Regional News

State’s recovery policy will be adjusted to protect new Medicaid enrollees

Dec 17, 2013

Washington State’s Health Care Authority is reassuring new Washington Apple Health (Medicaid) applicants that the state will amend its estate recovery policy to avoid unintended consequences for enrollees under the Medicaid expansion.

This change will align state policy with federal requirements and limit recoveries to enrollees 55 and over who are in long-term care and have related prescription drug and hospital costs.

For two decades, federal Medicaid statutes have required states to place liens on deceased clients’ estates in order to recover long-term care costs and associated medical expenditures.

In 2004, Washington expanded its estate recovery policy to apply to all Medicaid services and associated costs for clients 55 and older. While largely non-controversial over the last 10 years, new concerns were raised recently due to the different population of uninsured, non-disabled adults now being served under Medicaid expansion.

Health Care Authority Director Dorothy Teeter said she anticipates the cost of the move will be minimal since nearly all current recoveries are still tied to long-term care clients. Total recoveries in fiscal year 2013 were approximately $17 million.

“An outdated policy was producing significant concern from families newly eligible for Medicaid,” Teeter said. “Changing this old policy was simply the right the thing to do after hearing from many in our community who were questioning whether to sign up for coverage at all.”

State Medicaid Director MaryAnne Lindeblad said, “We are pleased with how many newly eligible families have signed up for Apple Health since October 1 and, by making this change, we are removing an additional perceived barrier to cost-effective coverage for uninsured Washingtonians.”

To effect this change, an emergency rule will be filed to amend WAC 182-527-2742, and the state will amend its Medicaid State Plan, which is the contract between the state and federal governments.

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