Received MERP letter from HMS in TX but our Dad wasn't in NH or on Medicaid. How much will they take?
We did have a home aide Afew times weeky for 2yr. How much money will they take. The house is only worth about 50K. I made about $2000. over the limit for hardship.
SSaustin - reread your post.....so did you respond to the initial letter by HMS & you were denied a hardship? If so, you really really need to file within the 60 days for an appeal. The appeals process is not done by HMS but a separate group with TXHHS. You kinda need to do the follow through &'respond to all the letters and file appeal.
Was the house empty during the period of time your elder was in the NH? Is so, who paid all the many costs on the house? All those are a class 2 -4 claim in probate & paid out before MERP class 7 claim. A 50k house is pretty modest and if you have a good amount of house maintenance expenses, it could be the costs for the sale of the house could not be cost effective. If you or other family has spent 10k a yr on the house for 3 years (30k) & the house has issues that would be a problem to sell it (needs new roof @ 8k); it could be the costs to sell which you or other family would need to pay plus Realtor commission, closing costs, vacant property insurance, etc are such that there goes the proceeds from the sale. MERP is limited to whatever the property sells for less your own claims against the property. Forcing a sale of the house may not meet the required cost benefit to do the claim. but you have to respond & document and be proactive in all this and it could mean going full independent probate with attorney.
Sendme - Medicare can't help you with your ? on Medi-Cal because Medi-Cal is the state of California's program and managed by CA uniquely. Medicare is federal & so uniform across the US. Medicaid depends on how each state chooses to spend it's own funds. Like some states use some of their Medicaid funding for NH to instead go to "discretionary" fund AL or PACE. Each states medicaid is managed uniquely. You need to contact your state directly to get answers on Medicaid.
The government agencies are all in this together and report to each other. However, when calling Medicare, they won't tell you anything about the Medi-Cal portion of Medicaid. Impossible to contact those people for any valuable or accurate information. Then, if you are not the person, good luck getting them to talk to you at all, because of the HIPPA laws (in re: privacy laws). There is a reason for this governmental run-a-round. Do not give up.
HMS is the outside contractor for state of TX merp and about a dz other states as well (GA, NY). HMS also has a different division that does compliance for CMS - Centers for Medicare & Medicaid at the federal level. They are a huge diversified company within the health care industry. I think they also deal with Stark law violations (they do the research).
SS in Austin (?) - for Tx is is NOT just NH Medicaid elderly that is subject to MERP. Any community based service that is within TXDADS list of covered programs are within MERP recovery purview. That aide your dad got probably was a service under some type of state funding that involved Medicaid $$$. now was the letter a "intent of file a claim" letter? If so, you or whomever was either the contact person for dad (whomever was his DPOA) or whomever is going to be his executrix /or as per his will needs to respond to HMS within the specific time frame indicated on the letter. If you do nothing, HMS assumes that the amount indicated is correct and can place a claim against dads estate. For Tx, it is a claim & a class 7 claim for tx probate. Not all states have MERP as a claim, most have the ability to do a lien on estate assets. Usually the only asset is the deceased elders home as they have to be impoverished in assets to even qualify for Medicaid. But sometimes an rider has a life insurance policy who has the beneficiary to be their estate.
So SSaustin - what's in the letter? & out of curiosity whats the amount? & did dad die still owning his home? Did he die with a valid will? Or did dad die intestate? Look at the TAC ( Texas administrative code) to see how all this runs - TAC is actually easier to read than TXHHS &TXDADS site IMHO.
MERP is MediCal Estate Recovery Program. See a free legal aid attorney to preserve your dad's home. This would be simple if you have a mom living there. The definition of financial hardship is fluid, and involves much more than just income/assets. For example, income can be decreased by the total of unpaid medical bills. See an attorney because you do not have enough information.
O.k. ... so far I have read down to JoAnn29 of 11 hours ago.... and thank all of you for ‘splainin” some of these abbreviations, which “did get my Goat”....once , a few Blogs ago...., but there are 3 Abbreviations I am still not sure about ...There must have been 50+ on the site I looked them up in. Here are what seemed close: HMS Hospital Management System ...? HMS Healthcare Management System ...? HMS Health and Medical Services ...? May have a slightly different meaning in every other State..........? And I agree with JessieBelle. The faster you find out details from the letter source, the faster you can be sure it is NOT Idendity theft..... what a horrible and sad comment of our times, that something like that could even happen... Since your letter was posted 6 days back... you may already have solved your questions ! I do hope so...and do wish you well...
Ssaustx, I don't understand, if your dad was not receiving Medicaid, then he should not be receiving any MERP letters whatsoever. I wonder if there is a case of mistaken identity with your dad's name--or worse, some type of scam artist trying to get money? If I got a letter like that I would first of all, verify it is from . Medicaid by going to the office listed in TX dept of Human Services and show them this letter. Something doesn't add up with what your describing. They can't put a Lien on your dad's home if he never received Medicaid.
Best thing is reread the letter. It may just informing you of a lean on the house. Don't think they will make u sell the house. Just that they will recoup the money the extended him. If he is not on SSI then you need to make a call.
