A snapshot of Georgia: Estate Recovery, a program of the Georgia Department of Community Health [Dec. 2007]

A Program Of The Georgia Department Of Community Health
A SNAPSHOT OF GEORGIA
Estate Recovery

Overview

Hardship Criteria

Estate Recovery has been allowed since the institution of the Medicaid program in 1965. It was made mandatory to the states by the federal government pursuant to the Omnibus Budget Reconciliation Act of 1993.
Estate Recovery applies to Medicaid recipients

In determining whether an undue hardship exists, the following criteria will be used: n The asset to be recovered is
an income producing farm of

n Who at the time of death were any age and an inpatient in a

one or more of the heirs and

nursing facility, intermediate care facility for the mentally retarded, or other mental institution n Who at the time of death were 55 years of age or older when the recipient received home and community based services instead of care in an institution

the annual gross income is limited to $25,000 or less; or n The recovery of assets would result in the applicant becoming eligible for governmental public

The Estate Recovery Statute has existed in Georgia since 1981. The Georgia Legislature amended the statute effective May 3, 2006 to allow for an exemption of estates worth $100,000 or less from recovery if

assistance based on need and/or medical assistance programs.

approved by the Centers for Medicare and Medicaid (CMS). On July 21,

2006, CMS denied the Georgia State Plan Amendment (SPA) that included the $100,000 exemption. Only

estates that are valued less than $25,000 are excluded from estate recovery because it is not cost effective

for the state to pursue recovery. The original agency rules regarding Estate Recovery were made effective

on August 5, 2004. The rules were amended effective November 8, 2006.

What is an "estate" in estate recovery?

The definition of an estate is "all real and personal property under the probate code." The estate also includes real property passing by joint tenancy, right of survivorship, life estate, survivorship, trust, annuity, homestead or any other arrangement. The estate additionally includes excess funds from a burial trust or
contract, promissory notes, cash, and personal property.

When must DCH be notified of a qualified estate?

DCH must be notified: n Within 30 days of the death of the recipient n If the personal representative of an estate makes a distribution either in whole or in part of the property of an estate without having reimbursed the Medicaid agency, the personal representative may be held personally liable

2 Peachtree Street, Atlanta, Ga 30303 w www.dch.georgia.gov

December 2007

A Snapshot Of Georgia Estate Recovery
Delayed Recovery
Recovery is delayed if: n The deceased recipient's spouse is still living n The deceased recipient has a living child under the age of 21 n The deceased recipient has a living child of any age that is blind or permanently and totally disabled per Title XIX of the Social Security Act
A lien may be placed on the home, but the recovery will be delayed while the following persons are still living in the home:
n A sibling of the recipient who was residing in the recipient's home for at least one year on a continuous basis immediately before the date that the recipient was institutionalized; and
n A child of the recipient who was residing in the recipient's home for at least two years on a continuous basis before the date that the recipient was institutionalized and who has established to the satisfaction of the Department that he or she provided care that permitted the recipient to reside at home rather than to become institutionalized.
The sibling or child of the recipient must demonstrate that he or she has been lawfully residing in the recipient's home on a continuous basis.
Additional Inforamtion
For additional information, contact the Estate Recovery Office, 770-916-0328 or visit our Web site www.dch.georgia.gov. Members with questions on Medicaid estate Recovery can submit them to: GAEstateRecovery@dch.ga.gov.