AARP Eye Center
Federal • State
The federal government should permit states to opt out of Medicaid estate recovery.
If estate recovery is utilized, the federal government and states should establish procedures for waiving estate recovery when undue hardship would result. States should be permitted to forgo estate recovery of Medicaid liens for families with low incomes.
States should use any permitted flexibilities to minimize the impact of estate recovery. This should include limiting the benefits for which the state pursues recovery to only those required by federal law. In addition, hardship waiver policies should be expanded and cost-effectiveness thresholds established.
Heirs should have an extended period of time to reimburse the state. They should not be forced to sell the deceased person’s home. They should also be protected from coercive tactics designed to force repayment of Medicaid expenditures.
Federal regulations should require states to use all money recovered from the estates of Medicaid recipients to improve the program.
The term “estate” under the estate recovery program should be defined no more broadly than it is under state probate law.
Federal regulations should ensure public accountability by requiring estate recovery programs to provide consistent and readily available data on the total costs of the program and the numbers of participants affected. Other essential information should be included, such as the number of exemptions, deferrals, hardship waivers, liens, and contested recoveries.
Federal regulations should ensure that consumers are adequately informed about Medicaid estate recovery. Recovery notices should be timely, clear, and easy to read (e.g., published in an adequate type size). They should include vital information concerning exemptions, deferrals, hardship waivers, liens, and consumer obligations and rights.
Federal regulations prohibiting states from placing liens on the property of Medicaid recipients who receive LTSS in the home and community should remain in force.