June 7, 2011, Introduced by Senator KAHN and referred to the Committee on Appropriations.
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
by amending sections 112g, 112h, 112i, 112j, and 112k (MCL
400.112g, 400.112h, 400.112i, 400.112j, and 400.112k), as added by
2007 PA 74.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 112g. (1) Subject to section 112c(5), the department of
community health shall establish and operate the Michigan medicaid
estate recovery program to comply with requirements contained in
section
1917 of title XIX. The department of community health shall
work
with the appropriate state and federal departments and
agencies
to review options for development of a voluntary estate
preservation
program. Beginning not later than 180 days after the
effective
date of the amendatory act that added this section and
every
180 days thereafter, the department of community health shall
submit
a report to the senate and house appropriations
subcommittees
with jurisdiction over department of community health
matters
and the senate and house fiscal agencies regarding options
for
development of the estate preservation program.
(2) The department of community health shall establish an
estate recovery program including various estate recovery program
activities. These activities shall include, at a minimum, all of
the following:
(a) Placing and recording liens on medical assistance
recipients' property to the extent permitted by section 1917(a) of
title XIX.
(b) (a)
Tracking assets and services of medical assistance
recipients
of medical assistance that are subject to estate
recovery.
(c) (b)
Actions necessary to collect
amounts subject to estate
recovery for medical services as determined according to subsection
(3)(a) provided to medical assistance recipients identified in
subsection (3)(b). Amounts subject to estate recovery shall not
exceed
the cost of providing the medical services. Any The
department of community health or its agent may negotiate
accelerated settlements of estate recovery claims with the spouse
or heirs of medical assistance recipients subject to estate
recovery if the medical assistance recipient is unlikely to return
to his or her home. The settlements shall take into account the
best
interests of the state, and the spouse, and the heirs.
(d) (c)
Other Performing other activities necessary to
efficiently and effectively administer the estate recovery program,
including receiving information and notices under section 112k.
(3) The department of community health shall seek appropriate
changes to the Michigan medicaid state plan and shall apply for any
necessary waivers and approvals from the federal centers for
medicare and medicaid services to implement the Michigan medicaid
estate recovery program. The department of community health shall
seek approval from the federal centers for medicare and medicaid
regarding all of the following:
(a) Which medical services are subject to estate recovery
under section 1917(b)(1)(B)(i) and (ii) of title XIX.
(b) Which recipients of medical assistance are subject to
estate recovery under section 1917(a) and (b) of title XIX.
(c) Under what circumstances the program shall pursue recovery
from
the estates of spouses of medical
assistance recipients of
medical
assistance who are subject to
estate recovery under section
1917(b)(2) of title XIX.
(d) The maximum divestiture look-back period for assets that
are subject to estate recovery under section 1917(c) of title XIX,
including assets placed in trusts by the medical assistance
recipient, and transferred for less than fair market value.
(e) (d)
What actions may be taken to obtain
funds from the
estates of medical assistance recipients subject to recovery under
section 1917 of title XIX, including notice and hearing procedures
that may be pursued to contest actions taken under the Michigan
medicaid estate recovery program.
(f) (e)
Under what circumstances the
estates of a medical
assistance
recipients will be recipient's
estate is exempt from the
Michigan
medicaid estate recovery program because of a hardship. At
the
time an individual enrolls in medicaid for long-term care
services,
the department of community health shall provide to the
individual
written materials explaining the process for applying
for
a waiver from estate recovery due to hardship. The department
of community health shall develop a definition of hardship
according
to section 1917(b)(3) of title XIX. that includes, but is
not
limited to, the following:The
department of community health
shall implement the provisions of section 1917(b)(2) of title XIX
to ensure that the heirs of medical assistance recipients subject
to the Michigan medicaid estate recovery program will not be
unreasonably harmed by the provisions of this program.
(i) An exemption for the portion of the value of the
medical
assistance
recipient's homestead that is equal to or less than 50%
of
the average price of a home in the county in which the medicaid
recipient's
homestead is located as of the date of the medical
assistance
recipient's death.
(ii) An exemption for the portion of an estate that is
the
primary
income-producing asset of survivors, including, but not
limited
to, a family farm or business.
(iii) A rebuttable presumption that no hardship exists
if the
hardship
resulted from estate planning methods under which assets
were
diverted in order to avoid estate recovery.
(f)
The circumstances under which the department of community
health
may review requests for exemptions and provide exemptions
from
the Michigan medicaid estate recovery program for cases that
do
not meet the definition of hardship developed by the department
of
community health.
(g)
Implementing the provisions of section 1396p(b)(3) of
title
XIX to ensure that the heirs of persons subject to the
Michigan
medicaid estate recovery program will not be unreasonably
harmed
by the provisions of this program.
(4) The department of community health shall not seek medicaid
estate recovery if the costs of that recovery exceed the amount of
recovery
available or if the estate
recovery is not in the best
economic interest of the state.
