Thursday, August 18, 2011

Is There a Deadline for the State of Ohio to Request Medicaid Estate Recovery?

The answer to this question of course is yes. However, thanks to a recent Ohio Supreme Court decision, that deadline may not be for years and years if no one notifies Ohio's Medicaid Estate Recovery Administrator of the death of a Medicaid recipient.

What is Medicaid Estate Recovery?

The Ohio Department of Job & Family Services is the Ohio administrative agency responsible for administering Medicaid (not to be confused with Medicare) benefits to Ohio residents. Because Medicaid eligibility is many times dependent upon a person's financial resources, there are numerous rules and regulations associated with a person's ability to receive Medicaid benefits as well as certain rules and regulations that allow the State of Ohio to recover Medicaid payments made to a beneficiary after that beneficiary dies.

Specifically, the administrator of the Medicaid Estate Recovery Program in Ohio may make a claim against a Medicaid recipient's estate after that recipient dies. If the Medicaid recipient dies having assets, those assets are subject to the claims of the estate recovery administrator to the extent of any Medicaid benefits paid for the benefit of that recipient during his or her lifetime.

What is the deadline?

Ohio Revised Code Section 2117.061(E) provides that the administrator must present a claim for estate recovery to the person responsible for the estate of the decedent recipient not later than ninety (90) days after the date on which the administrator receives the Medicaid Estate Recovery Reporting Form or one year after the decedent's death, whichever is later.

In the recent case of In Re Estate of Centorbi (2011), 129 Ohio St.3d 78, 2011-Ohio-2267, the Ohio Supreme Court determined that the "whichever is later" language actually extended the deadline beyond one year after the decedent's death where no Medicaid Estate Recovery Reporting Form is sent to the administrator. In other words, the administrator never has a deadline to make a claim against a decedent's estate unless and until the Medicaid Estate Recovery Reporting Form is sent to the administrator.

This outcome obviously can create an enormous amount of uncertainty and lack of finality when administering the estate of a deceased Medicaid recipient. Therefore, it is absolutely critical that any person responsible for the estate of a decedent that received Medicaid benefits, or even may have received Medicaid benefits (if you are unsure, the reporting form gives you safe harbor) send the Medicaid Estate Recovery Reporting Form to the administrator as soon as possible after the death of the recipient. By doing so, the administrator must present a claim to that responsible person (or other designated personal representative) within one year of the recipient's death. If the notice form is received by the administrator after that one year period, then the administrator of the program has an additional ninety (90) days to present the claim.

Questions about Medicaid claims or other estate questions? Contact our attorneys.