[ { "code": "AL", "name": "Alabama", "recovery_scope": "probate_only", "recovery_scope_note": "State Plan Att. 4.17-A item (7) defines estate as real and personal property and other assets as defined by Alabama probate law; no Alabama statute found that expands the definition. Admin. Code r. 560-X-33-.05 recovers for recipients 55+ (all services except Medicare cost sharing) and permanently institutionalized recipients. The Agency also places TEFRA liens on real property of permanently institutionalized recipients (r. 560-X-33-.06), payable on sale, transfer or death. Recovery deferred until death of surviving spouse; no rule found reaching the surviving spouse's estate.", "recovery_statute": "No estate definition statute found; Ala. Admin. Code r. 560-X-33-.05 and .06 (authority Code of Ala. 1975 Sec. 22-1-11, 22-6-8); State Plan Att. 4.17-A (TN AL-11-002)", "recovery_statute_url": "https://admincode.legislature.state.al.us/api/chapter/560-X-33", "state_plan_4_17_a_url": "https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/AL/AL-11-002-Att.pdf", "life_estate": "not_reachable", "life_estate_note": "Estate is limited to assets defined by Alabama probate law; the remainder passes to the remainderman at the life tenant's death outside probate. A TEFRA lien placed during life on an institutionalized recipient's home is a separate route.", "life_estate_cite": "State Plan Att. 4.17-A item (7); Ala. Admin. Code r. 560-X-33-.06", "lady_bird_deed": "unclear", "lady_bird_deed_note": "If valid, the remainder would pass outside probate and escape a probate-only claim, but no Alabama statute, reported case or Medicaid rule recognizing the enhanced life estate deed was found.", "lady_bird_deed_cite": "State Plan Att. 4.17-A item (7)", "tod_deed": "n/a", "tod_deed_note": "No Alabama statutory transfer on death deed for real property found; Alabama's TOD statute covers securities only (Uniform TOD Security Registration Act, Code of Ala. Title 8, ch. 6, art. 6, per section headings seen in search results).", "tod_deed_cite": "", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship property passes to the surviving joint tenant outside probate, and the estate is limited to probate assets. Joint tenancy statute text not read.", "joint_tenancy_cite": "State Plan Att. 4.17-A item (7)", "revocable_trust": "reachable", "revocable_trust_note": "Trust assets are outside the probate estate, but after the settlor's death revocable trust property is subject to claims of the settlor's creditors to the extent the probate estate is inadequate, so a Medicaid claim can plausibly reach it.", "revocable_trust_cite": "Code of Ala. Sec. 19-3B-505(a)(3), (b)(4)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No statute, reported case, title standard or Medicaid rule found. Searched Alabama Medicaid Admin. Code ch. 560-X-33 and web searches for Alabama enhanced life estate authority; only practitioner pages, which disagree.", "hardship_waiver_home": "Undue hardship only where the estate asset is a family farm or family business producing limited income that is the sole income-producing asset of one or more heirs; each heir applies separately. Not available where hardship was created by illegal divestment or for LTC partnership asset disregards. Lien on home barred while spouse, child under 21, disabled child or qualifying sibling lives there; lien recovery deferred for a sibling or caregiver child in residence.", "recovery_exemptions_note": "LTC Insurance Partnership assets disregarded are exempt from recovery. Claims pursued only when cost-effective (case by case). Since Sept. 1, 2019 (Act 2019-489, Code of Ala. Sec. 43-2-697) personal representatives and small estate petitioners must give notice to the Medicaid Agency before sixth-class claims or distributions are paid.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://admincode.legislature.state.al.us/api/chapter/560-X-33; https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/AL/AL-11-002-Att.pdf; https://law.onecle.com/alabama/title-19/19-3B-505.html; https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2025RS/SB106-eng.pdf", "confidence": "medium", "flags": "Estate definition rests on the State Plan and admin code; Alabama has no statute defining the recovery estate. Official code site (alison) is JS only and Justia/FindLaw blocked, so 19-3B-505 read from Onecle mirror (may be dated). Securities TOD act and Sec. 43-2-697 notice statute not read in full; 43-2-697 described from search snippet (Justia title) and county probate notices. 