How long after death must you wait to find out if Medicaid will take Mom's home to recover debt that was incurred in NH?

continued……….My feeling is that MERP is document driven, so if you don’t respond in writing to request, the claim is done automatically. They know that eventually something will happen & property will need to be cleared of claims in order to sell or transfer ownership. Eventually MERP claim will have to be dealt with & that is totally to their advantage. It’s more the approach of a debt collection agency.

Keep in mind that often heirs of deceased Medicaid recipients make the mistake of assuming that HMS is the final authority on all matters pertaining to estate recovery. That is, the heirs accept at face value whatever they are told by HMS staff regarding whether a claim will be filed and the amount of the claim. It is important to remember that HMS represents the State in the estate recovery process. It gets a % of the recovery. It does not represent the interests of the decedent’s family or heirs. For this reason, HMS’s position may be in direct opposition to the best interests of the heirs.

It’s my view that if you file for exemptions or expenses, it lets MERP know that you have no issue with documentation and probate. You are prepared to go to the mat (or the mattress aka the Godfather) on this. If all MERP functions were done by state employees, MERP could take forever and doesn’t matter what happens as they get paid the same fixed wage. But most states do MERP collections by outside contractor (HMS mainly) with the contractor getting a % of $. So an estate with exemptions or exclusions & is 50K value is going to take the same level of legal & courthouse time for as a 250K value house. I know what I'd go for........

But assuming you get through MERP exemptions or claims, there still will be details needed to legally transfer the property ownership. When you go to probate in TX, you will need to have an "Authorization & MERP Certification - July, 2013 edition" release form done by MERP to you in order for the probate judge to distribute the house as per the will. Also need to have this for a clear title issued from title company. It's a simple 1 page form. there probably is a similar document for property in Georgia that needs to be done & filed.

If it's a small estate (with a will, house & no debt) and you get the MERP certification form above, you might not even need full probate. In TX, you could do “Muniment of Title” to transfer house to whoever named in the will. Muniment is pretty minimal in courthouse time & cost, probably 1K & 3 hearings.

All these things are sticky. I’m a believer in having probate attorney as you want it to be done right. For TX if you’re in a big county (Bexar, Harris, Travis, Ft Bend…), it’s done via affadavit & notarized forms and is quick. In smaller counties every line can get read and all interested parties can be there so pack a lunch and get a hotel. If you have the paperwork together (death certificates, will, inventory, MERP forms) the actual attorney time is small and the fees modest.

On a general basis, I don't have an issue with MERP. I can understand why the feds made the states do some sort of recoup. But I do have a problem in that I bet 80% of families and the Medicaid applicant really don't fully realize what it means when they apply initially AND that just so often family is still bereaved from the death and just cannot deal with the details required in order to not have a claim or lien so are blindsided a year or so later when they go to sell the home.

MERP -Medicaid estate recovery gets to the heart of the issue of who should pay for long-term care -- the public through the tax-supported Medicaid program, &/or users of long-term care through their personal resources, including those remaining after death. Amounts collected from Medicaid recipients' estates are not insignificant in absolute terms. They do, however, pale next to total Medicaid spending for long-term care. And it's only going to increase, given that Medicaid is available only to those with very limited resources and the state of US economy.
In a way, the fact that so many people are poverty level will decrease the amount of MERP because many heirs will be able to do hardship exemptions.

At my mom's NH, there are 9 ladies & all of them have 1940-1950's era homes & all have decades of delayed home maintenance to some degree. For family doing anything other than just the bare minimum needed for the house would be a total waste & a bad investment. All but 2 sit empty. I don't think any of the houses can sell for the assessor value. My mom's certainly can't.

