Virginia would limit Medicaid estate claims for nursing facility care

The Department would seek repayment from estates for certain Medicaid-funded nursing facility care. This applies to people who receive Medicaid-funded nursing facility care, or for whom the Department makes those payments, and their estates after death. Recovery would be limited to the specified costs and could not exceed Medicaid payments for those services. For managed care, the recoverable amount would be capped at the lower of the part of the payment tied to covered services or the full payment rate. Recovery would be from the recipient's estate after death.

The Department could permanently waive an estate claim when it finds that enforcing it would cause substantial hardship. This applies to claims against the estate of an indigent or medically indigent person. The person whose estate is claimed against must be indigent or medically indigent. The Department must find that enforcing the claim would cause substantial hardship to the person's heirs or dependents. A waiver would permanently end recovery of that claim, in line with federal law.

The Department would publish information about estate recovery and hardship waivers in multiple languages. The information would explain estate recovery and how to apply for an undue hardship waiver. The information must be easy to find on the Department's website. It must be in English, Spanish, and the next four most commonly spoken languages in Virginia, based on the latest listed Census survey.

The Department would seek federal permission and submit documents needed to carry out the bill. This applies to carrying out the bill's provisions. The Department may update provider manuals and regulatory guidance as needed.