| | | 60 days of receipt of a claim by forwarding payment, issuing | | a notice of denial or issuing a copy of the explanation of | | benefits directly to the submitter of the claim. |
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| | | 2-I. Claims against estates of MaineCare recipients. Claims | against the estates of Medicaid MaineCare recipients are governed | | by this subsection. |
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| | | A. The department has a claim against the estate of a | Medicaid MaineCare recipient when, after the death of the | | recipient: |
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| | | (1) Property or other assets are discovered that | | existed and were owned by the recipient during the | period when Medicaid MaineCare benefits were paid for | | the recipient and disclosure of the property or assets | | at the time benefits were being paid would have | | rendered the recipient ineligible to receive the | | benefits; |
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| | | (2) It is determined that the recipient was 55 years | of age or older when that person received Medicaid | | MaineCare assistance; or |
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| | | (3) It is determined that the recipient has received | | or is entitled to receive benefits under a long-term | | care insurance policy in connection with which assets | | or resources are disregarded and medical assistance was | | paid on behalf of the recipient for nursing facility or | | other long-term care services. |
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| | B. The amount of Medicaid MaineCare benefits paid and | | recoverable under this subsection is a claim against the | | estate of the deceased recipient. |
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| | | (1) As to assets of the recipient included in the | | probated estate, this claim may be enforced pursuant to | Title 18-A, Article III 3, Part 8. |
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| | | (2) As to assets of the recipient not included in the | | probated estate, this claim may be enforced by filing a | | claim in any court of competent jurisdiction. |
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| | | C. A claim may not be made under paragraph A, subparagraph | | (2) or (3) until: |
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| | | (1) The recipient has no surviving spouse; and |
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| | | (2) The recipient has no surviving child who is under | | age 21 or who is blind or permanently and totally |
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