Healthcare Estate Liens Addressed By Legislature

The recent news that some families who are enrolled in Medical Assistance (through MNsure) have had substantial liens placed against their property was a shock to many Minnesotans.

According to the little publicized provision in the MNsure enrollment in MA (Medical Assistance, Minnesota’s version of Medicaid), if you’re 55 or older and on MA, the state places an estate claim with which to recover its costs after you and your spouse have died.

Statewide attention was focused on at least two (2) families living in Pine County within the Seven County region.  Both families recounted similar experiences in their enrollments into the MA program.  When asked about the issue, Sen. Tony Lourey of Kerrick, said the process “lacked transparency.”  “It is there in the fine print, but not anywhere near to the level that I think is acceptable,” Lourey said. The Senator has taken action to alleviate the current problem by introducing a bill that addresses select provisions of the law.

It’s worth knowing that the estate claim provision has always been in place for people enrolled in MA. However, with the 2014 expansion of MA under the ACA (Affordable Care Act), MNsure has brought younger people into the system (people in the 55-64 age range and with more assets).  It’s that group of individuals who are now are now most affected by the same MA lien provisions. If a proposed law from Sen. Lourey passes, nursing home and long-term care costs will still accrue liens against MA enrollees estates, but a number of the other expenses will be exempted from the lien process if the measure passes.

Sen. Lourey’s curative bill is SF#2501 – the first part of the legislative language summarizes the bill’s intent:

SF 2501 retroactively limits medical assistance estate recoveries for those individuals who receive medical assistance while not institutionalized.

Section 1 (256B.15, subdivision 1, paragraph e – Circumstances under which a claim must be filed) retroactively modifies the circumstances under which the Commissioner of Human Services is permitted to file a claim against the estate of an individual who received medical assistance while not residing in an institution.

For services rendered prior to January 1, 2014, a claim against an estate must be filed if a person received any medical assistance and the person was 55 years old or older at the time the service was rendered.

For services rendered after January 1, 2014, a claim against an estate must be filed, but only if the person was 55 years old or older at the time the service was rendered and the services provided were nursing home services, home and community-based services, or related hospital and prescription drug benefits.

      It should be noted that the language to create liens for this expanded group (55-64 years of age) was left as an option in 2014 for states that were operating insurance exchanges under the ACA.  Minnesota’s Dept. of Human Services decided to include that option, but did not do an adequate job of communicating that change to the MNsure Board which, in turn, created  much of the confusion that exists.

As of this printing, there is now a MN House companion bill similar to the Senate bill (HF#3467); it’s authored by Rep. Matt Dean of White Bear Lake.

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