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The income sources are from social security and a state pension, all but $45 of which goes toward her patient liability portion being paid to the state. The collection agengy is trying to collect. Can we ignore them? The debtee originally was advised of her status regarding title 19 when she went into the program. Can the collection agency garnish part of the pension?

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No, don't ignore them. Send them a letter detailing the patient's financial situation. Explain she is in a Nursing Home, on Medicaid, that her PNA is $45 and advise them who her POA is. If they go to court, there is nothing left there for the Judge to award to them. More likely they will sell the bad debt to another collection agency who won't have any luck either.
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