Detailed Answer
If you’ve inherited an estate in Montana and suspect the Department of Public Health and Human Services (DPHHS) filed a Medicaid claim against it, you have the right to obtain and review documentation supporting that claim. Under Mont. Code Ann. § 53-6-163, the state may seek reimbursement from the estate of a deceased Medicaid beneficiary for long-term care and related services provided.[53-6-163]
Follow these steps to request and examine the Medicaid claim records:
- Confirm the estate representative. Only the personal representative (executor) or an attorney officially appointed can request estate recovery records. Review the probate court’s letters of appointment to confirm your status.
- Draft a formal records request. Send a written request to the DPHHS Estate Recovery Program. Include:
- Decedent’s full name, date of birth, and Medicaid ID.
- Case or claim number (if known).
- Proof of your appointment as personal representative (copy of letters testamentary or letters of administration).
- Specific request for “all documentation, itemized billing and calculation worksheets” supporting the Medicaid recovery claim against the estate.
- Mail or email the request.
- Address: Estate Recovery Program, Montana DPHHS, PO Box 202953, Helena, MT 59620-2953.
- Email: dhhsestate@mt.gov (if available—confirm current address on the DPHHS website).
- Allow time for processing. State agencies typically respond within 30–45 days under the Montana Public Records Act (Mont. Code Ann. § 2-6-1001).
- Review the documents. Expect to receive:
- Notice of claim or demand letter.
- Itemized Medicaid EOBs (explanation of benefits).
- Invoices from care providers.
- Calculations showing the amount claimed against the estate.
- Verify accuracy and timelines. Compare dates, billed amounts, and eligibility periods. Look for duplicate charges or services not covered by Medicaid. Note any deadlines to dispute the claim in probate court.
- Consult an estate or probate attorney. If you spot errors or need to challenge the claim, an attorney can guide you through filing an objection in the probate proceeding. They can also help negotiate a settlement amount if appropriate.
Disclaimer: This article is for educational purposes only and is not legal advice. Always consult a licensed attorney before taking action on legal matters.
Helpful Hints
- Keep copies of every letter and email you send or receive.
- Track deadlines: probate courts impose strict time limits for objecting to creditor claims.
- Ask for a fee waiver or reduction if the estate has limited assets.
- Maintain organized spreadsheets to cross-check billed services against medical records.
- Follow up with DPHHS if you don’t receive a response within 45 days.