West Virginia Code
Article 5. Miscellaneous Provisions
§9-5-11c. Right of the Department of Health and Human Resources to Recover Medical Assistance

(a) Upon the death of a person who was fifty-five years of age or older at the time the person received welfare assistance consisting of nursing facility services, home and community-based services, and related hospital and prescription drug services, the Department of Health and Human Resources, in addition to any other available remedy, may file a claim or lien against the estate of the recipient for the total amount of medical assistance provided by Medicaid for nursing facility services, home and community-based services, and related hospital and prescription drug services provided for the benefit of the recipient. Claims so filed shall be classified as and included in the class of debts due the state.
(b) The department may recover pursuant to subsection (a) only after the death of the individual's surviving spouse, if any and only after such time as the individual has no surviving children under the age of twenty-one, or when the individual has no surviving children who meet the Social Security Act's definition of blindness or permanent and total disability.
(c) The state shall have the right to place a lien upon the property of individuals who are inpatients in a nursing facility, intermediate care facility for individuals with an intellectual disability or other medical institution who, after notice and an opportunity for a hearing, the state has deemed to be permanently institutionalized. This lien shall be in an amount equal to Medicaid expenditures for services provided by a nursing facility, intermediate care facility for individuals with an intellectual disability or other medical institution, and shall be rendered against the proceeds of the sale of property except for a minimal amount reserved for the individual's personal needs. Any such lien dissolves upon that individual's discharge from the medical institution. The secretary has authority to compromise or otherwise reduce the amount of this lien in cases where enforcement would create a hardship.
(d) No lien may be imposed on such individual's home when the home is the lawful residence of: (1) The spouse of the individual; (2) the individual's child who is under the age of twenty-one; (3) the individual's child meets the Social Security Act's definition of blindness or permanent and total disability; or (4) the individual's sibling has an equity interest in the home and was residing in the home for a period of at least one year immediately before the date of the individual's admission to a medical institution.
(e) The filing of a claim, pursuant to this section, neither reduces or diminishes the general claims of the Department of Health and Human Resources, except that the department may not receive double recovery for the same expenditure. The death of the recipient neither extinguishes or diminishes any right of the department to recover. Nothing in this section affects or prevents a proceeding to enforce a lien pursuant to this section or a proceeding to set aside a fraudulent conveyance.
(f) Any claim or lien imposed pursuant to this section is effective for the full amount of medical assistance provided by Medicaid for nursing facility services, home and community-based services, and related hospital and prescription drug services. The lien attaches and is perfected automatically as of the beginning date of medical assistance, the date when a recipient first receives treatment for which the Department of Health and Human Resources may be obligated to provide medical assistance. A claim may be waived by the department, if the department determines, pursuant to applicable federal law and rules and regulations, that the claim will cause substantial hardship to the surviving dependents of the deceased.
(g) Upon the effective date of this section, the Attorney General, on behalf of the State of West Virginia, shall commence an action in a court of competent jurisdiction to test the validity, constitutionality, and the ability of the Congress of the United States to mandate the implementation of this section. This subsection does not limit the right of others, including recipients, to intervene in any litigation, nor does it limit the discretion of the Attorney General or appropriate counsel to seek affected persons to act as parties to the litigation, either individually or as a class.

Structure West Virginia Code

West Virginia Code

Chapter 9. Human Services

Article 5. Miscellaneous Provisions

§9-5-1. Exemption of Grants From Certain Taxes and Claims

§9-5-2. Release of Liens and Reassignment of Insurance Policies

§9-5-3. Recipient of Assistance Not a Pauper

§9-5-4. Penalties for False Statements, etc.

§9-5-5. Recipients of Cash Grants

§9-5-6. Attorney General and Prosecuting Attorneys to Render Legal Services to Commissioner

§9-5-7. Visitation by County Employees

§9-5-8. Authority to Examine Witnesses, Administer Oaths and Take Affidavits

§9-5-8a. Authority to Subpoena Witnesses and Documents When Investigating the Provision of Medical Assistance Programs

§9-5-8b. Authority of Investigations and Fraud Management Division to Subpoena Witnesses and Documents

§9-5-9. Direct Cremation or Direct Burial Expenses for Indigent Persons

§9-5-10. Continuation of Present Aid; Contributions by Counties

§9-5-11. Definitions; Assignment of Rights; Right of Subrogation by the Department for Third-Party Liability; Notice Requirement for Claims and Civil Actions; Notice Requirement for Settlement of Third-Party Claim; Penalty for Failure to Notify the D...

§9-5-11a. Notice of Action or Claim

§9-5-11b. Release of Information

§9-5-11c. Right of the Department of Health and Human Resources to Recover Medical Assistance

§9-5-12. Medicaid Program; Maternity and Infant Care

§9-5-12a. Medicaid Program; Dental Care

§9-5-13. Pilot Program for Certain Aid Recipients Seeking Self-Employment

§9-5-14. Medicaid Program; Health Care Facilities Financed by Bonds; Rules Regarding Reimbursement of Capital Costs

§9-5-15. Medicaid Program; Preferred Drug List and Drug Utilization Review

§9-5-16. Medicaid Program; Legislative Purpose; Health Care Provider Reimbursement Study by Department; Hearings; Report

§9-5-16a. Medicaid-Certified Nursing Homes; Screening of Applicants and Residents for Mental Illness; Reimbursement of Hospitals

§9-5-17. Nonprofit Agency or Facility, in Receipt of Medicaid Moneys, Shall Provide Annual Accounting of Gross Receipts and Disbursements Including Salaries

§9-5-19. Summary Review for Certain Behavioral Health Facilities and Services

§9-5-20. Medicaid Program; Chronic Kidney Disease; Evaluation and Classification

§9-5-21. Annual Report to Joint Committee on Government and Finance Regarding Treatment for Autism Spectrum Disorders Provided by the Bureau for Medical Services

§9-5-22. Medicaid Managed Care Reporting

§9-5-23. Bureau of Medical Services Information

§9-5-24. Requiring Substance Abuse Treatment Providers to Give Pregnant Woman Priority Access to Services

§9-5-25. Medicaid Program Compact

§9-5-26. Supplemental Medicare and Medicaid Reimbursement

§9-5-27. Transitioning Foster Care Into Managed Care

§9-5-28. Requirement for Telehealth Rates

§9-5-29. Payments to Substance Use Disorder Residential Treatment Facilities Based Upon Performance-Based Outcomes

§9-5-30. Certified Community Behavioral Health Clinics