Assembly Bill No. 249–Committee on Health and Human Services

(On Behalf of Welfare Division—Child Support Enforcement)

February 16, 1999

____________

Referred to Committee on Health and Human Services

 

SUMMARY—Amends provisions governing recovery of assets pursuant to Medicaid estate recovery program. (BDR 38-449)

FISCAL NOTE: Effect on Local Government: No.

Effect on the State or on Industrial Insurance: No.

~

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to Medicaid; amending the provisions governing the recovery of assets pursuant to the Medicaid estate recovery program; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. Chapter 422 of NRS is hereby amended by adding thereto a

1-2 new section to read as follows:

1-3 1. Except as otherwise provided in this section, the welfare division

1-4 shall, to the extent that it is not prohibited by federal law, recover from a

1-5 recipient of public assistance, the estate of the recipient, the undivided

1-6 estate of a recipient of Medicaid or a person who signed the application

1-7 for public assistance on behalf of the recipient an amount not to exceed

1-8 the amount of public assistance incorrectly paid to the recipient, if the

1-9 person who signed the application:

1-10 (a) Failed to report any required information to the welfare division

1-11 that the person knew at the time he signed the application; or

1-12 (b) Failed to report to the welfare division within the period allowed

1-13 by the welfare division any required information that the person obtained

1-14 after he filed the application.

1-15 2. Except as otherwise provided in this section, a recipient of

1-16 incorrectly paid public assistance, the undivided estate of a recipient of

1-17 Medicaid or a person who signed the application for public benefits on

2-1 behalf of the recipient shall reimburse the division or appropriate state

2-2 agency for the value of the incorrectly paid public assistance.

2-3 3. The administrator or his designee may, to the extent that it is not

2-4 prohibited by federal law, determine the amount of, and settle, adjust,

2-5 compromise or deny a claim against a recipient of public assistance, the

2-6 estate of the recipient, the undivided estate of a recipient of Medicaid or a

2-7 person who signed the application for public assistance on behalf of the

2-8 recipient.

2-9 4. The administrator may, to the extent that it is not prohibited by

2-10 federal law, waive the repayment of public assistance incorrectly paid to

2-11 a recipient if the incorrect payment was not the result of an intentional

2-12 misrepresentation or omission by the recipient and if repayment would

2-13 cause an undue hardship to the recipient. The administrator shall, by

2-14 regulation, establish the terms and conditions of such a waiver,

2-15 including, without limitation, the circumstances that constitute undue

2-16 hardship.

2-17 Sec. 2. NRS 422.054 is hereby amended to read as follows:

2-18 422.054 "Undivided estate" means all real and personal property and

2-19 other assets included in the estate of a deceased recipient of Medicaid and

2-20 any other real and personal property and other assets in or to which he

2-21 had an interest or legal title immediately before or at the time of his death,

2-22 to the extent of that interest or title. The term includes , without limitation,

2-23 assets [passing by reason of joint tenancy, reserved life estate, survivorship

2-24 or trust, and] conveyed to a survivor, heir or assign of the deceased

2-25 recipient through joint tenancy, tenancy in common, survivorship, life

2-26 estate, living trust or other arrangement, including, without limitation,

2-27 any of the decedent’s separate property and his interest in community

2-28 property that was transferred to a community spouse pursuant to NRS

2-29 123.259 or pursuant to an order of a district court under any other provision

2-30 of law.

2-31 Sec. 3. NRS 422.2935 is hereby amended to read as follows:

2-32 422.2935 1. Except as otherwise provided in this section [, the

2-33 welfare division shall,] and to the extent it is not prohibited by federal law

2-34 and when circumstances allow [:

2-35 (a) Recover] , the welfare division shall recover benefits correctly paid

2-36 for Medicaid from:

2-37 [(1)] (a) The undivided estate of the person who received those

2-38 benefits; and

2-39 [(2)] (b) Any recipient of money or property from the undivided

2-40 estate of the person who received those benefits.