2025 SB106 (Small Estates Act amendments, engrossed version, effective Oct. 1, 2025 if enacted) keeps a Medicaid notice step for small estate petitions; enactment and final section numbering not verified. Alabama Medicaid site was down (connection refused), so the Agency FAQ was not read. No TOD deed confirmed only by absence in searches, not by the ULC enactment list." }, { "code": "AK", "name": "Alaska", "recovery_scope": "probate_only", "recovery_scope_note": "AS 47.07.055(e) makes the recipient's \"estate\" subject to a claim, and 7 AAC 160.990(b)(15) gives \"estate\" the meaning in the probate code, AS 13.06.050(16) (property of the decedent subject to AS 13.06 to 13.36 as it exists during administration). No expanded definition found. Claims have preference under AS 13.16.470 (AS 47.07.055(g)). Recovery covers only nursing facility, ICF/IID or other institutional care and HCBS waiver services received at 55 or older, plus related hospital and drug services (7 AAC 160.210(d)). TEFRA liens are authorized on real property of permanently institutionalized recipients (AS 47.07.055(a) to (d); 7 AAC 160.220). No provision found reaching the surviving spouse's estate. Two non-probate exceptions by statute: TOD deed property (AS 13.48.110) and revocable trust property (AS 13.36.368) answer for claims when the probate estate is insufficient.", "recovery_statute": "Alaska Stat. Sec. 47.07.055; 7 AAC 160.210 to 160.250; 7 AAC 160.990(b)(15); AS 13.06.050(16)", "recovery_statute_url": "https://www.akleg.gov/basis/statutes.asp?media=print&secStart=47.07.055&secEnd=47.07.055", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes outside the probate estate, which is all the Medicaid claim reaches. A lifetime TEFRA lien on an institutionalized recipient's real property is a separate route.", "life_estate_cite": "AS 47.07.055(e); 7 AAC 160.990(b)(15); AS 13.06.050(16)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Alaska authority found recognizing the enhanced life estate deed. If effective, the remainder would pass outside probate like a life estate; Alaska's statutory TOD deed is the usual equivalent.", "lady_bird_deed_cite": "", "tod_deed": "reachable", "tod_deed_note": "To the extent the probate estate cannot pay an allowed claim, the estate may enforce the liability against TOD deed property, on written demand by a creditor to the personal representative and within 12 months of death. The Medicaid claim is an allowed preferred claim, so this route plausibly lets the state reach the house.", "tod_deed_cite": "AS 13.48.110; AS 47.07.055(g)", "joint_tenancy": "n/a", "joint_tenancy_note": "Joint tenancy in real property is abolished; co-owners hold as tenants in common. Spouses hold as tenants by the entirety with survivorship, and recovery is deferred until the surviving spouse's death in any case.", "joint_tenancy_cite": "AS 34.15.110, 34.15.130, 34.15.140", "revocable_trust": "reachable", "revocable_trust_note": "After the settlor's death, property of a trust revocable at death is subject to claims to the extent the settlor's estate is not adequate, and claims allowed against the estate are allowed against the trust.", "revocable_trust_cite": "AS 13.36.368(a)(2), (b)", "tod_deed_recognized": "yes", "tod_deed_statute": "AS 13.48.010 to 13.48.195 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2014-07-21", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No statute, reported case or Medicaid rule found; searched Alaska statutes and 7 AAC 160 and web searches for Alaska enhanced life estate authority (only secondary pages, which say it is not recognized).", "hardship_waiver_home": "Waiver for undue hardship where recovery would impoverish the beneficiary, including where the beneficiary's primary residence is the estate's only significant asset and recovery would make the beneficiary eligible for public assistance, or where the beneficiary's primary residence is a home of modest value (50 percent or less of the average community home price at death) (7 AAC 160.240(b)). No lien on the home while a spouse, minor or disabled child, or sibling with equity who lived there 1 year before admission occupies it; no lien recovery while a sibling or a caregiver child (2 years residence plus care) lives there (AS 47.07.055(b), (c); 7 AAC 160.220(c)).", "recovery_exemptions_note": "Recovery limited to institutional and HCBS waiver services at 55+ (AS 