La. Admin. Code tit. 50 § I-8101

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-8101 - Definitions

Authorized Representative - the executor or succession attorney if a succession has been opened. If there is no executor or succession attorney, an heir, family member or the decedent's last authorized representative listed on the decedent's most recent Medicaid application.

Cost Effectiveness - t he process whereby the Medicaid agency balances and weighs that which it may reasonably expect to recover against the time and expense of recovery. Initiating estate recovery will be deemed to be cost effective when the amount reasonably expected to be recovered exceeds the cost of recovery and is greater than $1,000.

Estate - t he gross (total value) estate of the deceased as determined by Louisiana succession law and any interest in any property, whether movable or immovable, corporeal or incorporeal.

Heir - a descendant in the first degree.

Homestead - consists of a residence occupied by the owner and the land on which the residence is located, including any building and appurtenances located thereon, and any contiguous tracts up to a total of five acres if the residence is within a municipality, or up to a total of 200 acres of land if the residence is not located in a municipality. This same homestead shall be the individual's home which was occupied by the recipient immediately prior to the recipient's admission to a long term care facility or when the recipient began receiving home and community-based services.

Individual's Home -t he primary place of residence of the deceased recipient which was occupied by the recipient immediately prior to the recipient's admission to a long term care facility or when the recipient began receiving home and community-based services.

Undue Hardship - an undue hardship shall exist when initiating estate recovery would result in placing an unreasonable burden on an heir; and if an heir's family income is 300 percent or less of the U.S. Department of Health and Human Services federal poverty level guidelines as published annually in the Federal Register. An undue hardship may exist when:

1. the estate is the sole income producing asset of an heir and income from the estate is limited;

2. recovery would result in an heir becoming eligible to receive public assistance including, but not limited to Medicaid; or

3. any other compelling circumstances that would result in placing an unreasonable financial burden on an heir.

La. Admin. Code tit. 50, § I-8101

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 30:801 (April 2004), amended LR 37:339 (January 2011).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

NOTE: An undue hardship does not exist if the circumstances giving rise to the hardship were created by or are the result of estate planning methods under which assets were sheltered or divested in order to avoid estate recovery. It is the obligation of the heirs to prove undue hardship by a preponderance of the evidence.