In this session, staff presented a draft chapter and recommendations on Medicaid estate recovery for inclusion in the March report to Congress. Federal law requires state Medicaid programs to seek recovery from the estates of deceased beneficiaries for payments for long-term services and supports (LTSS) and related services received when beneficiaries were age 55 or older or were permanently institutionalized.
This presentation provided an overview of the topics discussed in the draft chapter, including additional background information on LTSS financial eligibility, legislative history and requirements, and program administration. It also summarizes key findings of analytic work on state variation in estate recovery policies, estate collections, and effects of estate recovery on seeking Medicaid coverage.
The Commission approved three recommendations. The first recommendation calls on Congress to make estate recovery optional rather than required. The second recommendation calls on Congress to allow states with managed long-term services and supports to pursue recovery based on the cost of services where it is less than the capitation payment paid to a managed care plan. The third recommendation calls on Congress to direct the Secretary of the U.S. Department of Health and Human Services (HHS) to establish minimum hardship waiver standards, including a minimum estate value threshold for estate recovery.