Rhode Island General Laws
Chapter 40-8 - Medical Assistance
Section 40-8-15. - Lien on deceased recipient’s estate for assistance.

§ 40-8-15. Lien on deceased recipient’s estate for assistance.
(a)(1) Upon the death of a recipient of Medicaid under Title XIX of the federal Social Security Act (42 U.S.C. § 1396 et seq. and referred to hereinafter as the “Act”), the total sum for Medicaid benefits so paid on behalf of a beneficiary who was fifty-five (55) years of age or older at the time of receipt shall be and constitute a lien upon the estate, as defined in subsection (a)(2), of the beneficiary in favor of the executive office of health and human services (“executive office”). The lien shall not be effective and shall not attach as against the estate of a beneficiary who is survived by a spouse, or a child who is under the age of twenty-one (21), or a child who is blind or permanently and totally disabled as defined in Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq. The lien shall attach against property of a beneficiary, which is included or includable in the decedent’s probate estate, regardless of whether or not a probate proceeding has been commenced in the probate court by the executive office or by any other party. Provided, however, that such lien shall only attach and shall only be effective against the beneficiary’s real property included or includable in the beneficiary’s probate estate if such lien is recorded in the land evidence records and is in accordance with subsection (e). Decedents who have received Medicaid benefits are subject to the assignment and subrogation provisions of §§ 40-6-9 and 40-6-10.
(2) For purposes of this section, the term “estate” with respect to a deceased individual shall include all real and personal property and other assets included or includable within the individual’s probate estate.
(b) The executive office is authorized to promulgate regulations to implement the terms, intent, and purpose of this section and to require the legal representative(s) and/or the heirs-at-law of the decedent to provide reasonable written notice to the executive office of the death of a beneficiary of Medicaid benefits who was fifty-five (55) years of age or older at the date of death, and to provide a statement identifying the decedent’s property and the names and addresses of all persons entitled to take any share or interest of the estate as legatees or distributees thereof.
(c) The amount of reimbursement for Medicaid benefits imposed under this section shall also become a debt to the state from the person or entity liable for the payment thereof.
(d) Upon payment of the amount of reimbursement for Medicaid benefits imposed by this section, the secretary of the executive office, or his or her designee, shall issue a written discharge of lien.
(e) Provided, however, that no lien created under this section shall attach nor become effective upon any real property unless and until a statement of claim is recorded naming the debtor/owner of record of the property as of the date and time of recording of the statement of claim, and describing the real property by a description containing all of the following: (1) Tax assessor’s plat and lot; and (2) Street address. The statement of claim shall be recorded in the records of land evidence in the town or city where the real property is situated. Notice of the lien shall be sent to the duly appointed executor or administrator, the decedent’s legal representative, if known, or to the decedent’s next of kin or heirs at law as stated in the decedent’s last application for Medicaid benefits.
(f) The executive office shall establish procedures, in accordance with the standards specified by the Secretary, United States Department of Health and Human Services, under which the executive office shall waive, in whole or in part, the lien and reimbursement established by this section if the lien and reimbursement would cause an undue hardship, as determined by the executive office, on the basis of the criteria established by the secretary in accordance with 42 U.S.C. § 1396p(b)(3).
(g) Upon the filing of a petition for admission to probate of a decedent’s will or for administration of a decedent’s estate, when the decedent was fifty-five (55) years or older at the time of death, a copy of the petition and a copy of the death certificate shall be sent to the executive office. Within thirty (30) days of a request by the executive office, an executor or administrator shall complete and send to the executive office a form prescribed by that office and shall provide such additional information as the office may require. In the event a petitioner fails to send a copy of the petition and a copy of the death certificate to the executive office and a decedent has received Medicaid benefits for which the executive office is authorized to recover, no distribution and/or payments, including administration fees, shall be disbursed. Any person and/or entity that receives a distribution of assets from the decedent’s estate shall be liable to the executive office to the extent of such distribution.
(h) Compliance with the provisions of this section shall be consistent with the requirements set forth in § 33-11-5 and the requirements of the affidavit of notice set forth in § 33-11-5.2. Nothing in these sections shall limit the executive office from recovery, to the extent of the distribution, in accordance with all state and federal laws.
(i) To ensure the financial integrity of the Medicaid eligibility determination, benefit renewal, and estate recovery processes in this and related sections, the secretary of health and human services is authorized and directed to, by no later than August 1, 2018: (1) Implement an automated asset verification system, as mandated by § 1940 of the Act, that uses electronic data sources to verify the ownership and value of countable resources held in financial institutions and any real property for applicants and beneficiaries subject to resource and asset tests pursuant to the Act in § 1902(e)(14)(D); (2) Apply the provisions required under §§ 1902(a)(18) and 1917(c) of the Act pertaining to the disposition of assets for less than fair market value by applicants and beneficiaries for Medicaid long-term services and supports and their spouses, without regard to whether they are subject to or exempted from resources and asset tests as mandated by federal guidance; and (3) Pursue any state plan or waiver amendments from the United States Centers for Medicare and Medicaid Services and promulgate such rules, regulations, and procedures he or she deems necessary to carry out the requirements set forth herein and ensure the state plan and Medicaid policy conform and comply with applicable provisions of Title XIX.
History of Section.P.L. 1982, ch. 191, § 1; P.L. 1992, ch. 133, art. 28, § 1; P.L. 1995, ch. 99, § 1; P.L. 2012, ch. 241, art. 11, § 5; P.L. 2018, ch. 47, art. 13, § 1.

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