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In Georgia my mother was in nursing home for 3 years and passed away 6 months ago. I received a letter from Medicaid saying they would review and let me know if they would take her home for Medicaid recovery expense. I still have not heard back from them and it has been 6 months. Is there a time limit on how long they can make you wait on their decision?

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Pam - Hot can't as no will, she's not executrix, probate can't open. For TX, if no will then it's intestate death & escheats to the state. She'd have to establish lineal heirship.

Hot - probably, as the cutoff is 3K, I think. Here's my thoughts on all this for what it's worth: First, I'd go to the DADS MERP site to see what the exact figure is for how low it needs to be not to be cost effective for HMS (who is the outside contractor for TX & about 15 other states); second I'd look at the DADS MERP exemption list to see if you or other lineal heirs could qualify for any of those & pull together the items needed for that; third, if you have any exclusions for costs related to maintenance and upkeep on the empty property gather those up. If you do, then you fax or send a certified letter with RRM within 60 days to file for whatever categories seem to apply with documentation as a lineal heir. Each heir has to file their own specific exemption or exclusion & with documentation too. HMS reviews it and will likely decline all and informs you so by certified letter in about 60 days; so you then file an appeal within 60 days that DADS (not HMS) reviews. In this period of time, you need to get an attorney to work on the lineal heirship.

So you have gotten just the first letter, right? What is Medicaid paid amount? Letters from HMS seem to be generated about every 3 weeks. Its a debt collectors type of series of letters with an attachment on the tally paid and they can start 9% interest in 180 days. There is someone on this site who has their mom's home with assessor value of 30K and she has been going back & forth for almost a year to get it value adjusted with HMS as house needs a ton of work and won't sell for assessed value. So apparently there is room for negotiation.

Be sure to look at the date of the inside letter and the date on the outside postmarked envelope - there could be a time lag of several days or a week plus between the two and you want to note that on any correspondence you send as all this is very timeframe dependent. Again you need to respond with documentation one way or the other within 60 days initially.

So dad had no will? I'd really look for a will. If mom predeceased dad and probate was done, I'd get the filing on that from the courthouse as the same attorney likely drew up will. In theory, with no will the estate is considered intestate and as such all escheat to the state. I'm not sure how MERP works when all escheated to the state. I'd imagine the state assumes priority. Not the best position for heirs.

21K - for both land & improvements (house)? Pretty low. Geez, where is this? Could the property sell for 21K and any idea of the days on market (DOM) for other houses in the same area where it is?

So just how do you feel about the property? Do you live there so you need the house? Or other family? OR Is it a total pain in the butt and not worth ever dealing with or returning to? Could it be worth the time & cost to get it? Is house current on taxes, utilities? Do you have the funds to deal with house costs (taxes, insurance, utilities, etc) for whatever seems to be the DOM period and your attorney's fees? If you paid for things on the property, do you have the receipts or cancelled checks to be able to present as exclusions to HMS and then to present as verifiable deductions to the Medicaid tally? Would your investment of both time and $ for the house make sense? Could you get insurance? OR is there just something about the house that makes it worthwhile?

If you really want the house, the worst possible scenario would be you'd need 21K to pay to the state to get the property. The rest of the Medicaid debt is not your problem. If you do this, I'd suggest paying for an appraisal as it may be worth less than the tax assessor's value.

If you have no interest in the house and no costs to be reimbursed from it's sale, having the situation being that there is no will, could be a good thing. You tell HMS that there's no will and property is of no interest to you. Not your problem & not your debt. State will have to deal with all. Let us know what you decide to do and what the correspondence reads. We all learn from each other.

