the federal department of health and human services and pursuant to 42 U.S.C. Sec. 1396p to waive recovery when such recovery would work an undue hardship.", "statute_citation": "RCW 43.20B.080", "id": "washington", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/washington/", "source": "https://app.leg.wa.gov/RCW/default.aspx?cite=43.20B.080", "source_quote": "(3) In the case of an individual who was fifty-five years of age or older when the individual received medical assistance, the department shall seek adjustment or recovery from the individual's estate, and from nonprobate assets of the individual as defined by RCW 11.02.005 , but only for medical assistance consisting of nursing facility services, home and community-based services, other services that the department determines to be appropriate, and related hospital and prescription drug services. Recovery from the individual's estate, including foreclosure of liens imposed under this section, shall be undertaken as soon as practicable, consistent with 42 U.S.C. Sec. 1396p.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "West Virginia", "estate_definition": "the department, in addition to any other available remedy, may file a claim or lien against the estate of the recipient for the total amount of medical assistance provided by Medicaid for nursing facility services, home and community-based services, and related hospital and prescription drug services provided for the benefit of the recipient. Claims so filed shall be classified as and included in the class of debts due the state.", "surviving_spouse_protection": "The department may recover pursuant to subsection (a) only after the death of the individual's surviving spouse, if any and only after such time as the individual has no surviving children under the age of twenty-one, or when the individual has no surviving children who meet the Social Security Act's definition of blindness or permanent and total disability.", "hardship_waiver": "A claim may be waived by the department, if the department determines, pursuant to applicable federal law and rules and regulations, that the claim will cause substantial hardship to the surviving dependents of the deceased.", "statute_citation": "\u00a79-5-11c", "id": "west-virginia", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/west-virginia/", "source": "https://code.wvlegislature.gov/9-5-11c/", "source_quote": "\u00a79-5-11c. Right of the department to recover medical assistance. (a) Upon the death of a person who was fifty-five years of age or older at the time the person received welfare assistance consisting of nursing facility services, home and community-based services, and related hospital and prescription drug services, the department, in addition to any other available remedy, may file a claim or lien against the estate of the recipient for the total amount of medical assistance provided by Medicaid for nursing facility services, home and community-based services, and related hospital and prescription drug services provided for the benefit of the recipient. Claims so filed shall be classified as and included in the class of debts due the state.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Wisconsin", "estate_definition": "\u201cProperty of a decedent\u201d means all real and personal property to which the recipient held any legal title or in which the recipient had any legal interest immediately before death, to the extent of that title or interest, including assets transferred to a survivor, heir, or assignee through joint tenancy, tenancy in common, survivorship, life estate, revocable trust, or any other arrangement, excluding an irrevocable trust.", "surviving_spouse_protection": "A claim under par. (a) is not allowable if the decedent has a surviving child who is under age 21 or disabled or a surviving spouse.", "statute_citation": "Wis. Stat. \u00a7 49.496", "id": "wisconsin", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/wisconsin/", "source": "https://docs.legis.wisconsin.gov/document/statutes/49.496", "source_quote": "(3) Recovery from estates. 49.496(3)(a) (a) Except as provided in par. (b) , the department shall file a claim against the estate of a recipient, and against the estate of a nonrecipient surviving spouse, for all of the following, subject to the exclusion of any amounts under the Long-Term Care Partnership Program established under s. 49.45 (31) , unless already recovered by the department under this section:", "verified_fields": [ "estate_definition", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] }, { "state": "Wyoming", "estate_definition": "\"Estate\" shall include all real and personal property and other assets included within the individual's estate, as defined for purposes of this state's probate law, and includes any other real and personal property and other assets in which the individual had any legal title or interest at the time of death to the extent of that interest, including such assets conveyed to a survivor, heir or assign of the deceased individual through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement.", "surviving_spouse_protection": "If a decedent who was single, or who was the surviving spouse of a married couple, is survived by a child who has not attained twenty-one (21) years of age or is blind or permanently and totally disabled as defined by 42 U.S.C. \u00a7 1382c, no claim shall be filed against the estate.", "hardship_waiver": "The department of health shall establish procedures, in accordance with standards specified by the secretary of health and human services, under which the department of health shall waive the application of this section if application would work an undue hardship on the basis of criteria established by the secretary.", "statute_citation": "Wyo. Stat. \u00a7 42-4-206", "id": "wyoming", "url": "https://referencesource.org/medicaid-estate-recovery-rules-by-state/wyoming/", "source": "https://www.wyoleg.gov/statutes/compress/title42.pdf", "source_quote": "42-4-206. Claims against estates. (a) If an individual receives any medical assistance pursuant to this chapter, upon the individual's death, if single, or upon the death of the survivor of a married couple, either of whom received medical assistance, the total amount paid for medical assistance rendered for the individual or the spouse shall be filed by the department of health as a claim against the estate of the individual or the estate of the surviving spouse in the court having jurisdiction to probate the estate.", "verified_fields": [ "estate_definition", "hardship_waiver", "surviving_spouse_protection" ], "derived_fields": [ "state", "statute_citation" ] } ] }