The whole MERP system was done in the early 2000 - 20002 when real estate was totally a go-go. So everybody's house just increased in value just by existing. In theory, MERP could be repaid in full and the family would get the rest of the money. $$ for everybody, everybody happy. Totally different conditions now.

my mother died to nursing home letting her fall and then sat her in a chair for a week setting in a mess having a bed sore so big it ate into the bone and she died of septic shock.I took a personal lawsuit out against them;and hired attorneys so we won the case and the judge made the decision.so the atty got 285,000 and he ordered that medicare would get 1200 and Medicaid 10,000 which they negotiated and came to a smaller settlement.I ended up with 95,000 and I paid a probate atty 15,000 funeral all the things that needed paid.My mother had nothing when she died nothing so after allpaid out there was 20,000 left and this has been 8 years ago im on a small social security check and now Medicaid wants to know where that 20,000 went 8 years later threatning to put a judgement on my home and maybe have me arrested;this is my money I had left out of the settlement so in 8yrs I don't know where it all went;please tell me whats going on.

You need to go onto the State of Georgia Medicaid website to see what's what under your states law for this to happen & how.

Keep in mind that Medicaid - although a federal & state program - is managed or administered by each state uniquely. So each states take on property rights, probate, death laws will determine just how MERP - Medicaid Estate Recovery is done. Many states have turned over MERP to outside contractors. I think GA has turned this function over to HMS. They are the big player in MERP and seem to approach it more akin to what a debt collector does, so keep that in mind.

My mom in TX still has her home & is in a NH & on Medicaid. So I try to keep up with MERP as dealing with it is in my future. TX MERP is done by HMS too. For what it's worth, here is what seems to happen in TX (going to be long, get a cup of coffee…)
1. MERP is done as an acknowledgment of agreement within the Medicaid application and renewals. The agreement basically means that if there are any assets after death that the state can do whatever legal to enforce the agreement.
Now for most on Medicaid, they are impoverished & no assets while alive but upon death the exempt home becomes non-exempt and part of their estate. Ditto for a life insurance policy who names the estate as beneficiary. Now to divvy up assets correctly after death you have to do probate. MERP - in theory- then has to go to probate court to present just as any other creditor does.

2. So your states probate laws are going to be very important. TX is a level of claim probate state and debts paid in order of claim class. MERP in TX is done as class 7 probate claim as a debt of the estate. Most states do not do it this way and MERP is a lien on equal footing in being paid. TX overall is an easy probate state. The claims against the estate are classified in order of payment: class 1 is funeral, burial, recent medical (limited to 15K); class 2 is maintenance of the estate (executor gets paid, if there is no $ but property then payment comes from eventual sale);…. MERP is a class 7. Whatever class your are, you have to file a claim in court, etc. I’ve been executrix before and believe me there is a huge opportunity for negotiation on debts against the estate, especially if the debtors realize you can/will/ might run probate out to the max. MERP can negotiate too as they have to do a claim release in order for you to get clear title. But MERP seems to have found a way around the probate bubble this by doing a claim by default (more on that below)

3. Property laws - this too will be important. TX law is pretty pro property rights and MERP cannot place a lien on the property. It is a claim on the property. A claim that has to be lifted unless there is another that supersedes it outside of probate - like a lady bird deed. Because of this MERP rates are lower in TX.

4. But before you worry about probate, a VERY IMPORTANT issue is whether or not MERP will even file a claim against the estate for Medicaid NH $$ recovery.
Now for TX, the Texas Health and Human Services Commission is the Medicaid agency in this state & has ultimate responsibility for MERP. However, many of the administrative functions for Medicaid have been delegated to the Dept of Aging and Disability Services, and the actual MERP collections are handled by a contractor (“HMS”). All this is on the state TxHHS website and it also easily found with the TAC - Texas Adminstrative Code. The TAC is mucho importante as it states the time frames required legally and spells out in detail the exemptions, etc. Your state will have something on-line on all this too.

It is up to family to see, file and document any exemptions, etc to MERP.