Also expect to get a letter from the tax assessor. They will want to know who the new owner is and their tax status. Letter will be sent to whichever address the October 2014 mailing went for taxes due in January, 2015. Your supposed to respond in 30 days. Texas allows 4 years for probate, so you should be able to have the house placed as "estate of" till new owner is determined. If you plan on keeping the property, make paying the taxes be a priority. Good luck and keep a sense of humor in all this.
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hotoiler, get an EIN# from the IRS and put all of Dad's assets there, including funds from the sale of the house/car/etc. look up Your Estate Under Texas Law (TX 96-127). You might want to talk to an estate attorney as well.
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Igloo572 I am in Tx an my dad just passed. In a NH under Medicaid. His property is appraised at 21k. I'm only child with no will and today got the letter of intent. I have no exemption or hardships. My father told me to shut the house down an not pay anything an he would deal with it when he got well. Well he never got well an never left the NH. You seem very knowledgeable about this. Do you think they will come after this small estate?
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Mch - Pennsylvania has HMS as the outside contractor for MERP. HMS seems to approach MERP much like what a debt collector does. HMS is very very good & have a sophisticated system to research debts. There doesn't seem to be a statute of limitations that i can find either so anything after PA signed off on MERP is fair game. Would be a date in 2005 or 2006.

BTW A different division does compliance and oversight for CMS.

Think of what debt collectors do: lots of letters, demand notices, notices that judgements can be done, etc. This is what is happening, isn't it?

My suggestion is to do 3 things:
1. You have to respond to the letters. State the facts as you know them - that moms estate was settled by probate court on XYZ date; that both Medicare & Medicaid accepted funds from the lawsuit settlement as full & final. As probate was closed, you are not responsible for any debts against the estate as that should have been presented in probate. As such there is no recoverable assets.
That you consider this matter closed and if they do not they need to respond to you in detail within 30 days. Keep this short & 1 page. You have to do this within the timeframe allowed as based in when you received the first letter.

You being on SS or handicapped isn't important, that it is NOT your debt is what is important. If your brother was executor, this should be his problem.

Send the letter certified mail AND with return registered receipt card ( the green post card ) from uspo. This will run under $10.00 & will be the best 10 you have spent ever! You HAVE to mail it this way to create a legal paper trail.

2. If you don't have all the lawsuit paperwork and probate paperwork, you need to get those. You do this after #1 is done & mailed. Probate is easy as you can probably go on-line to your county courthouse and for a small fee get them as a download; or you drive down there & pay to get them either then & there or they mail it. Take cash as many courthouses don't take checks or do a hefty surcharge on credit cards. If you go, the courthouse is best about 9:30/10 AM as court in sessions and less busy. take a valid ID, dress nice & conservatively and if you own property take your last tax assessor form so they know you are a taxpayer & member of the community. The ladies that staff the courthouse can be quite helpful.

Lawsuit stuff - old attorney should have this. They can charge you a research fee and copy fee for all this too. Now it may be filed at the courthouse (this kinda depends on how your state does lawsuits) so ask the ladies at the courthouse. If so, again you pay a fee for this but will be less than the research fee the law firm could charge you.

You may not need those, but you need to have them ready to refer to. It is worth spend $20-30 to have them.

3. Now you will get the RRR ( the green postcard) mailed back to you It will have date received put in along with a signature. Could be a actual signature or a stamp signature. As to what next depends on their response.

3a- Now if 30 days from the date on the card you get nothing from MERP, then you send another certified RRR letter stating something like: you have not heard back from them so you consider this issue closed.

OR
3b - they send a demand letter with specifics. Then you need an attorney.

You could have an attorney do all of this but really step 1 & 2 & 3a you can do. If you do nothing, you may find that MERP can do whatever by default. It's like not responding to a debt collector letter in 30 days. if you do nothing, you are basically agreeing that whatever is in the letter is accurate. Good luck & get on all this ASAP.
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no my mom had nothing and when money was taken out for medicare and Medicaid they said it would be closed.I live in Pennsylvania and my mothers name was never on my home I bought my own home.I LIVE ON A SMALL SOCIAL SECURITY CHECK AND DISABLED.HER HOME WAS SOLD BY MY BROTHER YEARS AGO SHE JUST HAD A SMALL CHECK AND PENSION.I was told I should be declared a hardship but this is 8 years after all was to be settled now wanting to put a judgement I am so upset ty so much for writing any help please let me know ty MC
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Mch - what state are you in? this is going to explain who is doing this.

Jeanne is spot on that you need to review the settlement documents from the law suit. Was it a "full & final" for both Medicare & Medicaid?

