Not sure how to deal with this letter from Medicaid?

Meowzer - The letter you got is probably a NOI / Notice of Intent (to file a claim or lien against an Estate). Look at the letter to see IF it actually came from the States Medicaid/ DHHS or (more likely) if it actually has been sent by the states outside contractor for MERP/ Medicaid Estate Recovery. There are 2 main outside contractors - HMS & PCG - and in my experience they very much function like a debt collectors & are very proactive. Contractors have an overall management / administration fee and get a % of the Recovery. HMS is the bigger player and has around 1/3+ of the states. This is just a part of what the parent HMS as a huge company does for health systems cost containment across the US.

Sometimes a letter with the debt Medicaid paid for the deceased is sent first & then a larger packet with a multi page questionnaire is sent after that within a few days later. Unless your mom died still owning her home OR had her term life insurance policy to have the beneficiary to be her Estate OR died with farm/ranch land OR somehow she inherited $, there will be no “estate”, no $, no assets upon her death. There can be no recovery as nothing to recover from.

To be on Medicaid they cannot have more than 2k in nonexempt assets to start with, so the likelihood is they died with under 2k in assets. The questionnaire is all about your (as her old DPOA or contact person in Medicaid files) providing the information with documentation to show why no a Recovery to be done as it’s not cost efficient to persue a federally required attempted Recovery action against your mom’s estate. All done so that MERP can close out your mom’s file. There will be a ? as to her bank balance on day of death, so you put that in and attach a copy of the bank statement. If bank account was POD to you, then that info is written in the questionnaire. Another will be about her life insurance, the amount and who beneficiary was. As long as the “estate” wasn’t the beneficiary of the insurance, it’s not an asset of her estate. There will be ?s on property, auto, inheritance, which you fill in as zero as she had none of these. Personally I’m of the opinion that you fill it out, attached whatever paperwork and make a xerox of all then mail it and supporting paperwork certified mail with the return registered receipt IF it will get it all closed out. So you stop getting collections letters and phone calls. There will be a tight submission date indicated on the letters, please try to get it in before then.

If your Recovery is actually done by state so done by state employees, it will likely be an initial questionnaire with no response back for months. If it’s the state, put in a line somewhere on the questionnaire, that unless you received a written response of the states concerns on specific assets within 30 days that you consider this matter closed by the mailed submission. Again you mail it certified with the return registered card. The duo from USPO is like $ 8.00 and considered legal.

It is NOT your debt.
It is a debt of your mothers, who is deceased.
Unless there are assets that can be an estate, there is no reason or requirement to open probate or do any other type of probate action - even if you mom had a valid will naming you as Executor.

About MERP, that was put into place by Geo. Bush era law the DRA / Deficit Recovery Act of 2005. DRA also put in to have Medicaid gifting / transfer penalty to be uniformly done by all states. Within DRAs MERP there are federal cost benefit/ cost effective requirements:
- value of the Estate has to be over 10k or
- assets of the deceased are under 3k or
- Medicaid's LTC bill under a set amount. I think this one varies by state (as each state manages thier medicaid uniquely) but it’s low like 5k.

I'm so sorry for your loss.

It does my heart good to read of the love you and your mom shared. What a beautiful, amazing legacy to leave your daughter.

May God grant you grieving mercies. HUGS!

Hi ohmeowzer,

I'm so sorry about your mom. Did you receive a form to fill out or just a letter? I don't believe we needed to send any documentation besides my mom signing a form saying that he had no valuable assets or possessions. We provided documentation of his finances when he applied for Medicaid and was in the same boat as your mom (no assets -- no house, etc.) He was only on Medicaid for a few months. I think in those kinds of cases (where they already know the person was in poverty) it is a formality, and an opportunity for the govt. to let the "estate" know that they need to first reimburse Medicaid if there is anything left of value. Please try not to worry though it is even harder not to when you are already so sad. Hoping you feel a little better day by day. Hugs.

Unfortunately it is SOP (Standard Operating Procedure) to send out a letter to the family of a deceased person who received Medicaid assistance whether that person had any assets or not.  In some states, this SOP is even written as a LAW that the State's Medicaid Office MUST ATTEMPT TO RECOVER any assets that the deceased person had; otherwise the State Medicaid Office could be fined by the State Department of Health and Human Services for not doing their job in recovering assets from those who received benefits from Medicaid while they were alive.

I am sorry that you are having to experience this SOP.  All you can do is contact the State Medicaid Office and ask them what do you need to do to verify that your Mother had no assets.  Try not to dwell on it.  It is just "one of those items on the checklist" that need to be done when someone dies.   {{{HUGS}}}

Thank you ahmijoy I think we are very lucky to have jo ann,,I saw that letter and bawled ..I still cry over moms death it was very difficult to let her go but I had to ,,she fought to live believe me ..I stayed with her until the end ..I hugged and kissed her thanked her..we played her fav songs , prayed ..oh I loved her so much ..my heart belonged to Mom and she went without nothing ,,I miss her ..now I get this stupid letter and almost peed my pants ,,,thank you all for your love and concern and for helping me ,,,Mom lived with me so I go in her room and see her belongings and miss her so much ,,I talk to her all time anyway thank you

Nothing particularly helpful to add, just wanted to say I’m very sorry for your loss. Losing a beloved mom is a special mind of pain and I wish you peace and comfort in place of the hassles you’re getting. My mom was also on Medicaid, she had a surviving spouse so situation on recovering assets is different, but you don’t deserve a cold, impersonal letter at this sad time, sorry you had to deal with that

joann if I could hug you I would ...thank you so much ..

If no home to sell then no recovery. This is just standard with them. If the letter doesn't say anything about how you go about proving there is no money, call them and ask what proof they need to show there was no money to recover. Family is not responsible for the debt.