47.07.055(e)). Claim pursued only if recovery is at least twice the administrative and legal cost, with a $10,000 minimum net (7 AAC 160.210(c)). SLMB Medicare cost sharing exempt; broad American Indian and Alaska Native exemption including ANCSA stock, land, homesites and settlement trust interests (7 AAC 160.250). State may claim ABLE accounts (AS 47.07.055(h)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.akleg.gov/basis/statutes.asp?media=print&secStart=47.07.055&secEnd=47.07.055; https://www.akleg.gov/basis/aac.asp?media=print&secStart=7.160.210&secEnd=7.160.250; https://www.akleg.gov/basis/aac.asp?media=print&secStart=7.160.990&secEnd=7.160.990; https://www.akleg.gov/basis/statutes.asp?media=print&secStart=13.06.050&secEnd=13.06.050; https://www.akleg.gov/basis/statutes.asp?media=print&secStart=13.48.010&secEnd=13.48.195; https://www.akleg.gov/basis/Bill/Text/28?Hsid=HB0060B; https://www.akleg.gov/basis/Bill/detail/28?Root=HB60; https://www.akleg.gov/basis/statutes.asp?media=print&secStart=13.36.368&secEnd=13.36.368; https://www.akleg.gov/basis/statutes.asp?media=print&secStart=34.15.110&secEnd=34.15.140", "confidence": "high", "flags": "Coordinator hint that Alaska has no TOD deed is wrong: HB 60, ch. 10 SLA 14, signed Apr. 22, 2014, effective July 21, 2014, enacted the Uniform Real Property Transfer on Death Act. Probate-only classification rests on the regulation's cross-reference to the probate code definition; State Plan Att. 4.17-A not retrieved (health.alaska.gov returned 403). TOD and trust exposure are statutory creditor routes, not confirmed agency practice." }, { "code": "AZ", "name": "Arizona", "recovery_scope": "probate_only", "recovery_scope_note": "A.R.S. Sec. 36-2935(A) lets AHCCCS file a claim against a member's estate and gives it a lien on the member's property. The ALTCS rule defines estate by reference to the probate code (R9-28-901, citing A.R.S. Sec. 14-1201(23): the property of the decedent whose affairs are subject to Title 14). The AHCCCS estate recovery brochure (DE-810, Rev. 06/19) says the claim is filed only against property subject to Small Estate Affidavit or probate. Recovery applies to ALTCS (long-term care) members 55 or older (R9-28-910). Arizona uses TEFRA liens on real property of permanently institutionalized members (90 or more consecutive days) and a post-death lien on real property under Sec. 36-2935. No recovery from a surviving spouse's estate was found.", "recovery_statute": "A.R.S. Sec. 36-2935; Ariz. Admin. Code R9-28-901, R9-28-910, R9-28-911", "recovery_statute_url": "https://www.azleg.gov/ars/36/02935.htm", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes outside probate, so it is outside the probate-based estate. A TEFRA lien filed during life attaches only to the member's interest, which ends at death.", "life_estate_cite": "A.R.S. Sec. 36-2935(A); R9-28-901; A.R.S. Sec. 14-1201(23)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Arizona authority for the deed was found. If valid, the remainder passes outside probate, but a retained power to revoke would make it a nonprobate transfer that is liable for allowed estate claims when the probate estate is insufficient (Sec. 14-6102(A), (I)).", "lady_bird_deed_cite": "A.R.S. Sec. 14-6102(A), (I); R9-28-901", "tod_deed": "unclear", "tod_deed_note": "A beneficiary deed passes the house outside probate, and the brochure limits the claim to probate or small estate property. But the beneficiary takes subject to liens the owner was subject to in life, so a TEFRA lien filed before death survives (Sec. 33-405(A)). The general nonprobate transfer statute also makes transferees liable for allowed claims when the probate estate is insufficient (Sec. 14-6102). No AHCCCS text read applies either rule to beneficiary deeds.", "tod_deed_cite": "A.R.S. Sec. 33-405(A); Sec. 14-6102(A), (F), (G), (I); AHCCCS DE-810 (Rev. 06/19) FAQ 8, 9", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The AHCCCS brochure says a home owned jointly with right of survivorship is subject to the claim only when the joint owner has already died. A survivorship interest in real estate is expressly left out of the nonprobate transferee liability statute.", "joint_tenancy_cite": "AHCCCS DE-810 (Rev. 06/19) FAQ 8; A.R.S. Sec. 14-6102(I)", "revocable_trust": "reachable", "revocable_trust_note": "After the settlor's death, property of a trust that was revocable at death is subject to the settlor's creditors' claims to the extent the probate