Nebraska Medicaid Estate Recovery

Neb. Rev. Stat. 68-919(1) makes a Medicaid recipient indebted to the Department of Health and Human Services for the total amount paid for medical assistance on the recipient's behalf if the recipient was fifty-five or older when the assistance was provided, or if the recipient resided in a medical institution and the department determined, at institutionalization or application for medical assistance, whichever is later, that the recipient could not reasonably have been expected to be discharged and resume living at home. The debt arises during the recipient's life but is held in abeyance until death, and it does not include interest (68-919(2)(a) and (3)). Nebraska recovers as a creditor rather than through a lien. DHHS publishes the answer plainly on its own estate recovery page: it does not put liens on property, and it describes itself as a creditor similar to a doctor or hospital. The statute backs that up, because the Nebraska Medicaid real property lien section, 68-990, was made null and void as of August 24, 2017 by Laws 2019, LB593, section 8. In a probated estate DHHS files a creditor's claim in the county court, and 30-2487(a)(4) puts that claim in the fourth class of demands alongside reasonable and necessary medical and hospital expenses of the last illness, behind costs and expenses of administration, reasonable funeral expenses, and debts and taxes preferred under federal law. Claims of the state are subject to the ordinary Nebraska nonclaim bar at 30-2485(a): two months after the first publication of the notice to creditors when notice is given in compliance with 25-520.01 and 30-2483, or three years after death when it is not. Two notice duties fall on the person settling the estate. Under 30-2483(b), if the decedent was fifty-five or older or resided in a medical institution as defined in 68-919(1), the notice to creditors must also be provided to DHHS with the decedent's social security number and, where a spouse predeceased the decedent, that spouse's name and social security number, in the delivery manner the department designates, and a notice that does not conform is void. Under 77-2018.02(6) the same notice is required when an independent inheritance tax proceeding is filed without any probate. Where there is no probate at all, DHHS sends an Asset Form for Non-Probated Estates to the decedent's contact person and determines a recovery amount from it. Anyone holding or administering the assets, including a personal representative, a successor trustee of a revocable trust that became irrevocable at death, or a person with an interest in the assets, may ask DHHS under 68-919(4)(c) to certify whether medical assistance reimbursement is due, and DHHS publishes a Request for Certification of No Recoverable Amount form for that purpose. An action to recover the debt may be brought at any time before five years after the last of the recipient's death, the death of the recipient's spouse, the youngest minor child reaching twenty-one, or a determination that an adult child is no longer blind or totally and permanently disabled (68-919(4)(d)).