Compilation of Rules and Regulations of the State of Georgia
Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH
Chapter 111-3 - MEDICAL ASSISTANCE
Subject 111-3-8 - ESTATE RECOVERY
Rule 111-3-8-.03 - Notification to Member or Their Heirs

Universal Citation: GA Rules and Regs r 111-3-8-.03

Current through Rules and Regulations filed through September 23, 2024

(1) If a debt is due pursuant to this section from the estate of a Member, the administrator of the nursing facility, intermediate care facility for individuals with intellectual disabilities, or medical institution in which the Member resided at the time of their death, the Medicaid case manager for community based services and/or the personal representative, if applicable, shall report the death to the Department within thirty (30) days of the death of the Member.

(2) If the personal representative of an estate makes a distribution either in whole or in part of the property of an estate to the Heirs, next of kin, distributes, legatees, or devisees without having executed the obligations pursuant to this section, the personal representative may be held personally liable for the amount of medical assistance paid on behalf of the Member, for the full value of the property belonging to the estate which may have been in the custody or control of the personal representative.

(3) When the Department receives notification of an affected Medicaid Member's death, a written notice will be provided to any known personal representative and any known Heirs which:

(a) Explains the terms and conditions of estate recovery and refers to the applicable statute and regulations;

(b) Advises of the Department's intent to recover the value of Medicaid benefits correctly paid on the Member's behalf from the Member's estate and states the amount;

(c) Explains that the Department's recovery action may include filing a lien on real property when recovery is delayed;

(d) Explains that the Heirs may file an undue hardship waiver and the procedures and time frames for filing the waiver;

(e) Advises the Heirs of their right to a hearing and the method by which they may obtain a hearing; and

(f) Includes a statement advising the amount of the claim may increase if there are additional Medicaid claims that have not yet been processed.

O.C.G.A § 49-4-147.1.

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