LD 1319
pg. 315
Page 314 of 460 PUBLIC Law Chapter 20 Page 316 of 460
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LR 2000
Item 1

 
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.

 
2-I. Claims against estates of MaineCare recipients. Claims
against the estates of Medicaid MaineCare recipients are governed
by this subsection.

 
A. The department has a claim against the estate of a
Medicaid MaineCare recipient when, after the death of the
recipient:

 
(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;

 
(2) It is determined that the recipient was 55 years
of age or older when that person received Medicaid
MaineCare assistance; or

 
(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.

 
B. The amount of Medicaid MaineCare benefits paid and
recoverable under this subsection is a claim against the
estate of the deceased recipient.

 
(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.

 
(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.

 
C. A claim may not be made under paragraph A, subparagraph
(2) or (3) until:

 
(1) The recipient has no surviving spouse; and

 
(2) The recipient has no surviving child who is under
age 21 or who is blind or permanently and totally


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