Mallory, sorry, I reread the letter. It explains that Medicaid recipriants are told about the asset rule but SSI recipriants aren't. Its up to the NH to tell SSI residents that if they have assets a lean will be put against them. Upon the sale of assets they will recoup monies they gave the resident. This happened to my Aunt. There was a 23,000 lean on her house when she died.
It sounds like you need to contact HMS to find out what is going on. If no one was on Medicaid or in a NH, I don't know why you would be receiving this letter. Could it have been identity theft? I don't know. I would contact the company quickly to find out what is going on.
Its within SS office but not taken out of SS but out general taxes. SSI reciprients usually given Mrdicaid. You can only receive SSI if u have no other income or not enough quarters for SS. (My nephew has an annuity from his Mom and didn't qualify) If u own a home, you will be allowed to remain in it but lean will be put on the house. At the time the home is sold, the lean will need to be satisfied. If there are no assets, then they can not request their money reinbursed.
I don't understand how SSI (Supplemental Security Income) which is welfare benefit from Social Security, could be in charge of MERP or telling Medicaid recipients anything. Medicaid has nothing to do with SSI, or.maybe someone can explain where the Medicaid office is within The Social Security Office? ....NH is Nursing Home and MERP is Medicaid Estate Recovery Process (not Plan).
Seems Merp is "Medicaid Recovery Estate Plan". NH facilities have to inform those on SSI that medicaid will get their money back if there is an estate. YOUR Department of aging and Disabilities Service may be able to help u. I put MERP letter in search and found a letter written to NH facilities explaining it all and what they had to do.
Is your father on SSI? If so, the letter might just be an explanation that a lean will be put on his estate and that at the time the house is sold, they will recover the money they gave him for his support. If the lean is more than the house is worth, they take the loss. Children r not made to pay it back.
Yes, using initials doesn't help since each states depts are different names. I think NH is nursing home. How did u get an aide? This is hard without reading the letter.
Oh, dear, ...Ok...... dear ....start over .... You received a what....a MERP letter {???} from whom...?HMS? ,,, in Texas , but your Dad wasn't in New Hampshire.... or on Madicaid.... and why would maidicaid or who ever take what from you ....???
17 Answers
Helpful Newest
First Oldest
First
Was the house empty during the period of time your elder was in the NH? Is so, who paid all the many costs on the house? All those are a class 2 -4 claim in probate & paid out before MERP class 7 claim. A 50k house is pretty modest and if you have a good amount of house maintenance expenses, it could be the costs for the sale of the house could not be cost effective. If you or other family has spent 10k a yr on the house for 3 years (30k) & the house has issues that would be a problem to sell it (needs new roof @ 8k); it could be the costs to sell which you or other family would need to pay plus Realtor commission, closing costs, vacant property insurance, etc are such that there goes the proceeds from the sale. MERP is limited to whatever the property sells for less your own claims against the property. Forcing a sale of the house may not meet the required cost benefit to do the claim. but you have to respond & document and be proactive in all this and it could mean going full independent probate with attorney.
ADVERTISEMENT
There is a reason for this governmental run-a-round. Do not give up.
SS in Austin (?) - for Tx is is NOT just NH Medicaid elderly that is subject to MERP. Any community based service that is within TXDADS list of covered programs are within MERP recovery purview. That aide your dad got probably was a service under some type of state funding that involved Medicaid $$$. now was the letter a "intent of file a claim" letter? If so, you or whomever was either the contact person for dad (whomever was his DPOA) or whomever is going to be his executrix /or as per his will needs to respond to HMS within the specific time frame indicated on the letter. If you do nothing, HMS assumes that the amount indicated is correct and can place a claim against dads estate. For Tx, it is a claim & a class 7 claim for tx probate. Not all states have MERP as a claim, most have the ability to do a lien on estate assets. Usually the only asset is the deceased elders home as they have to be impoverished in assets to even qualify for Medicaid. But sometimes an rider has a life insurance policy who has the beneficiary to be their estate.
So SSaustin - what's in the letter? & out of curiosity whats the amount? & did dad die still owning his home? Did he die with a valid will? Or did dad die intestate? Look at the TAC ( Texas administrative code) to see how all this runs - TAC is actually easier to read than TXHHS &TXDADS site IMHO.
See a free legal aid attorney to preserve your dad's home. This would be simple if you have a mom living there.
The definition of financial hardship is fluid, and involves much more than just income/assets. For example, income can be decreased by the total of unpaid medical bills. See an attorney because you do not have enough information.
HMS Hospital Management System ...?
HMS Healthcare Management System ...?
HMS Health and Medical Services ...?
May have a slightly different meaning in every other State..........?
And I agree with JessieBelle. The faster you find out details from the letter source, the faster you can be sure it is NOT Idendity theft..... what a horrible and sad comment of our times, that something like that could even happen...
Since your letter was posted 6 days back... you may already have solved your questions ! I do hope so...and do wish you well...
Is your father on SSI? If so, the letter might just be an explanation that a lean will be put on his estate and that at the time the house is sold, they will recover the money they gave him for his support. If the lean is more than the house is worth, they take the loss. Children r not made to pay it back.