2-41 [(b) Recover from the recipient of Medicaid or the person who signed

2-42 the application for Medicaid on behalf of the recipient an amount not to

3-1 exceed the benefits incorrectly paid to the recipient if the person who

3-2 signed the application:

3-3 (1) Failed to report any required information to the welfare division

3-4 which he knew at the time he signed the application; or

3-5 (2) Failed within the period allowed by the welfare division to report

3-6 any required information to the welfare division which he obtained after he

3-7 filed the application.]

3-8 2. The welfare division shall not recover benefits pursuant to

3-9 [paragraph (a) of] subsection 1, except from a person who is neither a

3-10 surviving spouse nor a child, until after the death of the surviving spouse, if

3-11 any, and only at a time when the person who received the benefits has no

3-12 surviving child who is under 21 years of age or is blind or permanently and

3-13 totally disabled.

3-14 3. Except as otherwise provided by federal law, if a transfer of real or

3-15 personal property by a recipient of Medicaid is made for less than fair

3-16 market value, the welfare division may pursue any remedy available

3-17 pursuant to chapter 112 of NRS with respect to the transfer.

3-18 4. The amount of Medicaid paid to or on behalf of a person is a claim

3-19 against the estate in any probate proceeding only at a time when there is no

3-20 surviving spouse or surviving child who is under 21 years of age or is blind

3-21 or permanently and totally disabled.

3-22 5. The administrator may elect not to file a claim against the estate of a

3-23 recipient of Medicaid or his spouse if he determines that the filing of the

3-24 claim will cause an undue hardship for the spouse or other survivors of the

3-25 recipient. The administrator shall adopt regulations defining the

3-26 circumstances that constitute an undue hardship.

3-27 6. Any recovery of money obtained pursuant to this section must be

3-28 applied first to the cost of recovering the money. Any remaining money

3-29 must be divided among the Federal Government, the department and the

3-30 county in the proportion that the amount of assistance each contributed to

3-31 the recipient bears to the total amount of the assistance contributed.

3-32 7. [An action to recover money owed to the department of human

3-33 resources as a result of the payment of benefits for Medicaid must be

3-34 commenced within 6 months after the cause of action accrues. A cause of

3-35 action accrues after all of the following events have occurred:

3-36 (a) The death of the recipient of Medicaid;

3-37 (b) The death of the surviving spouse of the recipient of Medicaid;

3-38 (c) The death of all children of the recipient of Medicaid who are blind

3-39 or permanently and totally disabled as determined in accordance with 42

3-40 U.S.C. § 1382c; and

3-41 (d) The arrival of all other children of the recipient of Medicaid at the

3-42 age of 21 years.] Any recovery by the welfare division from the undivided

4-1 estate of a recipient pursuant to this section must be paid in cash to the

4-2 extent of:

4-3 (a) The amount of Medicaid paid to or on behalf of the recipient after

4-4 October 1, 1993; or

4-5 (b) The value of the remaining assets in the undivided estate,

4-6 whichever is less.

4-7 Sec. 4. NRS 422.29355 is hereby amended to read as follows:

4-8 422.29355 1. The welfare division may, to the extent not prohibited

4-9 by federal law, petition for the imposition of a lien pursuant to the

4-10 provisions of NRS 108.850 against real or personal property of a recipient

4-11 of Medicaid as follows:

4-12 (a) The welfare division may obtain a lien against a recipient’s property,

4-13 both real or personal, before or after his death in the amount of assistance

4-14 paid or to be paid on his behalf if the court determines that assistance was

4-15 incorrectly paid for the recipient.

4-16 (b) The welfare division may seek a lien against the real property of a

4-17 recipient at any age before his death in the amount of assistance paid or to

4-18 be paid for him if he is an inpatient in a nursing facility, intermediate care

4-19 facility for the mentally retarded or other medical institution and the

4-20 welfare division determines, after notice and opportunity for a hearing in

4-21 accordance with its regulations, that he cannot reasonably be expected to be

4-22 discharged and return home.

