Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter VII
Section 144-101-VII-5 - Estate Recovery
Subsection 144-101-VII-5.04 - RECOVERY PROCEDURE

Universal Citation: 144-101-VII-5 ME Code Rules ยง 144-101-VII-5.04

Current through 2024-38, September 18, 2024

Assets subject to recovery pursuant to this section will be identified primarily through the MaineCare eligibility process. This method is not intended to be exclusive and assets may be identified through any legal means.

5.04-1 Processing Claims against Assets

When it is determined that a MaineCare Member's estate is subject to recovery, the Department may file:

A. A claim in Probate Court against all assets included in the deceased Member's estate. The process for filing such a claim is governed by existing provisions of the Probate Code regarding creditors' claims. See 18-C M.R.S. Article 3, Part 8.

B. A claim in any court of competent jurisdiction against real and personal property and other assets in which the Member had any legal interest at death to the extent of that interest.

C. A claim in any court of competent jurisdiction or any other legal means to recover the cost of medical services provided during a period of inaccurate eligibility. A notice of intent to recover shall be provided prior to filing suit.

D. If asserted against the estate, a claim may not be enforced until:
1. The Member has no surviving spouse; and

2. The Member has no surviving child who is under age twenty-one (21); or

3. The Member has no surviving child who is blind or permanently and totally disabled. For the purposes of this section, a surviving child must be blind or determined to be disabled at the time the Department seeks recovery.

The time the Department seeks recovery means the earlier of (1) the date of the Department's notice of claim to the legally authorized representative of the estate or known family members or heirs; or (2) the date on which the Department files a claim in Probate Court.*

*The Department shall submit to CMS and anticipates approval for a State Plan Amendment related to these provisions.

E. The Department shall provide heirs, assignees or transferees of a deceased Member an opportunity to pay a claim under this subsection through a voluntary payment arrangement that is acceptable to the Department. The payment arrangement may consist of a payment plan, promissory note, or other payment mechanism.

5.04-2 A claim made under this section must be waived if enforcement of the claim would create an undue hardship under criteria described herein or if the costs of collection are likely to exceed the amount recovered. A waiver may be granted in full or in part. A waiver may not be granted if the Member or waiver applicant acted to lose, diminish, divest, encumber or otherwise transfer any value of or title to an asset for the purpose of preventing recovery under this subsection.

5.04-3 The Department may accept, hold, transfer title to and sell real property to collect a claim under this subsection. The Department may receive title to real property from a personal representative, special or public administrator, creditor, heir, devisee, assignee or transferee in full or partial satisfaction of a claim under this subsection.

Claims in subparagraphs above will be pursued against the person who holds the property or asset in which the Member had a legal interest at death, other than a bona fide purchaser for value. If the asset or property is transferred or dissipated with intent to avoid the Department's claim, such action will be considered fraudulent and the person responsible will be held liable.

Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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