Medicaid Estate Recovery in Rhode Island

Who is subject to recovery

R.I. Gen. Laws 40-8-15 reaches recipients who were 55 or older when they received Medicaid, and covers all periods of receipt from age 55 onward.¹

What is recovered

The total sum of Medicaid benefits paid on the recipient's behalf from age 55 onward is asserted as a lien against the probate estate in favor of EOHHS.¹

What counts as the estate

The EOHHS regulation limits the lien to property included or includable in the probate estate. Property passing by operation of law, by beneficiary designation, or under a trust, deed, annuity, or insurance contract is excluded.²

The lien does attach where there is no probate because the estate was settled under the small-estates statute (R.I. Gen. Laws 33-24-1 et seq.).²

When recovery is deferred or barred

The lien does not attach when the recipient is survived by a spouse, a child under 21, or a child who is blind or permanently and totally disabled.¹

How the state files its claim

When the decedent was 55 or older, the probate petitioner sends a copy of the petition and the death certificate to the EOHHS Legal Office, and files a copy of that notice with the probate court before the hearing (with the petition itself in a voluntary proceeding).²

This notice is in addition to the known-creditor notice under R.I. Gen. Laws 33-11-5.1. If the notice is not sent and the decedent received recoverable Medicaid benefits, no estate distributions, payments, or administration fees may be disbursed.²

The EOHHS claim is a debt of the estate, paid before distribution to heirs; on payment, EOHHS issues a discharge of the lien.¹

Undue-hardship waiver

R.I. Gen. Laws 40-8-15(f) requires EOHHS to waive the lien and reimbursement in whole or in part when it would cause an undue hardship, using the criteria set by the U.S. Secretary of Health and Human Services under 42 U.S.C. 1396p(b)(3).¹

The EOHHS regulation implements the hardship provision as a postponement of the lien's execution, in whole or in part, and reviews a granted hardship at least every two years.²

The heir or beneficiary applying must have used the property as a principal residence on the date of death, have lived there continuously for at least 24 months before the death, and have gross income no more than 250% of the federal poverty level with assets no more than the Medically Needy resource standard.²

Long-term care partnership policies

For a Qualified Long-Term Care Insurance Partnership policy, the total amount the policy paid as of the date of death is disregarded in determining the amount recoverable from the estate (210-RICR-10-00-4.7).²

Liens on real property

No lien attaches to real property unless a statement of claim naming the owner of record and describing the property by tax assessor's plat and lot and street address is recorded in the land evidence records of the city or town where the property sits.¹

Governing law: R.I. Gen. Laws 40-8-15; 210-RICR-10-00-4.4; 210-RICR-10-00-4.9

Notice to the EOHHS Legal Office filed with the probate court

before the hearing²

Forms on estate assets requested by EOHHS

within 30 days of the EOHHS request¹

Written application for an undue-hardship postponement

within 45 days of the date EOHHS files its claim with the probate court²

Probate court

Receives a copy of the notice to the EOHHS Legal Office before the hearing, and the EOHHS claim²

• A standalone estate-recovery web page

1. 1.R.I. Gen. Laws 40-8-15
2. 2.210-RICR-10-00-4