Was your home ever in moms name and became yours after she died?
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yes I have the papers where they settled to medicare and Medicaid ty for your answer any or all info is greatly appreciated
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Can you contact the law firm that negotiated the deal with Medicaid, or do you perhaps have copies of the documents from that time? If Medicaid settled for a certain amount, it is settled (or so I would think). Do they just need to be reminded of this?

I am truly sorry for all the grief and aggravation you have experienced.
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my mother died to nursing home letting her fall and then sat her in a chair for a week setting in a mess having a bed sore so big it ate into the bone and she died of septic shock.I took a personal lawsuit out against them;and hired attorneys so we won the case and the judge made the decision.so the atty got 285,000 and he ordered that medicare would get 1200 and Medicaid 10,000 which they negotiated and came to a smaller settlement.I ended up with 95,000 and I paid a probate atty 15,000 funeral all the things that needed paid.My mother had nothing when she died nothing so after allpaid out there was 20,000 left and this has been 8 years ago im on a small social security check and now Medicaid wants to know where that 20,000 went 8 years later threatning to put a judgement on my home and maybe have me arrested;this is my money I had left out of the settlement so in 8yrs I don't know where it all went;please tell me whats going on.
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All I know is that the wheels of government turn Very slowly.
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I think you should move forward, file the Will with the Probate Court and submit the asset report, the debt report and allow the Judge to render a decision.
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Sunny - all the states are now required to have in place MERP, had to have it into law in 2005 - 2006 when states had federal DRA placed into their administrative code. Just how varies by state law approach to probate & property rights & consumer rights.

Your state should have the basics on Medicaid website.

There seems to be an increase in MERP actions as states are more going to outside contractors to do this. So they are much more aggressive as their payout is dependent on collection.

It will be interesting as merp filing is more known, because if family realize they will never ever get ownership of mawmaws house, there will be no reason to ever pay a penny on anything on it ever. Perhaps live there & pay utililities. But otherwise no insurance, taxes, maintenance, just walk away and let it become blighted. If there a mortgage, absolutely no reason to ever pay for anything house. As between mortgage holder & merp, they will get all proceeds from a sale. If family is never going to own it, why bother. You don't spend a penny. The state wants it?, well then it's the states problem.

I do wonder if in a different scenario: that you don't deal with it - you never open probate. let it go into limbo &'gomto tax sale. You see property like that all over, just dead houses falling apart slowly.

Family could get it at tax sale for very little & MERP gets zero.

MERP kinda assumes that family will do whatever to keep mawmaw house.
But what if they don't?
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Great information Igloo572! I'm taking notes, even though I don't live in Texas. My situation is different, but I'll deal with it eventually.

I do wonder if Medicaid MEDICAL seeks reimbursement from the decease's estate. I've read a little about it, but I'm never sure what to believe. I've also been told by an Elder Care attorney in NC and a NC Social Worker who took my cousin's application one thing, but I'm a skeptical person.
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Mch - "attorney paid Medicare" - what do you mean by this? Medicare is a direct benefit entitlement which you paid into via FICA. Medicare does not seek repayment. As far as I'm aware the only time Medicare comes back for reinbusrement is when Medicare paid for services due to an event, which you get a settlement for later on. Like you sue for a slip-N-fall then get hospitalized which Medicare paid for; then later get 100k settlement, so Medicare wants to be reimbursed from settlement. So was this the situation? & you got 95k?
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how long does Medicaid have to ask for repayment?My mother died 11 years ago because of the nursing home I took a lawsuit out and after attorney fees I had approx. 95000 to pay for funeral all exspenses and had 20,000 left the attorney paid medicare what they wanted and Medicaid now 8 years later they want more and want to put a judgement on my home can they do this
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continued……….My feeling is that MERP is document driven, so if you don’t respond in writing to request, the claim is done automatically. They know that eventually something will happen & property will need to be cleared of claims in order to sell or transfer ownership. Eventually MERP claim will have to be dealt with & that is totally to their advantage. It’s more the approach of a debt collection agency.

