Louisiana Health must run an estate recovery program and follow federal limits when seeking recovery of medical assistance payments.
§153.4. Medicaid Estate Recovery, legislative findings A. The Legislature of Louisiana finds: (1) Louisiana has a long tradition of constitutional provisions and legislation preserving the rights of descendants to inherit the immovable property of their ascendants in the first degree. For nearly two hundred years, state laws required a portion of the estate of residents to be inherited by the children of the deceased. In addition, Louisiana has sought to ensure the inviolability of the right of home ownership to citizens of the state through numerous state constitutions since 1864. (2) Article XII, Section 9 of the Constitution of Louisiana, the substance of which dates back to the Louisiana Constitution of 1879, guarantees an exemption from seizure and sale of a homestead. The constitutionally recognized and statutorily implemented exemption, originally enacted in 1880, provides a fifteen thousand dollar homestead exemption from sale and seizure and provides a full exemption from sale and seizure for debts related to catastrophic illness or injury. B. The state of Louisiana must establish an estate recovery program in compliance with Subchapter XIX of the Social Security Act, 42 U.S.C. 1396p, as amended. C. Therefore, the legislature declares that a comprehensive plan should be developed to address the federal requirements for an estate recovery program while at the same time recognizing the state's long tradition of protecting the citizens' rights to home ownership and the state's interest in assuring the transfer of real property within family units. D. The Louisiana Department of Health shall establish an estate recovery program for the purpose of recovering medical assistance payments made on behalf of individual recipients from the succession estates of those individuals. The department shall seek recovery of medical assistance payments for only those instances mandated by Subchapter XIX of the Social Security Act, 42 U.S.C. 1396p, as amended. For purposes of this Section, the claim of the department shall be considered a privilege on the succession estate, and shall have a priority equivalent to an expense of last illness as prescribed in Civil Code Article 3252 et seq. E. The department shall not seek recovery against the estate of a deceased recipient of the amount of any benefits paid if the amount of the assistance to be recovered is economically inappropriate in relation to the expenses of the recovery. The department shall not institute estate recovery on the first fifteen thousand dollars or one-half the median value of the homestead in each parish whichever is higher. F.(1) The estate recovery efforts of the department shall be in accordance with Subchapter XIX of the Social Security Act, 42 U.S.C. 1396p, as amended. The department shall not take any action to recover in the case of undue hardship. (2) An undue hardship to any heir, as defined by rule, shall exist if an heir’s family income is three hundred percent or less of the applicable federal poverty guideline as published in the Federal Register by the United States Department of Health and Human Services. (3) The department shall promulgate rules and regulations to implement the provisions of this Section. G. Such rules and regulations shall be in accordance with Subchapter XIX of the Social Security Act, 42 U.S.C. 1396p, as amended. The department is hereby authorized to compromise, settle, or waive any recovery of medical assistance authorized by this Section upon good cause shown. The department's recovery from the succession estate may be reduced in consideration of reasonable and necessary expenses incurred by the recipient's heirs, subsequent to the recipient's admission to a long-term care facility, in order to maintain the homestead of the recipient, if the homestead is part of the succession estate. H. To the extent that there is any conflict between the provision of this Section and the standards that are specified by the secretary of the United States Department of Health and Human Services, the federal standard shall prevail. Acts 2003, No. 226, §1; Acts 2018, No. 206, §5.