Medicaid Estate Recovery in Arkansas

Medicaid Estate Recovery in Arkansas: key facts

Recovery scope

Medical payments correctly made from August 13, 1993 and later for care in a nursing facility, an ICF/IID, or a home and community-based waiver program.

Who is subject

Individuals 55 or older who received nursing facility, ICF/IID, or waiver services; and individuals of any age who were permanently institutionalized in a nursing facility or ICF/IID and had to pay all but a minimal amount of their income for care.

Recovery postponed

Not waived but postponed while there is a surviving spouse, a surviving minor child, or a child of any age who is blind or permanently and totally disabled — or while a caregiver son or daughter who lived in the home for the two years before the recipient entered care, or a sibling who lived in the home for the year before, still lives there.

Never recovered

Interests acquired through a properly executed and recorded beneficiary deed (Ark. Act 570 of 2021, once documentation is given to the entity seeking recovery); resources protected by a Qualified Long-Term Care Insurance Partnership Policy; and any recovery that is not cost effective.

Hardship waiver

The personal representative or distributee may apply within 30 days after receiving the DHS-20 Notice of Estate Recovery, by mailing a statement of the facts to the Third Party Liability Unit, Attention: Decedents' Estates, P.O. Box 1437, Slot S296, Little Rock, AR 72203-1437.

Hardship factors

The DCO Hardship Waiver Committee weighs whether the asset is a beneficiary's sole income-producing asset; whether a beneficiary would become eligible for public benefits without the estate proceeds; whether the inheritance would let a beneficiary leave public benefits; whether the asset is a home worth 50% or less of the county average home price at the date of death; and other compelling circumstances.

Governing law: Ark. Code Ann. 20-76-436; DHS Medical Services Policy Manual MS H-600 – H-730 (rev. 08/29/2022)

Steps to take when someone dies

1. Determine whether the deceased received Medicaid nursing facility, ICF/IID, or waiver services at age 55 or older, or was permanently institutionalized at any age.
2. Watch for the Notice of Estate Recovery (form DHS-20) that the DHS Third Party Liability Unit mails to the personal representative, or to the distributee of a small estate.
3. Treat the filed claim as a debt of the estate before distributing assets to heirs. DHS files the claim with the probate clerk and mails a copy to the personal representative, the estate's attorney, or the distributee.
4. To seek an undue-hardship waiver, mail a statement of the facts to the Third Party Liability Unit, Decedents' Estates, within 30 days of receiving the DHS-20, with:
   • Tax returns, income statements, or other documents supporting the hardship
   • The facts that establish the undue hardship on the survivors
5. If the DCO Hardship Waiver Committee denies the waiver, appeal within 30 days of receiving the decision.

Frequently asked questions