estate is inadequate, so the Medicaid estate claim can reach a house in the trust.", "revocable_trust_cite": "A.R.S. Sec. 14-10505(A)(3); Sec. 14-6102(B)(2)", "tod_deed_recognized": "yes", "tod_deed_statute": "A.R.S. Sec. 33-405 (beneficiary deed)", "tod_deed_effective": "2001-08-09", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Arizona statute, reported case or AHCCCS rule recognizing an enhanced life estate deed was found. A web search returned only practitioner pages that conflict with each other. Sec. 33-405(H) preserves other lawful methods of postponing enjoyment until death but does not describe this deed.", "hardship_waiver_home": "AHCCCS must waive when the estate is only residential real property and an heir or devisee either runs a business there (12 months before death, over 50 percent of livelihood) or lives there, lived there at death and for the prior 12 months, and owns no other residence (R9-28-911(C)(1)). Request within 30 days of notice (R9-28-911(B)). A TEFRA lien is not enforced while a sibling (one year before admission) or caregiver child (two years before admission) lives in the home (DE-810 FAQ 10).", "recovery_exemptions_note": "Recovery is limited to ALTCS benefits paid at 55 or older (R9-28-910). Native American and Alaska Native trust and non-trust property, natural resource remainder interests and culturally significant property are exempt (R9-28-911(E)).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://www.azleg.gov/ars/36/02935.htm; https://www.azleg.gov/ars/36/02956.htm; https://www.azleg.gov/ars/14/01201.htm; https://www.azleg.gov/ars/14/06102.htm; https://www.azleg.gov/ars/14/10505.htm; https://www.azleg.gov/ars/33/00405.htm; https://www.azleg.gov/legtext/45leg/1r/laws/0112.pdf; https://www.azleg.gov/legtext/54Leg/1R/laws/0019.pdf; https://www.azleg.gov/general-effective-dates/; https://www.law.cornell.edu/regulations/arizona/Ariz-Admin-Code-SS-R9-28-901; https://www.law.cornell.edu/regulations/arizona/Ariz-Admin-Code-SS-R9-28-910; https://www.law.cornell.edu/regulations/arizona/Ariz-Admin-Code-SS-R9-28-911; http://web.archive.org/web/2019id_/https://www.azahcccs.gov/Members/Downloads/Publications/DE-810_english.pdf; https://goyff.az.gov/sites/default/files/meeting-documents/materials/ahcccs_-_estate_recovery_program.pptx_1_0.pdf", "confidence": "medium", "flags": "Statutes read on azleg.gov, but the rule that ties estate to the probate definition (R9-28-901) was read only on the LII copy (azsos.gov 403), and the AHCCCS Eligibility Policy Manual ch. 1900 and current DE-810 returned 403 (brochure read via 2019 Wayback copy). A search snippet of the current manual says a home passing by beneficiary deed or survivorship is not subject to estate recovery but that liens may attach during life to property under a life estate deed or beneficiary deed; not read, so not relied on. Sec. 33-405 amended by Laws 2019, Ch. 19 (approved 2019-03-22); no 2024 to 2026 amendment to Sec. 36-2935 or 33-405 found. File AZ-recovery-altcs.txt actually holds Sec. 36-2956 (injury liens). TOD deed effective date detail: 2001-08-09, Laws 2001, Ch. 112, HB 2280; general effective date of the 2001 first regular session." }, { "code": "AR", "name": "Arkansas", "recovery_scope": "probate_only", "recovery_scope_note": "Benefits are a debt at death and DHS 'may make a claim against the estate' (Sec. 20-76-436(a)); DHS files the claim with the probate clerk, or if there is no probate records a demand notice with the county clerk. The 1996 rule defines estate as 'all real and personal property owned by the individual at his death', and the DHS guide says assets passing to a beneficiary outside probate are not collected. From Act 1918 of 2005 until Act 570 of 2021 the statute also reached property passing by beneficiary deed; Act 570 removed that. No pre-death liens (DHS guide). No recovery from the surviving spouse's estate found.", "recovery_statute": "Ark. Code Ann. Sec. 20-76-436 (as amended by Act 570 of 2021)", "recovery_statute_url": "https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2021R%2FPublic%2FACT570.pdf", "state_plan_4_17_a_url": "https://humanservices.arkansas.gov/wp-content/uploads/Packet-for-Posting-Medical-Services-Policy-Section-A-116-H-100-H-400-H-600-and-H-700.pdf", "life_estate": "not_reachable", "life_estate_note": "On the life tenant's death the remainderman owns full title, so the house is not property owned at death or passing through probate, where the Medicaid