RECOVERY WAIVER

Recovery shall be deemed to not be cost effective and shall be waived when:

• The amount of Medicaid payments for services and benefits subject to recovery is less than three thousand dollars ($3,000), or

• The assets in the estate are below five thousand dollars ($5,000).

Recovery shall be waived if enforcement of the claim will cause undue or substantial hardship to the surviving heirs of the decedent.  Undue or substantial hardship shall include the following:

• Real or personal property included in the estate is the sole source of income for a survivor and the net income derived is below 75 percent of the federal poverty level for the dependents of the survivor(s) claiming hardship, or

• Recovery would result in forced sale of the residence of a survivor who lived in the residence for at least 12 months immediately prior to and on the date of the decedent's death and who would be unable to obtain an alternate residence because the net income available to the survivor and his spouse is below 75 percent of the federal poverty level and assets in which the survivor or his spouse have an interest are valued below twelve thousand dollars ($12,000).

Undue hardship shall not include loss of a pre-existing standard of living nor the establishment of a source of maintenance that did not exist prior to the decedent's death.

A claim of undue hardship to a survivor shall be made in writing to the Division of Medical Assistance estate recovery administrator within 30 days after the surviving heir claiming undue hardship has been notified of the Medicaid claim.  The claim of hardship shall describe the financial circumstances of the heir and the basis for his dependence on assets in the decedent's estate.