Medicaid Estate Recovery
Recovering payments from the estates of Medicaid recipients is a complex, multi-layered process that requires knowledge, skill, and sensitivity. It is also a practice that can be time consuming, labor intensive, and costly. Evolving regulations set against heightened demand for equity, integrity, and cost control mean that state Medicaid programs are increasingly difficult to manage. This is especially true at a time when interest in Medicaid expansion competes with tighter budgets, lower revenues, and ramping fraud, waste, and abuse. We know that the stringent standards governing these programs can create uncertainty in determining the way forward, particularly for new or underdeveloped programs, such as Medicaid estate recovery (ER).
What It Is
To meet Medicaid’s mission of providing a health care safety net for the nation’s most vulnerable populations, states are federally mandated to recover allowable expenses paid on behalf of certain beneficiaries receiving Medicaid benefits from their estates. These efforts not only provide a cost-effective way to offset state and federal expenditures, but also shift some of the burden of paying for benefits away from the taxpayer by allowing states to spend their share of recovered funds to preserve and/or expand services for beneficiaries.
Why It Matters
ER serves as a source of revenue for states, but also opens questions about fairness, equity, and access. Beneficiary advocates have expressed growing concern that ER programs contribute to social inequities, treat heirs inconsistently, recoup little compared to overall benefit spending, and even deter some individuals from seeking services offered through the Medicaid program. Reconciling these issues is imperative for state Medicaid agencies charged with the weighty responsibility of pursuing ER. Together, these things represent urgent challenges that require skilled and strategic responses from the right partner.
The Right Partner
Myers and Stauffer is one of the few firms in the country whose focus is on behalf of government agencies to ensure they spend public funds in compliance with state and federal laws and regulations. We offer a full complement of services designed to assist our state and federal clients in succeeding with every aspect of their operations.
Mike Johnson, CPA, CFE
Ryan Farrell, CFE