claim is filed.", "life_estate_cite": "Ark. Code Ann. Sec. 20-76-436(a)(2); 016.20.96 Ark. Code R. 005, Sec. 1345.1; 20 CAR Sec. 502-427(c)(2)(B)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Arkansas authority for a life estate deed with a retained power to sell was found. If valid, the remainder passes outside probate and would not be reachable, but its status is untested; the statutory beneficiary deed serves the same purpose.", "lady_bird_deed_cite": "Ark. Code Ann. Sec. 20-76-436(a)(2); Sec. 18-12-608(f)(1)", "tod_deed": "not_reachable", "tod_deed_note": "Act 570 of 2021 deleted the rules that made a beneficiary deed grantee take subject to the DHS claim and let DHS claim against the grantee's interest. The DHS manual now says recovery will not be made from a properly executed and recorded beneficiary deed once documentation is given.", "tod_deed_cite": "Ark. Code Ann. Sec. 18-12-608(a)(1)(B) and Sec. 20-76-436 (Act 570 of 2021, Sec. 1 and 2); DHS Medical Services Policy Manual H-600, H-630", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The surviving joint tenant takes by survivorship outside probate, and the Medicaid claim is filed against the probate estate. DHS says assets passing outside probate are not collected.", "joint_tenancy_cite": "Ark. Code Ann. Sec. 20-76-436(a)(2); DHS PUB 428, Your Guide to Medicaid Estate Recovery (2010)", "revocable_trust": "not_reachable", "revocable_trust_note": "Trust property passes outside probate. The Arkansas Trust Code makes a revocable trust liable for the settlor's creditors only during the settlor's lifetime; it has no provision like the uniform code's after-death liability.", "revocable_trust_cite": "Ark. Code Ann. Sec. 28-73-505(a)(1), (2) (as set out in HB 1394 of 2023); Sec. 20-76-436(a)(2)", "tod_deed_recognized": "yes", "tod_deed_statute": "Ark. Code Ann. Sec. 18-12-608 (beneficiary deed)", "tod_deed_effective": "2005-08-12", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Arkansas statute, reported case or DHS rule recognizing an enhanced life estate deed was found. The Medicaid resource rule (20 CAR Sec. 502-427(c)) covers ordinary life estates only; Sec. 18-12-608(f)(1) preserves other deferred-enjoyment conveyances but does not name this one. Web searches returned only secondary pages.", "hardship_waiver_home": "By statute DHS must consider whether the asset is a home worth 50% or less of the average home price in the county, the sole income-producing asset of an heir or beneficiary deed grantee, or whether the inheritance keeps an heir off public benefits (Sec. 20-76-436(b)(2)). The manual also postpones recovery on a home while a caregiver child (2 years before admission) or a sibling (1 year before admission) lives there (H-630).", "recovery_exemptions_note": "State additions: DHS does not pursue recovery when there is a surviving spouse, a child under 21, or a blind or disabled child of any age (manual H-630 and DHS guide; the manual says this is a postponement). Assets protected by a Long-Term Care Partnership policy are exempt (H-600). Recovery is not sought where not cost effective (Sec. 20-76-436(b)(1)). Recovery covers nursing facility, ICF/IID and HCBS waiver recipients 55 or older and permanently institutionalized recipients of any age.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/ar/title-20-public-health-and-welfare/ar-code-sect-20-76-436/; https://codes.findlaw.com/ar/title-18-property/ar-code-sect-18-12-608/; https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2021R%2FPublic%2FACT570.pdf; https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2005%2FPublic%2FACT1918.pdf; https://law.onecle.com/arkansas/title-20/20-76-436.html; https://law.onecle.com/arkansas/title-18/18-12-608.html; https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FHB1394.pdf; https://www.law.cornell.edu/regulations/arkansas/016-20-96-Ark-Code-R-005; https://arkleg.state.ar.us/Home/FTPDocument?path=%2FAssembly%2FMeeting+Attachments%2F040%2F5095%2FD.12.a+DHS+DCO+Med+Servs+Policy+Manual+and+Relevant+Acts.pdf; https://humanservices.arkansas.gov/wp-content/uploads/Packet-for-Posting-Medical-Services-Policy-Section-A-116-H-100-H-400-H-600-and-H-700.pdf; https://humanservices.arkansas.gov/wp-content/uploads/Your_Guide_to_Medicaid_Estate_Recovery_in_Arkansas.pdf; https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=20&chapterID=186&subChapterID=230&partID=792&subPartID=7992§ionID=52653; https://senate.arkansas.gov/senate-news/posts/2021/07/long-list-of-new-election-laws-to-take-effect/", "confidence": "medium", "flags": "Current