FastCounsel

Detailed Answer

Under Utah law, the Medicaid Estate Recovery Program requires the Division of Medicaid & Health Financing (DMHF) to seek reimbursement from the estates of certain Medicaid recipients, including amounts paid for nursing facility care, home- and community-based services, and related hospital and prescription drug services. See Utah Code RAG 26-19-7 (Estate Recovery Program). Federal law (42 U.S.C. 1396p) also authorizes states to recover these costs. However, both federal and state regulations allow you to request a hardship waiver if recovery would impose an undue hardship on heirs or dependents.

Step 1: Review the Estate Recovery Notice

After a Medicaid recipient passes away, DMHF sends a Notice of Estate Recovery to the estate’s personal representative or heir. This notice includes the amount DMHF intends to recover and explains your right to request a hardship waiver.

Step 2: Obtain the Hardship Waiver Request Form

Download the Hardship Waiver Request Form from the Utah Medicaid website: https://medicaid.utah.gov/estate-recovery.

Step 3: Gather Supporting Documentation

• Proof of Ownership: Copy of the deed or title showing inherited property.
• Financial Records: Bank statements, tax returns, and current income and expense statements for all heirs or dependents.
• Appraisal: A recent professional appraisal of the property’s fair market value.
• Hardship Explanation: A written statement describing why enforcing recovery would create undue hardship. Common grounds include preventing a spouse, minor child, or disabled heir from retaining their primary residence or essential assets.

Step 4: Complete and Submit the Form

1. Fill out all required fields on the Hardship Waiver Request Form.
2. Attach all supporting documentation.
3. Mail the completed packet to:
   Division of Medicaid & Health Financing
   P.O. Box 143101
   Salt Lake City, UT 84114-3101
4. Alternatively, hand-deliver to the DMHF office at 288 N. 1460 W., Salt Lake City, UT 84116.

Step 5: DMHF Review and Decision

Upon receipt, DMHF must acknowledge your request within 30 days. Under Utah Admin. Code R414-76-3 (Hardship Waiver Criteria), DMHF reviews the evidence, may request additional information, and must issue a written decision within 90 days. If denied, you can appeal to the Utah Office of Administrative Hearings within 30 days of the decision.

Key Statutory References

• Utah Code 26-19-7: Estate Recovery Program
• 42 U.S.C. 1396p: Federal Estate Recovery
• Utah Admin. Code R414-76-3: Hardship Waiver Criteria

Disclaimer: This article is for informational purposes only. It does not constitute legal advice and does not create an attorney-client relationship. Consult a qualified attorney for advice regarding your situation.

Helpful Hints

• File your hardship waiver request within 30 days of receiving the DMHF notice to preserve your appeal rights.
• Keep copies of all forms and correspondence you send to DMHF.
• If you miss the deadline, request a late filing waiver explaining why you could not file on time.
• Consider obtaining a professional appraisal to strengthen your hardship claim.
• Reach out to legal aid organizations in Utah if you need help completing forms or understanding the process.