Kansas Medicaid Estate Recovery

Recovery is generally blocked or delayed for: A surviving spouse, because there is no recovery of correctly paid medical assistance until after the surviving spouse has died, and KDHE holds the recovery action until then (K.S.A. 39-709(k)(2) and MKEESM 1725.4); A surviving child under 21, because no claim is established while one is living (K.S.A. 39-709(k)(2) and MKEESM 1725.1); A surviving child of any age who is blind or permanently and totally disabled, because no claim is established while one is living (K.S.A. 39-709(k)(2) and MKEESM 1725.1); The home, while the recipient's spouse, a child under 21, a blind or permanently disabled child, or a sibling who has an equity interest in it and lived there for at least the year before the recipient entered long-term care is residing in it, which blocks KDHE from placing a lien at all (MKEESM 1725.2, tracking 42 U.S.C. 1396p(a)(2)); The home, until after the death of the recipient's surviving spouse and while any child 20 or younger, blind or disabled adult child, or brother or sister who lived there for at least the year before admission and continuously since is residing in it, which are the conditions a lien can be enforced under (K.S.A. 39-709(k)(5)); A caregiver child, because KDHE policy also blocks enforcement of a home lien while a child of the recipient lives there who provided care that let the recipient stay at home and put off nursing facility entry for at least two years (MKEESM 1725.2, tracking 42 U.S.C. 1396p(b)(2)(B)(ii), a condition K.S.A. 39-709(k)(5) does not restate); Anyone granted an undue hardship waiver, which a recipient, a recipient's spouse, or a member of the recipient's surviving family may request against estate recovery action including a lien, and which KDHE decides by weighing the type of assets involved, whether another way to satisfy the claim exists, what the family did to help the decedent and hold down medical costs Medicaid would otherwise have paid, the effect of recovery on the surviving family's finances, the effect on a business the decedent held an interest in, and any other relevant factor (MKEESM 1725.3, a procedure 42 U.S.C. 1396p(b)(3)(A) requires every state to keep); A home the recipient returns to, because a lifetime lien dissolves if the recipient is discharged, returns home and lives on the property the lien attached to for 90 continuous days without being readmitted as an inpatient (K.S.A. 39-709(k)(4)(B)).

After a Kansas Medicaid (KanCare) recipient dies, the Kansas Department of Health and Environment recovers correctly paid medical assistance from the recipient's estate. K.S.A. 39-709(k)(2) makes the amount of any medical assistance paid after June 30, 1992 a claim against the property, or any interest in property, belonging to and part of the estate of a deceased recipient, and where there is no estate it charges the estate of the surviving spouse. The same subsection reaches funds of the recipient or the spouse held in a payable on death bank account under K.S.A. 9-1215 or in a credit union beneficiary account under K.S.A. 17-2263 or 17-2264, and it makes transfers of real or personal property by a recipient without adequate consideration voidable and subject to being set aside. In a decedent's estate the Medicaid claim is a first class demand under K.S.A. 59-1301, ranking behind only the expenses of an appropriate funeral in the amount reasonably necessary. KDHE may also lien the recipient's real property. After death the lien is filed with the register of deeds of the county where the property sits, within one year of the date of death, and must contain the legal description of every parcel in that county. During the recipient's lifetime a lien may be filed only after notice and an opportunity for a hearing, and may be enforced only on competent medical testimony that the recipient cannot reasonably be expected to be discharged and returned home; six months of compensated inpatient care at a nursing home or other medical institution is itself that determination (K.S.A. 39-709(k)(4)). KDHE's Estate Recovery Unit also claims a deceased recipient's nursing home personal needs account and any funds left in a prepaid funeral or burial arrangement after reasonable funeral expenses are paid, and it may serve a written claim on a financial institution, which then may not release the account to a beneficiary until the claim is satisfied (MKEESM 1725.5). The claim is reduced by the value of benefits a long-term care insurance policy paid on the recipient's behalf (K.S.A. 39-709(k)(2)).

Yes. Kansas offers an undue-hardship waiver. Contact Kansas Department of Health and Environment, Division of Health Care Finance (Estate Recovery Unit) at 785-296-3982 to request the waiver and ask about deadlines.

Kansas Department of Health and Environment, Division of Health Care Finance (Estate Recovery Unit), phone 785-296-3982, https://www.kdhe.ks.gov/159/Medicaid-Health-Care-Finance.