codified text of Sec. 20-76-436 and 18-12-608 read on FindLaw (current as of March 28, 2024), not an official code site; Arkansas has no free official code. The Act 570 PDF loses its strike-through formatting; the deletion of the beneficiary deed language is confirmed by comparing the pre-2021 text (onecle) with the current FindLaw text and by DHS manual H-600. Beneficiary deed effective date 2005-08-12 comes from a search snippet of an Arkansas AG opinion (91st day after the May 13, 2005 adjournment); the opinion page itself was not retrievable. Act 243 of 2007 amended Sec. 18-12-608 (not read). The rule defining 'estate' as property owned at death dates from 1996; no newer definition found. Attachment 4.17-A not found (medicaid.gov SPA AR-17-0015 returned 403); the URL given is the DHS manual H-600 packet. No 2022 to 2026 amendment to Sec. 20-76-436 or 18-12-608 found by web search, but the arkleg bill search was not run. Older code copies still online (Justia 2010 to 2020, onecle) show the pre-2021 text that let DHS claim against beneficiary deed grantees. TOD deed effective date detail: 2005-08-12, Act 1918 of 2005, HB 1137, approved 2005-04-11, no emergency clause); Medicaid claim removed by Act 570 of 2021 (HB 1162, approved 2021-04-05, effective 2021-07-28." }, { "code": "CA", "name": "California", "recovery_scope": "probate_only", "recovery_scope_note": "For deaths on or after Jan. 1, 2017, 'estate' means only the real and personal property and other assets in the individual's probate estate that federal law requires to be subject to recovery (W&I Code Sec. 14009.5(f)(3), (g)), as amended by SB 833 (Stats. 2016, ch. 30, Sec. 22). Recovery is also limited to the federally mandated services (nursing facility, HCBS and related hospital and drug services at 55+). For deaths before 2017, the State Plan defined estate to include joint tenancy, tenancy in common, survivorship, life estate, living trust and annuity assets. The State Plan (SPA 16-030, approved 2017-03-24, effective 2017-01-01) provides for TEFRA liens on the home of a permanently institutionalized recipient after notice and hearing. No claim is made against the estate of a surviving spouse for a predeceased Medi-Cal spouse for deaths on or after 2017 (State Plan 4.17(c)(1)(a)); no claim at all when a spouse or registered domestic partner survives (Sec. 14009.5(b)(2)(B)).", "recovery_statute": "Cal. Welf. & Inst. Code Sec. 14009.5; 22 CCR Sec. 50961 to 50966", "recovery_statute_url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14009.5", "state_plan_4_17_a_url": "https://www.dhcs.ca.gov/formsandpubs/laws/Documents/16-030_ApvPkg.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder is not part of the probate estate, so it is outside the post-2017 definition. Even before 2017 the regulation said the claim does not apply to the life estate or the remainder when the remainder was irrevocably transferred.", "life_estate_cite": "Cal. Welf. & Inst. Code Sec. 14009.5(f)(3); 22 CCR Sec. 50961(i), (j)", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "Under the statute the remainder passes outside probate, so it is outside the probate-only estate for deaths since 2017. But the unamended regulation still says that where the decedent held a life estate and made a revocable transfer of the remainder, the claim applies to the full value as if the decedent owned it outright; that rule predates SB 833 and conflicts with the statute.", "lady_bird_deed_cite": "Cal. Welf. & Inst. Code Sec. 14009.5(f)(3), (g); 22 CCR Sec. 50961(i) (last amended 2015)", "tod_deed": "unclear", "tod_deed_note": "The TOD deed passes the house outside probate, and DHCS says recovery is limited to probate assets. But the TOD act makes the beneficiary personally liable, up to the property's net value, for the transferor's unsecured debts, and liable to the estate for a share of them if probate is opened. The statutory deed form says the property is subject to the transferor's debts. Whether DHCS can use these sections for the Medi-Cal claim was not found.", "tod_deed_cite": "Cal. Prob. Code Sec. 5672, 5674, 5677, 5642; Welf. & Inst. Code Sec. 14009.5(f)(3)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship property passes outside probate and outside the post-2017 probate-only estate. It was expressly reachable only for deaths before 2017.", "joint_tenancy_cite": "Cal. Welf. & Inst. Code