§ 42-4-207 — Recovery of incorrect payments; recovery of correct payments; liens

Wyoming § 42-4-207

• Jurisdiction: Wyoming
• Title 42: Welfare
• Ch. 4: MEDICAL ASSISTANCE AND SERVICES
• Art. 2: MEDICAID BENEFIT RECOVERY

Text

(a) The department may through appropriate action recover
any incorrect payment of medical assistance under this chapter
on behalf of a recipient and may adjust any subsequent payment
by an amount equal to the incorrect payment. Any recovery shall
be prorated to the federal government in proportion to the
amount it contributed for medical assistance rendered.
(b) In addition to subsection (a) of this section and
subject to a court order for recovery, the department may file a
lien upon all real and personal property of the recipient for
the incorrect payment of medical assistance on his behalf.
(c) The department may file a pre-death lien upon real
property of an individual for medical assistance correctly paid
under this chapter to an individual:
(i) Who is an inpatient in a nursing facility,
intermediate care facility for people with intellectual
disability, or other medical institution; and
(ii) With respect to whom the department determines,
after notice and opportunity for a hearing, cannot reasonably be
expected to be discharged from the medical institution and to
return home.
(d) No lien may be imposed under subsection (c) of this
section on an individual's home if any of the following persons
are lawfully residing in the home:
(i) The spouse of the individual;
(ii) The individual's child who is under age
twenty-one (21), or is blind or disabled as defined in 42 U.S.C.
1382c; or
(iii) A sibling of the individual, who has an equity
interest in the home and who was residing in the home for a
period of at least one (1) year immediately before the date of
the individual's admission to the medical institution.
(e) No lien imposed under subsection (c) of this section
shall be subject to recovery if any of the following persons are
lawfully residing in the home on a continuous basis since the
date of the individual's admission to the facility or
institution:
(i) A sibling of the individual who was residing in
the individual's home for a period of at least one (1) year
immediately before the date of the individual's admission to the
facility or institution;
(ii) A child of the individual who was residing in
the individual's home for a period of at least two (2) years
immediately before the date of the individual's admission to the
facility or institution, and who establishes by a preponderance
of the evidence that he provided care to the individual which
permitted the individual to reside at home rather than in a
facility or institution.
(f) Any lien imposed with respect to an individual
pursuant to subsection (c) of this section shall dissolve upon
that individual's discharge from the medical institution and
return home.
(g) Nothing in this section shall require an applicant for
medical assistance under this chapter to enter into agreement
for a lien upon his real and personal property for the payment
of medical assistance on his behalf.
(h) Upon sale of the property on which a lien has been
imposed pursuant to subsection (c) or (j) of this section, the
department shall seek recovery of the amount stated in its lien.
Transfers of real or personal property on or after the look-back
dates defined in 42 U.S.C. § 1396p by recipients of medical
assistance under this chapter, or their spouses, without
adequate consideration are voidable and may be set aside by an
action in district court.
(j) The department may file a lien against the property of
any estate, as defined in W.S. 42-4-206(g), of a deceased
recipient for the amount of medical assistance provided while
the recipient was fifty-five (55) years of age or older or while
the recipient was an inpatient in a nursing facility,
intermediate care facility for people with intellectual
disability or other medical institution. The department shall
perfect this lien by filing a notice in the county in which the
real property exists. The department may file an amended lien
prior to the entry of the final order closing the estate.
(k) The department may file a lien upon real property
pursuant to W.S. 2-18-103(g) upon the death of the grantor. The
department may file such lien regardless of whether the grantee
applied for a certificate of clearance pursuant to W.S.
2-18-103(n) or filed an affidavit to establish the death of the
grantor pursuant to W.S. 34-11-101.