Keep in mind that often heirs of deceased Medicaid recipients make the mistake of assuming that HMS is the final authority on all matters pertaining to estate recovery. That is, the heirs accept at face value whatever they are told by HMS staff regarding whether a claim will be filed and the amount of the claim. It is important to remember that HMS represents the State in the estate recovery process. It gets a % of the recovery. It does not represent the interests of the decedent’s family or heirs. For this reason, HMS’s position may be in direct opposition to the best interests of the heirs.

It’s my view that if you file for exemptions or expenses, it lets MERP know that you have no issue with documentation and probate. You are prepared to go to the mat (or the mattress aka the Godfather) on this. If all MERP functions were done by state employees, MERP could take forever and doesn’t matter what happens as they get paid the same fixed wage. But most states do MERP collections by outside contractor (HMS mainly) with the contractor getting a % of $. So an estate with exemptions or exclusions & is 50K value is going to take the same level of legal & courthouse time for as a 250K value house. I know what I'd go for........

But assuming you get through MERP exemptions or claims, there still will be details needed to legally transfer the property ownership. When you go to probate in TX, you will need to have an "Authorization & MERP Certification - July, 2013 edition" release form done by MERP to you in order for the probate judge to distribute the house as per the will. Also need to have this for a clear title issued from title company. It's a simple 1 page form. there probably is a similar document for property in Georgia that needs to be done & filed.

If it's a small estate (with a will, house & no debt) and you get the MERP certification form above, you might not even need full probate. In TX, you could do “Muniment of Title” to transfer house to whoever named in the will. Muniment is pretty minimal in courthouse time & cost, probably 1K & 3 hearings.

All these things are sticky. I’m a believer in having probate attorney as you want it to be done right. For TX if you’re in a big county (Bexar, Harris, Travis, Ft Bend…), it’s done via affadavit & notarized forms and is quick. In smaller counties every line can get read and all interested parties can be there so pack a lunch and get a hotel. If you have the paperwork together (death certificates, will, inventory, MERP forms) the actual attorney time is small and the fees modest.

On a general basis, I don't have an issue with MERP. I can understand why the feds made the states do some sort of recoup. But I do have a problem in that I bet 80% of families and the Medicaid applicant really don't fully realize what it means when they apply initially AND that just so often family is still bereaved from the death and just cannot deal with the details required in order to not have a claim or lien so are blindsided a year or so later when they go to sell the home.

MERP -Medicaid estate recovery gets to the heart of the issue of who should pay for long-term care -- the public through the tax-supported Medicaid program, &/or users of long-term care through their personal resources, including those remaining after death. Amounts collected from Medicaid recipients' estates are not insignificant in absolute terms. They do, however, pale next to total Medicaid spending for long-term care. And it's only going to increase, given that Medicaid is available only to those with very limited resources and the state of US economy.
In a way, the fact that so many people are poverty level will decrease the amount of MERP because many heirs will be able to do hardship exemptions.

At my mom's NH, there are 9 ladies & all of them have 1940-1950's era homes & all have decades of delayed home maintenance to some degree. For family doing anything other than just the bare minimum needed for the house would be a total waste & a bad investment. All but 2 sit empty. I don't think any of the houses can sell for the assessor value. My mom's certainly can't.

The whole MERP system was done in the early 2000 - 20002 when real estate was totally a go-go. So everybody's house just increased in value just by existing. In theory, MERP could be repaid in full and the family would get the rest of the money. $$ for everybody, everybody happy. Totally different conditions now.
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You need to go onto the State of Georgia Medicaid website to see what's what under your states law for this to happen & how.

Keep in mind that Medicaid - although a federal & state program - is managed or administered by each state uniquely. So each states take on property rights, probate, death laws will determine just how MERP - Medicaid Estate Recovery is done. Many states have turned over MERP to outside contractors. I think GA has turned this function over to HMS. They are the big player in MERP and seem to approach it more akin to what a debt collector does, so keep that in mind.