3. The Letter of Intent - Now at some point after death, for TX the state will send out a "letter of intent" to whomever is on file as the contact for the deceased. It sounds like you got this letter, correct? Usually within the letter there will be stated the amount paid by the state Medicaid's program (amount paid is not the amount owed necessarily either) and also within the letter will indicate something about filing for exemptions, etc. If you all qualify for any of the exemptions, etc, it is CRITICAL that you respond to the letter within the indicted time frame that you qualify for & will file for an exemption, etc. Texas MERP rules allow numerous exemptions from estate recovery, certain deductions from the estate recovery claim, and waivers of estate recovery based on undue hardship. There are special rules addressing undue hardship waivers involving a homestead. The rules further allow for a review of the denial of a request for an undue hardship waiver. But you HAVE TO LET THE STATE KNOW by your response that these exist. Then the state will send out the forms you have to fill out tailored for whatever exemption, etc you are filing for. Which you return with all documentation within the time-frame indicated. If you don't, then what seems to happen is that the state can place a claim by default.

The state has to do a cost/benefit analysis to determine if the MERP claim should be done. If you do nothing, then the state can place a claim basically by default as you have presented no reason for the state not too.

Now for TX one current glitch is that the system is set up that recovery clock is set by the contractor. Doesn't start ticking till the state administrator lets the state contractor be aware of the claim. There seems to be a often a time lag between the two and it is totally allowed under TAC rules to happen. On this site, there have been posts from family who are finding out about the claim often a year after the death.

Some states seem to send out a basic letter stating the MERP exists type of info letter right after death and then at a later point the contractor sends out the "letter of intent". My thought is that this is done to see if family is going to open probate as that is going to require lots more of MERP rather than dealing with family who does nothing and MERP can do a claim or lien by default or can file probate as an interested party.

more in next post

Sunny - all the states are now required to have in place MERP, had to have it into law in 2005 - 2006 when states had federal DRA placed into their administrative code. Just how varies by state law approach to probate & property rights & consumer rights.

Your state should have the basics on Medicaid website.

There seems to be an increase in MERP actions as states are more going to outside contractors to do this. So they are much more aggressive as their payout is dependent on collection.

It will be interesting as merp filing is more known, because if family realize they will never ever get ownership of mawmaws house, there will be no reason to ever pay a penny on anything on it ever. Perhaps live there & pay utililities. But otherwise no insurance, taxes, maintenance, just walk away and let it become blighted. If there a mortgage, absolutely no reason to ever pay for anything house. As between mortgage holder & merp, they will get all proceeds from a sale. If family is never going to own it, why bother. You don't spend a penny. The state wants it?, well then it's the states problem.

I do wonder if in a different scenario: that you don't deal with it - you never open probate. let it go into limbo &'gomto tax sale. You see property like that all over, just dead houses falling apart slowly.

Family could get it at tax sale for very little & MERP gets zero.

MERP kinda assumes that family will do whatever to keep mawmaw house.
But what if they don't?

I think you should move forward, file the Will with the Probate Court and submit the asset report, the debt report and allow the Judge to render a decision.

Medicaid should have a lien on the property. When the house is sold, the lien is satisfied at the closing table. Then the heirs would get the remainder. Check and see if there is a lien on the property.

how long does Medicaid have to ask for repayment?My mother died 11 years ago because of the nursing home I took a lawsuit out and after attorney fees I had approx. 95000 to pay for funeral all exspenses and had 20,000 left the attorney paid medicare what they wanted and Medicaid now 8 years later they want more and want to put a judgement on my home can they do this

Mch - "attorney paid Medicare" - what do you mean by this? Medicare is a direct benefit entitlement which you paid into via FICA. Medicare does not seek repayment. As far as I'm aware the only time Medicare comes back for reinbusrement is when Medicare paid for services due to an event, which you get a settlement for later on. Like you sue for a slip-N-fall then get hospitalized which Medicare paid for; then later get 100k settlement, so Medicare wants to be reimbursed from settlement. So was this the situation? & you got 95k?

Great information Igloo572! I'm taking notes, even though I don't live in Texas. My situation is different, but I'll deal with it eventually.

I do wonder if Medicaid MEDICAL seeks reimbursement from the decease's estate. I've read a little about it, but I'm never sure what to believe. I've also been told by an Elder Care attorney in NC and a NC Social Worker who took my cousin's application one thing, but I'm a skeptical person.

All I know is that the wheels of government turn Very slowly.