If the surviving spouse is the Medicaid recipient can medicaid take the surviving spouse's newly awarded assets for back payment to them?

That depends on the amount of the assets. You'll need to check with Medicaid to see how your state handles this. Good luck,
Carol

Denise - was this an insurance policy and the Medicaid receipient is the beneficiary? or is it where someone died and left a hard asset, like house or land or securities, to them?
They don't have to accept the benefit, this is sticky and you need an estate & probate savvy attorney to work this out. What they can do is refuse it and then it goes to whomever is next on the list as beneficiary of assets of the estate, if that is allowed in your state. If this is still working it's way through probate, you need to speak to whomever is executrix and asap. I've been executrix twice and one of my aunts left a parcel to a family member who lives in a double tax state (estate & income) and he just didn't want the land or the issues related to all that. He refused acceptance and it went to me, as executrix, to choose to whom to default to. It can be done but you need good legal to do it properly.

If they are inheriting because the recently deceased died intestate (no will) and they are the surviving heir, you need to find out how your state does intestate stuff before they refuse. The MERP (Medicaid Estate Recovery Program) office in your state is going to know how this works and it may be that MERP will file for recovery of the asset that is set to go to the Medicaid recepient heir. It would be a pro-active claw-back by MERP and whether MERP could do this is super dependent on each states viewpoint on estate (death laws) & probate as MERP has to work within the states law on probate (that's where recovery get's done)