Medicaid Estate Recovery in Rhode Island

Medicaid Estate Recovery in Rhode Island: key facts

Who is subject

Recipients who were 55 or older when they received Medicaid; recovery covers all periods of receipt from age 55 onward (R.I. Gen. Laws 40-8-15).

Recovery amount

The total sum of Medicaid benefits paid on the recipient's behalf from age 55 onward, asserted as a lien against the probate estate. The lien reaches only 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. It does attach where the estate is settled under the small-estates statute instead of probate.

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.

Probate notice required

When the decedent was 55 or older, the probate petitioner must send a copy of the petition and the death certificate to the EOHHS Legal Office, Virks Building, 3 West Road, Cranston, RI 02920, and file a copy of that notice with the probate court before the hearing (with the petition itself in a voluntary proceeding). This is in addition to the known-creditor notice under R.I. Gen. Laws 33-11-5.1. Without the notice, no estate distributions, payments, or administration fees may be disbursed.

Undue hardship waiver

EOHHS must 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) (R.I. Gen. Laws 40-8-15(f)).

Hardship application deadline and test

The EOHHS regulation implements the hardship provision as a postponement of the lien's execution. An heir or beneficiary applies in writing within 45 days after EOHHS files its claim with the probate court; the applicant 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. EOHHS issues a final written decision within 90 days and reviews a granted hardship at least every two years (210-RICR-10-00-4.12 through 4.14).

Long-term care partnership policy

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).

Real property lien recording

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.

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

Steps to take when someone dies

1. Determine whether the deceased received Medicaid at age 55 or older.
2. When the decedent was 55 or older, send a copy of the probate petition and the death certificate to the EOHHS Legal Office, Virks Building, 3 West Road, Cranston, RI 02920, as the statute requires before the estate distributes anything, and file a copy of that notice with the probate court before the hearing.
3. Respond to the EOHHS request for estate asset information; the estate representative must complete the required forms within 30 days of the request.
4. Address the EOHHS claim as a debt of the estate before distributing to heirs; on payment, EOHHS issues a discharge of the lien.
5. To ask EOHHS to postpone the lien for undue hardship, apply in writing within 45 days after EOHHS files its claim with the probate court (210-RICR-10-00-4.13).

Frequently asked questions