Five Things you Need to Know About Colorado’s Medicaid Recovery Program

Medicaid is a needs based, joint federal and state program that often enters the lives of senior citizens when it comes to paying for nursing home expenses. But many don’t realize that the cost of medical expenses that are paid for by Colorado’s Medicaid program are subject to a recovery program.

Not only can Medicaid recover its costs through any tort or liability proceeds the patient may be entitled to, but it also may recoup costs through an estate recovery program.

 

Following are five facts that you should know regarding this program:

1. The acceptance of Medicaid assistance creates a debt that is enforceable after the death of the client.

Estate recovery applies to those Medicaid clients who have received services after 1992 and were age 55 or older at the time of the service or who were institutionalized.

2. Colorado’s estate recovery program is administered by a third party, not the state’s Medicaid program itself.

The Colorado Department of Health Care Policy & Financing (DHCPF) contracts with Health Management Systems, Inc. (HMS) to administer the Colorado Estate Recovery Program.

3. Estate Recovery is accomplished in two ways, either a lien is placed on the client’s property or a claim is filed against their estate when they pass.

4. Colorado limits Medicaid estate claims to property in a “probate” estate.

In Colorado, “estate” is legally defined as the property of the deceased whose affairs are subject to the Probate Code.

5. Certain properties may be exempt from the program.

A home may be exempt from the estate recovery program if a spouse, sibling, or in some instances a child is living in the home. Property may also be exempted if the heirs to the estate will be forced to rely on public assistance if they do not receive the inheritance, or if the inheritance allows them to discontinue public assistance.

 

Obviously, Medicaid law is complex with many rules and regulations. The Medicaid lawyers in Colorado Springs and Denver CO can help you navigate the specifics of the program before, during, and after applying for assistance, including Medicaid planning to help preserve both eligibility and a family’s property.

Hammond Law Group, PC – Medicaid attorneys in Colorado Springs and Denver CO

Comments 20

  • ChavonMarch 15, 2017 at 2:36 pm

    I am an attorney in Texas. I am trying to locate the the provisions which establish the hardship waiver determination for Medicaid recovery from an estate. Any assistance would be appreicated

    • Hammond Law GroupMarch 21, 2017 at 12:41 pm

      Hello Chavon, we recommend contacting the Colorado Code of Regulations:

      DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
      Medical Services Board
      MEDICAL ASSISTANCE – SECTION 8.000
      10 CCR 2505-10 8.063

  • Tim ChaseMay 2, 2018 at 1:15 pm

    Can you explain lines 3 & 4 in more detail? When you say "property" are you referring to "real" property, i.e. house & land? Or, does Medicaid also attach furnishings in the "Claim" or the "lien"?
    Thanks
    Tim Chase

  • Colt JohnsonJune 14, 2018 at 7:24 am

    I'm in colorado and my mom passed away so the HMS is doing a recovery on her Medicaid and its almost 300,000. Now I didn't inherit anything cause there was no will but I am her only child and her house is an USDA house so what do i do?

  • JacquieJuly 19, 2018 at 1:51 pm

    My mother is on Medicaid and living in a nursing home. Is my mother able to sell her home to pay loans back to family members and to set aside money for funeral? FYI – the house is in pretty bad disrepair, outstanding taxes, etc.

    • Hammond Law GroupJuly 23, 2018 at 9:23 am

      Hi Jacquie, thank you for reaching out to us! Please call our office at (719) 520-1474 to schedule a phone consultation with Chad Spencer and he will help you determine what options are available. Wishing you and your family all the best!

  • Omar MAugust 19, 2019 at 11:03 am

    My grandmother before she passed away added my name to her house deed. She was in a nursing home and recieiving medicaid. How do i find out if medicaid is going to do an estate recovery?

    • Hammond Law GroupAugust 21, 2019 at 9:12 am

      Hi Omar,

      If the house passed directly to you as a joint tenant (name is on the deed) then it didn't go through probate. If the house is not subject to probate then it is unlikely that the state will attempt to recover against the house. If the state is going to attempt to recover, you will receive a letter and technically, as a creditor, the state has a year to make it's claim. Hope that helps make it a little more clear and please give us a call at 719-520-1474 if you have further questions.

