CMS rejects Georgia plan to raise threshold for exemptions to Medicaid estate recovery rules

Aug 20 2006

CMS has rejected a Georgia law that would have prohibited the state from recovering up to $100,000 of a deceased Medicaid beneficiary's estate to recover costs for nursing home care, the Atlanta Journal-Constitution reports.

Current Georgia law exempts the first $25,000 of a Medicaid beneficiary's estate from being recovered by the state to offset the cost of the beneficiary's nursing home care.

Federal rules require states to recover such costs, and "Georgia is one of the last states to implement" such laws, the Journal-Constitution reports.

The proposed law, which was approved by the state Legislature but was contingent on approval from CMS, would have raised the limit on what the state could recover from $25,000 to $100,000.

It also would have retroactively exempted Medicaid beneficiaries from any estate recovery if they were enrolled in the program at the time the estate recovery plan took effect, according to the Journal-Constitution.

CMS, which notified state officials of the decision earlier this month, said the $100,000 limit was "somewhat excessive." Renard Murray, associate regional administrator for CMS, said the retroactive exemption also was problematic because "[w]e can't exempt some individuals and not others."

Mark Trail, chief of Medical Assistance Plans for the state Department of Community Health, said his agency does not plan to appeal, adding, "We don't have a basis for an appeal."

Trail estimates that fewer than 5,000 state residents will be affected by the decision (Tharpe/Miller, Atlanta Journal-Constitution, 8/17).

In related news, Gov. Sonny Perdue (R) on Thursday said the state would exempt from recovery efforts any care received before May 3, the day he signed the bill establishing the rules for the recovery program (Miller, Atlanta Journal-Constitution, 8/18).