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Disclaimer: This article is for informational purposes only and does not constitute legal advice.

Detailed Answer

When a New Jersey resident receives Medicaid benefits and later passes away, the State may seek recovery from the person’s estate. If you inherit that estate, you can obtain and review all documents related to the Medicaid claim by following these steps.

1. Confirm Your Role as Estate Representative

Only the court-appointed executor or administrator can access probate and Medicaid claim records. If you are not yet appointed, file a petition with the County Surrogate’s Office to become the estate representative.

2. Obtain the Claim from the Surrogate’s Court

Under N.J.S.A. 30:4D-40 (Recovery of payments), the Division of Medical Assistance & Health Services (DMAHS) must file a claim in the Surrogate’s Court of the county where the probate proceeding is pending. To access this file:

1. Contact the County Surrogate’s Office with the estate file number and decedent’s full name.
2. Request inspection of the claim docket and ask for copies of the claim, notice, and any filed objections.
3. Pay standard copying or certification fees as required by the Surrogate’s Office.

3. Request Administrative Records from the NJ DHS Estate Recovery Program

The New Jersey Open Public Records Act (N.J.S.A. 47:1A-1 et seq.) lets you obtain supporting documents directly from DMAHS. To file an OPRA request:

1. Visit the NJ OPRA portal or send a written request to:

2. Include the decedent’s name, Medicaid ID, date of death, and estate file number.
3. Specify the records you need (e.g., itemized billing statements, case memos, correspondence).
4. Monitor responses: agencies must respond within 7 business days under OPRA.

4. Review Key Documents

Once you receive the files, check for:

• Notice of estate recovery claim and any amendments
• Itemized statements from nursing homes or care providers
• Medicaid eligibility and waiver documentation
• Proof of payments made by Medicaid
• Correspondence between DMAHS and healthcare providers

5. Understand the Deadline to Dispute

In the probate process, you generally have 20 days from service of the Medicaid claim to file objections under N.J.S.A. 3B:22-21. Timely objections can delay recovery or reduce the amount claimed.

Helpful Hints

• Gather decedent details (Medicaid ID, date of death) before making requests.
• Always reference the estate file number in communications with the Surrogate’s Office.
• Be specific in your OPRA request to avoid delays—list exact documents and date ranges.
• Track all deadlines and send requests via certified mail when possible.
• Consider obtaining provider records under HIPAA if you need further evidence to challenge billed services.
• If the process becomes complex, consult a probate or elder law attorney promptly.