Citations Affected: IC 12-7-2-128.5; IC 12-15.
Synopsis: Medicaid liens and services. Authorizes the office of
Medicaid policy and planning (office) to: (1) place a lien on a Medicaid
recipient's real property if the office determines that the recipient will
not return to live in the property; and (2) enforce the lien if the property
is sold or upon the death of the recipient. Provides certain exemptions.
Permits the office to recover from a deceased Medicaid recipient
nonprobate assets in which the recipient has an interest at death but
that do not pass through the probate estate. Requires the office to apply
for approval to: (1) amend the state Medicaid plan to include personal
care services; (2) amend the aged and disabled waiver to modify
income eligibility requirements to include spousal impoverishment
protection provisions; and (3) apply for a Medicaid waiver to fund
adult foster care. Requires the office of the secretary of family and
social services to: (1) reduce the number of individuals on a waiting list
compiled by the area agencies on aging for services offered under the
community and home options to institutional care for the elderly and
disabled (CHOICE) program before July 1, 2005; and (2) amend any
Medicaid waiver for home and community based services so that an
eligible individual receives services within 90 days after being
determined eligible for the services.
Effective: Upon passage; July 1, 2002; January 1, 2003.
January 14, 2002, read first time and referred to Committee on Ways and Means.
A BILL FOR AN ACT to amend the Indiana Code concerning
Medicaid.
medical institution and return home, the office shall obtain a lien
on the Medicaid recipient's real property for the cost of all
Medicaid expenditures made on behalf of the recipient.
Sec. 3. The office may not obtain a lien under this chapter if any
of the following persons lawfully reside in the home of the
Medicaid recipient who resides in the medical institution:
(1) The Medicaid recipient's spouse.
(2) The Medicaid recipient's child who is:
(A) less than twenty-one (21) years of age; or
(B) disabled as defined by the federal Supplemental
Security Income program.
(3) The Medicaid recipient's sibling who has an ownership
interest in the home and who has lived in the home
continuously beginning at least twelve (12) months before the
recipient was admitted to the medical institution.
Sec. 4. Before obtaining a lien on a Medicaid recipient's real
property under this chapter, the office shall notify in writing the
Medicaid recipient, the Medicaid recipient's guardian, the
Medicaid recipient's attorney in fact, or the Medicaid recipient's
authorized representative, of the following:
(1) The office's determination that the Medicaid recipient
cannot reasonably be expected to be discharged from the
medical institution.
(2) The office's intent to impose a lien on the Medicaid
recipient's home.
(3) The Medicaid recipient's right to a hearing under
IC 12-15-28 upon the Medicaid recipient's request regarding
whether the requirements for the imposition of a lien are
satisfied.
Sec. 5. (a) The office shall obtain a lien under this chapter by
filing a notice of lien with the recorder of the county in which the
real property subject to the lien is located. The notice shall include
the following:
(1) The name and place of residence of the individual against
whose property the lien is asserted.
(2) A legal description of the real property subject to the lien.
(b) Upon the office's request, the county auditor or assessor of
a county shall furnish the office with the legal description of any
property in the county registered to the recipient.
(c) The office shall file one (1) copy of the notice of lien with the
county office of family and children in the county in which the real
property is located. The county office of family and children shall
retain a copy of the notice with the county office's records.
(d) The office shall provide one (1) copy of the notice of lien to
the recipient whose real property is affected.
Sec. 6. (a) Beginning on the date on which a notice of lien is
recorded in the office of the county recorder under section 5 of this
chapter, the notice of lien:
(1) constitutes due notice of a lien against the Medicaid
recipient's real property for any amount then recoverable and
any amount that becomes recoverable under this article; and
(2) gives a specific lien in favor of the office.
(b) The lien continues from the date of filing the lien until the
lien is satisfied or released.
Sec. 7. The office may bring proceedings in foreclosure on a lien
arising under this chapter during the lifetime of the Medicaid
recipient if the Medicaid recipient or a person acting on behalf of
the Medicaid recipient sells the property.
Sec. 8. (a) The office may not enforce a lien under this chapter
if the Medicaid recipient is survived by any of the following:
(1) The recipient's spouse.
(2) The recipient's child who is:
(A) less than twenty-one (21) years of age; or
(B) disabled as defined by the federal Supplemental
Security Income program.
(b) The office may not enforce a lien under this chapter as long
as any of the following individuals reside in the home:
(1) The recipient's child of any age if the child:
(A) resided in the home for at least twenty-four (24)
months before the Medicaid recipient was admitted to the
medical institution;
(B) provided care to the Medicaid recipient that delayed
the Medicaid recipient's admission to the medical
institution; and
(C) has resided in the home on a continuous basis since the
date of the individual's admission to the medical
institution.
(2) The Medicaid recipient's sibling who has an ownership
interest in the home and who has lived in the home
continuously beginning at least twelve (12) months before the
Medicaid recipient was admitted to the medical institution.
Sec. 9. (a) The office shall release a lien imposed under this
chapter within ten (10) business days after the county office of
family and children receives notice that the Medicaid recipient:
(1) was discharged from the medical institution; and
(2) is living in the home.
(b) The county recorder shall waive the filing fee for the filing
of a release made under this section.
for under this SECTION was approved. The office shall file the
affidavit under this subsection not later than five (5) days after the
office is notified that the proposed amendment is approved.
(e) If the office receives approval of the proposed amendment to
the state Medicaid plan under this SECTION from the United
States Department of Health and Human Services and the
governor receives the affidavit filed under subsection (d), the office
shall implement the amendment not more than sixty (60) days after
the governor receives the affidavit.
(f) The office may adopt rules under IC 4-22-2 necessary to
implement this SECTION.
the office files an affidavit with the governor attesting that the
federal waiver amendments applied for under this SECTION are
in effect. The office shall file the affidavit under this subsection not
later than five (5) days after the office is notified that the waiver
amendments are approved.
(d) If the United States Department of Health and Human
Services approves the waiver amendments requested under this
SECTION and the governor receives the affidavit filed under
subsection (c), the office shall implement the waiver amendments
not more than sixty (60) days after the governor receives the
affidavit.
(e) The office may adopt rules under IC 4-22-2, including rules
that regulate adult foster care services provided by a waiver under
this SECTION, that are necessary to implement this SECTION.
(f) This SECTION expires July 1, 2008.
Services approves the waiver amendments requested under this
SECTION and the governor receives the affidavit filed under
subsection (e), the office shall implement the waiver amendments
not more than sixty (60) days after the governor receives the
affidavit.
(g) The reduction of the number of individuals on the waiting
list required under this SECTION shall not be achieved by
reducing services or changing eligibility determination.
(h) The office may adopt rules under IC 4-22-2 necessary to
implement this SECTION.