      Kind regards,
      Tiana Rivera
      Marketing Manager

  • Dana HudsonSeptember 16, 2019 at 9:40 am

    What is a typical estimate for your services, from consultation to resoltion? I've looked at Medicaid on like and haven't got a clue.

    • Hammond Law GroupSeptember 16, 2019 at 9:54 am

      Hi Ms. Hudson,

      Thank you for reading our blog and reaching out. We have found over our many years in practice that estate plans are unique to each individual. We find it best to meet with people in person to understand their situation and particular needs in order to provide an accurate estimate. We provide free educational workshops that offer a free consultation with an attorney by attending. If you would like to attend please register here: https://coloradoestateplan.com/register/

      Kind regards,
      Tiana Rivera
      Marketing Manager

  • Marley PotterNovember 6, 2019 at 6:51 pm

    My mother passed in April of 2018 and owned a small home. Is there a time limit for Medicaid to file? We need to place the home in my name with her will to begin repairs. The home is beginning to become inhabitable.

    • Hammond Law GroupNovember 7, 2019 at 1:41 pm

      Hi Ms. Potter,

      Thank you for reaching our blog and reaching out. Medicaid has a year to file, so at this point you should be fine. If you need assistance transferring the title of your mother's home please give us a call at 719-520-1474. Wishing you and your family well.

      Kind regards,
      Tiana Rivera
      Marketing Manager

      • Marley PotterNovember 7, 2019 at 1:59 pm

        Thank you so much for your time. Is there a law stating they only have a year that I can print when I decide to sell it ? To prove to the buyer it can not be filed upon?

        • Hammond Law GroupNovember 11, 2019 at 11:56 am

          Current through the 2019 Legislative Session
          Section 15-12-803 – Limitations on presentation of claims
          (1)
          (a) All claims against a decedent's estate that arose before the death of the decedent, including claims of the state of Colorado and any subdivision thereof, whether due or to become due, absolute or contingent, liquidated or unliquidated, founded on contract, tort, or other legal basis, if not barred earlier by other statutes of limitations, are barred against the estate, the personal representative, any transferee or other person incurring liability under section 15-15-103, and the heirs and devisees of the decedent, unless presented as follows:
          (I) As to creditors barred by publication, within the time set in the published notice to creditors;
          (II) As to creditors barred by written notice, within the time set in the written notice;
          (III) As to all creditors, within one year after the decedent's death.
          (b) In addition to the limitations on presentation of claims in paragraph (a) of this subsection (1), claims barred by the nonclaim statute at the decedent's domicile are also barred in this state.
          (2) All claims against a decedent's estate that arise at or after the death of the decedent, including claims of the state and any subdivision thereof, whether due or to become due, absolute or contingent, liquidated or unliquidated, founded on contract, tort, or other legal basis, are barred against the estate, the personal representative, any transferee or other person incurring liability under section 15-15-103, and the heirs and devisees of the decedent, unless presented as follows:
          (a) A claim based on a contract with the personal representative, within four months after performance by the personal representative is due;
          (b) Any other claim, within four months after it arises.
          (3) Nothing in this section affects or prevents:
          (a) Any proceeding to enforce any mortgage, pledge, or other lien upon property of the estate;
          (b) To the limits of the insurance protection only, any proceeding to establish liability of the decedent or the personal representative for which he is protected by liability insurance; or
          (c) Collection of compensation for services rendered and reimbursement for expenses advanced by the personal representative or by the attorney or accountant for the personal representative of the estate.
          (4) This section is a nonclaim statute that cannot be waived or tolled, and it shall not be considered a statute of limitations.
          (5) Unless section 15-10-106 is determined to apply, and subject to the provisions of subsection (3) of this section, claims that are not presented in accordance with subsections (1) and (2) of this section are barred even if addressing the merits of the claim would not delay the settlement and distribution of the estate.
          C.R.S. § 15-12-803

          L. 73: R&RE, p. 1592, § 1. C.R.S. 1963: § 153-3-803. L. 75: (3)(c) added, p. 598, § 34, effective July 1. L. 79: (1)(a) amended, p. 650, § 10, effective July 1. L. 90: (1) R&RE, p. 905, § 3, effective July 1. L. 2006: IP(1)(a) and IP (2) amended and (4) and (5) added, p. 373, § 2, effective July 1.

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