4-23 2. No lien may be placed on a recipient’s home pursuant to paragraph

4-24 (b) of subsection 1 for assistance correctly paid if:

4-25 (a) His spouse;

4-26 (b) His child who is under 21 years of age or blind or permanently and

4-27 totally disabled as determined in accordance with 42 U.S.C. § 1382c; or

4-28 (c) His brother or sister who is an owner or part owner of the home and

4-29 who was residing in the home for at least 1 year immediately before the

4-30 date the recipient was admitted to the medical institution,

4-31 is lawfully residing in the home.

4-32 3. Upon the death of a recipient the welfare division may seek a lien

4-33 upon his undivided estate as defined in NRS 422.054.

4-34 4. The state welfare administrator shall release a lien pursuant to this

4-35 section:

4-36 (a) Upon notice by the recipient or his representative to the

4-37 administrator that the recipient has been discharged from the medical

4-38 institution and has returned home;

4-39 (b) If the lien was incorrectly determined; or

4-40 (c) Upon satisfaction of the welfare division’s claim.

4-41 Sec. 5. NRS 147.070 is hereby amended to read as follows:

4-42 147.070 1. Every claim for an amount of $250 or more filed with the

4-43 clerk must be supported by the affidavit of the claimant that:

5-1 (a) The amount is justly due (or if the claim is not yet due, that the

5-2 amount is a just demand and will be due on the ..... day of ........).

5-3 (b) No payments have been made thereon which are not credited.

5-4 (c) There are no offsets to the amount demanded to the knowledge of the

5-5 claimant or other affiant.

5-6 2. Every claim filed with the clerk must contain the mailing address of

5-7 the claimant. Any written notice mailed by an executor or administrator to

5-8 the claimant at the address furnished is proper notice.

5-9 3. When the affidavit is made by any other person than the claimant,

5-10 the reasons why it is not made by the claimant must be set forth in the

5-11 affidavit.

5-12 4. The oath may be taken before any person authorized to administer

5-13 oaths.

5-14 5. The amount of interest must be computed and included in the

5-15 statement of the claim and the rate of interest determined.

5-16 6. [The] Except as otherwise provided in subsection 7, the court may,

5-17 in its discretion, for good cause shown, allow a defective claim or affidavit

5-18 to be corrected or amended on application made at any time before the

5-19 filing of the final account.

5-20 7. The court shall allow the welfare division of the department of

5-21 human resources to amend at any time before the filing of the final

5-22 account a claim for the payment of benefits for Medicaid that the

5-23 division identifies after the original claim has been filed.

5-24 Sec. 6. NRS 147.110 is hereby amended to read as follows:

5-25 147.110 1. Within 15 days after the time for filing claims has

5-26 expired, as provided in this chapter, the executor or administrator shall

5-27 examine all claims filed and shall either endorse on each claim his

5-28 allowance or rejection, with the day and the year thereof, or shall file a

5-29 notice of allowance or rejection with the date and the year thereof, and such

5-30 notice of allowance or rejection shall be attached to the claim allowed or

5-31 rejected.

5-32 2. Within 5 days after the 15 days specified in subsection 1, the

5-33 executor or administrator shall present all claims allowed by him to the

5-34 district judge for his approval or rejection.

5-35 3. If an executor or administrator [shall refuse or neglect] refuses or

5-36 neglects to endorse on a claim his allowance or rejection within 15 days, as

5-37 specified in this section, or [shall] does not file a notice of allowance or

5-38 rejection, the claim shall be deemed rejected, but the executor or

5-39 administrator may, nevertheless, allow the claim at any time before the

5-40 filing of the final account.

6-1 4. If a claim is deemed rejected pursuant to subsection 3, the

6-2 executor or administrator must, not more than 10 days after the

6-3 rejection, provide written notice of the rejection by registered mail to all

6-4 affected creditors.

~