(5) An itemized list of medicaid payments provided by the
department of community health is prima facie evidence in
substantiating a claim under the Michigan medicaid estate recovery
program.
(5)
The department of community health shall not implement a
Michigan
medicaid estate recovery program until approval by the
federal
government is obtained.
(6)
The department of community health shall not recover
assets
from the home of a medical assistance recipient if 1 or more
of
the following individuals are lawfully residing in that home:
(a)
The medical assistance recipient's spouse.
(b)
The medical assistance recipient's child who is under the
age
of 21 years, or is blind or permanently and totally disabled as
defined
in section 1614 of the social security act, 42 USC 1382c.
(c)
The medical assistance recipient's caretaker relative who
was
residing in the medical assistance recipient's home for a
period
of at least 2 years immediately before the date of the
medical
assistance recipient's admission to a medical institution
and
who establishes that he or she provided care that permitted the
medical
assistance recipient to reside at home rather than in an
institution.
As used in this subdivision, "caretaker relative"
means
any relation by blood, marriage, or adoption who is within
the
fifth degree of kinship to the recipient.
(d)
The medical assistance recipient's sibling who has an
equity
interest in the medical assistance recipient's home and who
was
residing in the medical assistance recipient's home for a
period
of at least 1 year immediately before the date of the
individual's
admission to a medical institution.
(7)
The department of community health shall provide written
information
to individuals seeking medicaid eligibility for long-
term
care services describing the provisions of the Michigan
medicaid
estate recovery program, including, but not limited to, a
statement
that some or all of their estate may be recovered.
(8)
The department of community health shall not charge
interest
on the balance of any Michigan medicaid estate recovery
payments.
(9)
The department of community health shall not place or
record
a lien on qualifying property under the tax equity and
fiscal
responsibility act of 1982, Public Law 97-424 (TEFRA).
Sec.
112h. For the purposes of sections 112g to 112j:112k:
(a)
"Estate" means all property and other assets included
within
an individual's estate that is subject to probate
administration
under article III of the estates and protected
individuals
code, 1998 PA 386, MCL 700.3101 to 700.3988, except
assets
otherwise subject to claims under section 3805(3) of the
estates
and protected individuals code, 1998 PA 386, MCL 700.3805,
are
not part of the estate. all real and personal property and other
assets in which the medical assistance recipient had any legal
title or interest at the time of death to the extent of that
interest, including, but not limited to, assets conveyed to a
deceased medical assistance recipient's survivor, heir, or assign
through joint tenancy, tenancy in common, survivorship, life
estate, living trust, or other arrangement.
(b) "Michigan medicaid estate recovery program" means the
estate recovery program established under section 112g.
(c) (b)
"Property" means that term "Personal representative"
and "property" mean those terms as defined in section 1106 of the
estates and protected individuals code, 1998 PA 386, MCL 700.1106.
Sec. 112i. Revenue collected through Michigan medicaid estate
recovery program activities shall be used to fund the activities of
the Michigan medicaid estate recovery program. Any remaining
balances
shall be treated as an expenditure credit for long-term
care
support and services in the medical
services appropriation
unit of the annual department of community health appropriation.
Sec.
112j. (1) The department of community health may
promulgate rules for the Michigan medicaid estate recovery program
according to the administrative procedures act of 1969, 1969 PA
306, MCL 24.201 to 24.328.
(2)
Not later than 1 year after implementation of the Michigan
medicaid
estate recovery program and each year after that, the
department
of community health shall submit a report to the senate
and
house appropriations subcommittees with jurisdiction over
department
of community health matters and the senate and house
fiscal
agencies regarding the cost to administer the Michigan
medicaid
estate recovery program and the amounts recovered under
the
Michigan medicaid estate recovery program.
Sec.
112k. The Michigan medicaid estate recovery program shall
only
apply to medical assistance recipients who began receiving
medicaid
long-term care services after the effective date of the
amendatory
act that added this section.
(1) Not later than 30 days after a personal representative is
appointed to an estate by a court under the estates and protected
individuals code, 1998 PA 386, MCL 700.1101 to 700.8206, the
personal representative shall provide by ordinary mail a properly
completed Michigan medicaid estate recovery program reporting form
prescribed in subsection (2) to the department of community health.
(2) The department of community health's third party liability
director shall prescribe a Michigan medicaid estate recovery
program reporting form. The form shall require the personal
representative of the decedent's estate to provide all of the
following information:
(a) The personal representative's name and contact
information.
(b) A list of all the decedent's real and personal property
and other assets that may be part of the decedent's estate.
(c) The birth date and social security number of the decedent.
(d) The birth date and social security number of the
decedent's spouse, if there is a spouse, and whether the spouse is
alive as of the date the personal representative signed the
reporting form required under this section.
(e) Whether the decedent received a hardship waiver for the
debt of another medical assistance recipient, and if so, the name,
social security number, and birth date of the other medical
assistance recipient.