Medi- Minutes

NH Surrenders! 
Medicaid Recovery Settlement 
May Signal Trend for Other States

In a recent settlement that interrupts a string of decisions in favor of aggressive Medicaid estate recovery, the State of New Hampshire was forced to change its estate recovery practices, to refund up to $5 million that had been wrongfully recovered, and to release and discharge approximately $20 million in real estate liens and mortgage deeds.

Federal Medicaid law requires states to recover Medicaid expenses from the estates of recipients who were over 55 when they received long-term care assistance. In states where the definition of "estate" has been expanded to include jointly held property, the state may attempt to recover expenses from the estate of the Medicaid recipient’s surviving spouse. But such recovery must take place after the death of the recipient’s surviving spouse or dependent or disabled children. Several states have been successful in the past year with aggressive tactics against the estates of surviving spouses.

But New Hampshire, which has not yet even expanded the definition of "estate" to include jointly held property, crossed lines even those states would not. New Hampshire’s Medicaid recovery practices clearly conflicted with federal law:

• Filing liens after the recipient’s death against real property partly owned by the surviving spouse;
• Demanding payment from the surviving spouse during his or her lifetime before releasing Medicaid liens;
• Refusing to limit Medicaid claims to the recipient’s ownership interest in real property; and
• Refusing to give notice and hearing either before or after the filing of Medicaid liens.

• Pay back all money wrongfully recovered, with interest;
• Stop placing liens on homes where the surviving spouse still resides;
• Stop forcing the surviving spouse to pay Medicaid expenses of a deceased recipient;
• Stop recovering Medicaid expenses from a surviving spouse’s estate.