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We have requested information on what they are owed and they have not provided it. We do not believe any funds were received from Medicaid for my mothers care, as all expenses were paid from her funds directly. How do we dispute this? She was in a nursing home for 18 months and we have all the cancelled checks for hospital and care showing it came from personal accounts. We are unable to sell her house as they have advised there is a debt of over $16,000.

I’m assuming your mom is deceased. So just who did you request the information from? I’m assuming by you screen name that your in TX, so was it TXDADS, TxHHS, HMS, or just to who did you ask this info from?
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Just who has “advised there is a debt of 16k”?
If for the latter, if it’s the title co, is it that there’s a current offer on the house with an Act of Sale scheduled but title co has found a “cloud”. So sale is stalled. Is that it? You should ask your Realtor to have the title co send you a copy on what title co found as to what the cloud is. Cloud Mistakes can happen especially if your mothers name is common or the street name is common.

In order to get state agencies or state outside contractor to honor a request, you have to have some legal standing. Like your Executor appointed with Letters Testamentary. DPOA doesn’t matter anymore as the elder is dead. If your in TX & opened probate and MERP has entered it as a claim, it is a class 7 claim for probate. I’d suggest you get with your probate attorney as to if it’s feasible for the type of administration your under to do the sale and then have the distribution of assets done after the sale. So house can be sold while a challenge to a claim is done through probate, then distribution done.

TX Medicaid room & board daily rate past couple of years is now about $172 a day reimbursement. (Super low too) So 16k abt 3 months of LTC NH Medicaid payments. If its that type of Medicaid repayment that MERP is looking at, you might want to carefully review her payments to the NH. TX NH that take Medicare, Medicaid and also take private pay run about 6k-8k a mo. If you mom’s checks don’t show around at least 120k-145k paid out systematiclly over 18 mos to NH, then she wasn’t all private pay. 

Whomever is Executor can ask TX DADS for a copy of her Medicaid application if you are challenging the debt file as a claim in probate. Imo You kinda have to be in probate to have the legal framework to challenge debts.

MERP is not limited to NH LTC Medicaid. Any LTC type of Medicaid program since Bush era Deficit Reduction Act of 2005 got signed into your state for those over 55 can have a Estate Recovery attempt. So regular continuing community based programs like adult day care programs, mental health counseling, PACE, all can have Recovery as these usually require the participant to be a “dual” to enroll as the programs have all cost shared between the M&Ms and you cannot just private pay even if you wanted to. Dual means on Medicare and Medicaid. Sometimes folks become a “dual” to be in a community program but later on when they move out of their house they are able to private pay for NH care. So there’s no NH Medicaid. But their dpoa or heirs don’t realize that the old dual program that mom signed onto years before is lurking with a Estate Recovery claim.
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Mom was on Medicaid for health insurance only? I would assume she had Medicare and medicaid was her supplimental? Not sure why she would have paid anything. The hospital would bill Medicare and the balance would be paid by Medicaid. Who paid out of her "funds". You should have paperwork from Medicaid with a case number on it and the name of the caseworker. Call the CW and ask for a letter showing how much the person owes. I had my letter in a couple of days. It takes a while to put a lean on a house. The letter tells you where to send a check to. Use that at time the house sells if no lean by that time. A check should be made out to them at time of closing.
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Reply to JoAnn29
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