(1)The general assembly finds,
determines, and declares that the cost of providing medical assistance to qualified
members throughout the state has increased significantly in recent years; that such
increasing costs have created an increased burden on state revenues while
reducing the amount of revenues available for other state programs; that
recovering some of the medical assistance from the estates of medical assistance
members would be a viable mechanism for members to share in the cost of
assistance; and that an estate recovery program would be a cost-efficient method
of offsetting medical assistance costs in an equitable manner. The general
assembly also declares that, in order to ensure that medicaid is available for low-income individuals, reasonable restrictions consiste
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(1) The general assembly finds,
determines, and declares that the cost of providing medical assistance to qualified
members throughout the state has increased significantly in recent years; that such
increasing costs have created an increased burden on state revenues while
reducing the amount of revenues available for other state programs; that
recovering some of the medical assistance from the estates of medical assistance
members would be a viable mechanism for members to share in the cost of
assistance; and that an estate recovery program would be a cost-efficient method
of offsetting medical assistance costs in an equitable manner. The general
assembly also declares that, in order to ensure that medicaid is available for low-income individuals, reasonable restrictions consistent with federal law should be
placed on the ability of persons to become eligible for medicaid by means of
making transfers of property without fair and valuable consideration.
(2) (a) Medical assistance paid on behalf of any individual who was fifty-five
years of age or older when the individual received such assistance may be
recovered by the state department from the estate of such individual in accordance
with paragraph (c) of this subsection (2).
(b) Medical assistance paid on behalf of any individual who is
institutionalized may be recovered by the state department from the estate of such
individual in accordance with paragraph (c) of this subsection (2).
(c) The state department shall establish an estate recovery program only
insofar as such program is in accordance with Title XIX of the federal Social
Security Act, 42 U.S.C. sec. 1396p, as amended, and shall not take any action to
recover medical assistance when the amount of assistance to be recovered is
economically inappropriate in relation to expenses of recovery.
(3) The state department is authorized to file liens against any property of an
individual who is institutionalized and from whom the state department may recover
medical assistance pursuant to paragraph (b) of subsection (2) of this section.
(4) The state department may compromise, settle, or waive any recovery of
medical assistance authorized pursuant to subsection (2) of this section upon good
cause shown.
(5) Subject to any limitation concerning estate recovery in Title XIX of the
federal Social Security Act, 42 U.S.C. sec. 1396p, as amended, the amount of any
medical assistance paid pursuant to the provisions of this article and articles 5 and
6 of this title is a claim against the estate pursuant to the provisions of section 15-12-805 (1), C.R.S.
(6) The state board shall promulgate rules to implement the provisions of
this section, including rules limiting the eligibility for medical assistance if the
person made a voluntary assignment or transfer of property without fair and
valuable consideration prior to applying for medical assistance. A contract for an
exempt burial fund for an individual shall include a provision restricting the full
amount to the cost of the burial and stating that any portion not expended for the
burial costs shall be refunded to the state department by the mortuary as
reimbursement for the cost of medical assistance provided to the individual. Said
rules shall be in accordance with Title XIX of the federal Social Security Act, 42
U.S.C. sec. 1396p, as amended.
(7) Effective upon the implementation of a private-public partnership
program for financing long-term care pursuant to section 25.5-6-110, this section
shall apply to participants of such program only after excluding from the amount
that may otherwise be recovered from such person's estate an amount allowed by
rules adopted by the state board in accordance with section 25.5-6-110.