My mom in TX still has her home & is in a NH & on Medicaid. So I try to keep up with MERP as dealing with it is in my future. TX MERP is done by HMS too. For what it's worth, here is what seems to happen in TX (going to be long, get a cup of coffee…)
1. MERP is done as an acknowledgment of agreement within the Medicaid application and renewals. The agreement basically means that if there are any assets after death that the state can do whatever legal to enforce the agreement.
Now for most on Medicaid, they are impoverished & no assets while alive but upon death the exempt home becomes non-exempt and part of their estate. Ditto for a life insurance policy who names the estate as beneficiary. Now to divvy up assets correctly after death you have to do probate. MERP - in theory- then has to go to probate court to present just as any other creditor does.

2. So your states probate laws are going to be very important. TX is a level of claim probate state and debts paid in order of claim class. MERP in TX is done as class 7 probate claim as a debt of the estate. Most states do not do it this way and MERP is a lien on equal footing in being paid. TX overall is an easy probate state. The claims against the estate are classified in order of payment: class 1 is funeral, burial, recent medical (limited to 15K); class 2 is maintenance of the estate (executor gets paid, if there is no $ but property then payment comes from eventual sale);…. MERP is a class 7. Whatever class your are, you have to file a claim in court, etc. I’ve been executrix before and believe me there is a huge opportunity for negotiation on debts against the estate, especially if the debtors realize you can/will/ might run probate out to the max. MERP can negotiate too as they have to do a claim release in order for you to get clear title. But MERP seems to have found a way around the probate bubble this by doing a claim by default (more on that below)

3. Property laws - this too will be important. TX law is pretty pro property rights and MERP cannot place a lien on the property. It is a claim on the property. A claim that has to be lifted unless there is another that supersedes it outside of probate - like a lady bird deed. Because of this MERP rates are lower in TX.

4. But before you worry about probate, a VERY IMPORTANT issue is whether or not MERP will even file a claim against the estate for Medicaid NH $$ recovery.
Now for TX, the Texas Health and Human Services Commission is the Medicaid agency in this state & has ultimate responsibility for MERP. However, many of the administrative functions for Medicaid have been delegated to the Dept of Aging and Disability Services, and the actual MERP collections are handled by a contractor (“HMS”). All this is on the state TxHHS website and it also easily found with the TAC - Texas Adminstrative Code. The TAC is mucho importante as it states the time frames required legally and spells out in detail the exemptions, etc. Your state will have something on-line on all this too.

It is up to family to see, file and document any exemptions, etc to MERP.

3. The Letter of Intent - Now at some point after death, for TX the state will send out a "letter of intent" to whomever is on file as the contact for the deceased. It sounds like you got this letter, correct? Usually within the letter there will be stated the amount paid by the state Medicaid's program (amount paid is not the amount owed necessarily either) and also within the letter will indicate something about filing for exemptions, etc. If you all qualify for any of the exemptions, etc, it is CRITICAL that you respond to the letter within the indicted time frame that you qualify for & will file for an exemption, etc. Texas MERP rules allow numerous exemptions from estate recovery, certain deductions from the estate recovery claim, and waivers of estate recovery based on undue hardship. There are special rules addressing undue hardship waivers involving a homestead. The rules further allow for a review of the denial of a request for an undue hardship waiver. But you HAVE TO LET THE STATE KNOW by your response that these exist. Then the state will send out the forms you have to fill out tailored for whatever exemption, etc you are filing for. Which you return with all documentation within the time-frame indicated. If you don't, then what seems to happen is that the state can place a claim by default.

The state has to do a cost/benefit analysis to determine if the MERP claim should be done. If you do nothing, then the state can place a claim basically by default as you have presented no reason for the state not too.

Now for TX one current glitch is that the system is set up that recovery clock is set by the contractor. Doesn't start ticking till the state administrator lets the state contractor be aware of the claim. There seems to be a often a time lag between the two and it is totally allowed under TAC rules to happen. On this site, there have been posts from family who are finding out about the claim often a year after the death.

Some states seem to send out a basic letter stating the MERP exists type of info letter right after death and then at a later point the contractor sends out the "letter of intent". My thought is that this is done to see if family is going to open probate as that is going to require lots more of MERP rather than dealing with family who does nothing and MERP can do a claim or lien by default or can file probate as an interested party.

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Medicaid should have a lien on the property. When the house is sold, the lien is satisfied at the closing table. Then the heirs would get the remainder. Check and see if there is a lien on the property.
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