My Uncle is 80 years old and received SSI/Medicaid benefits in New York starting in 1974 and ending in 1998 when he received an inheritance from his mother. He is now living in an assisted living facility in New York and is privately paying for his assisted living care as well as paying for his Medicare insurance. His total net worth is approximately $1.2 million. Question: Upon his passing, does his Estate have to reimburse the government for the SSI/Medicaid benefits that he received in the years prior to receiving his inheritance under any laws including Estate Recovery law in New York and if so, how is the amount to be reimbursed calculated?
Welcome! Thank you for your question.Was the inheritance from his mother in a trust or were they distributed directly to him?It is going to take me a few hours to research the beginning of estate recovery in NY. Check back this evening. JohnJohn Elder41091.7951688657
I wanted to update you that I am still searching. This is a very difficult question that hinges on Medicaid's estate recovery criteria in the mid 70s through the 90s. I am searching CMS guidelines. Generally I would not spend this much time on a question but Medicaid is my specialty practice and I am VERY curious about the answer to your question myself. Please let me know if you become no longer interested in my research so that I do not waste my time typing out a response. Please know that even if it takes me more than 24 hours, I will let you know if I cannot find the answer.
The history of estate recovery in New York is not that clear because estate recovery is performed county by county in New York and not state wide. It does appear that NY has had an estate recovery program since 1990 and some counties could have been recovering from estates since Medicaid began in 1965.In 1993 as part of a large Medicaid overhaul Congress passed OBRA 1993. Congress included a provision in the Omnibus Budget Reconciliation Act of 1993 (OBRA ‘93)that required states to implement a Medicaid estate recovery program. NY amended the NY Code in 1994 to comply with OBRA 1993. This amendment requires estate recovery for all Medicaid services provided for individuals over age 55. The recovery that Medicaid can claim is based on the exact amount spent on a person after age 55. There is not an interest charge for accrued amounts.I give you that history because it is clear that NY Medicaid will have an estate recovery claim against your Uncle from 1993 until 1998. It is possible that the county that provided him services prior to 1993, and after he turned 55, would also have a claim against his estate. It is also just as likely that they do not have a claim for those prior years or even a record of the amount Medicaid paid for his care.I wish that I had more specific possibilies of recovery but the history is not clear because of the county by county method that NY still uses for estate recovery.
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Thank you for you help! I will be talking with my Uncle and will contact you if I have any further questions.
Dave Pratt
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