Sec. 14009.5(f)(3), (g); State Plan Att. 4.17-A, item 3", "revocable_trust": "unclear", "revocable_trust_note": "Trust property is outside the probate estate, so outside the post-2017 definition. But Probate Code Sec. 19001 makes revocable trust property subject to claims of creditors of the probate estate to the extent the probate estate is inadequate. Whether DHCS uses this for Medi-Cal claims was not found.", "revocable_trust_cite": "Cal. Prob. Code Sec. 19001(a); Welf. & Inst. Code Sec. 14009.5(f)(3)", "tod_deed_recognized": "yes", "tod_deed_statute": "Cal. Prob. Code Sec. 5600 to 5698 (revocable transfer on death deed)", "tod_deed_effective": "2016-01-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "agency_rule", "lady_bird_authority": "No statute or reported case found. The Medi-Cal regulation 22 CCR Sec. 50961(i) addresses a decedent who held a life estate and made a revocable transfer of the remainder (treating it as full ownership for pre-2017 recovery). Prob. Code Sec. 5602 preserves other lawful methods of postponing enjoyment until death. Web search found only conflicting law firm pages.", "hardship_waiver_home": "DHCS must waive the claim, subject to federal approval, when the estate is a homestead of modest value: fair market value 50 percent or less of the county average home price at death (Sec. 14009.5(c)(2), (f)(5); State Plan 16-030). Regulation criteria include an aged, blind or disabled heir who lived in the home 1 year before death and cannot get financing; a caregiver who lived in the home and gave 2 or more years of care that delayed institutionalization; income-producing business, farm or ranch; heir who gave the property to the decedent for no consideration; equity needed to make the home habitable (22 CCR Sec. 50963(a)). No hardship when created by estate planning to avoid recovery (Sec. 50963(d)).", "recovery_exemptions_note": "For deaths since 2017: no recovery at all if a spouse or registered domestic partner survives, and no later claim against the survivor's estate (Sec. 14009.5(b)(2)(B); State Plan 4.17(c)(1)(a)). Recovery only for federally mandated LTC services. IHSS personal care and Medicare cost sharing excluded (22 CCR 50961(c)). DHCS may treat continued collection as not cost-effective when the potential net collection is under $5,000 (State Plan Att. 4.17-A item 5). American Indian and Alaska Native property exempt per SMM 3810 (DHCS page).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://california.public.law/codes/welfare_and_institutions_code_section_14009.5; https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB833; https://web.archive.org/web/20260801174217id_/https://www.dhcs.ca.gov/services/estate-recovery-program/; https://web.archive.org/web/2024id_/https://www.dhcs.ca.gov/formsandpubs/laws/Documents/16-030_ApvPkg.pdf; https://www.law.cornell.edu/regulations/california/22-CCR-50961; https://www.law.cornell.edu/regulations/california/22-CCR-50963; https://www.law.cornell.edu/regulations/california/22-CCR-50960; https://california.public.law/codes/probate_code_section_5600; https://california.public.law/codes/probate_code_section_5602; https://california.public.law/codes/probate_code_section_5610; https://california.public.law/codes/probate_code_section_5614; https://california.public.law/codes/probate_code_section_5642; https://california.public.law/codes/probate_code_section_5650; https://california.public.law/codes/probate_code_section_5652; https://california.public.law/codes/probate_code_section_5670; https://california.public.law/codes/probate_code_section_5672; https://california.public.law/codes/probate_code_section_5674; https://california.public.law/codes/probate_code_section_5677; https://california.public.law/codes/probate_code_section_5678; https://california.public.law/codes/probate_code_section_215; https://california.public.law/codes/probate_code_section_9202; https://california.public.law/codes/probate_code_section_19001; https://california.public.law/codes/probate_code_section_18200; https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB315; https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB1305; https://sjud.senate.ca.gov/sites/sjud.senate.ca.gov/files/sb_1305_roth_senate_judiciary_committee_analysis.pdf", "confidence": "medium", "flags": "Statute text read on california.public.law (a mirror; leginfo.legislature.ca.gov timed out for scripts and WebFetch), so medium; the recovery definition was also confirmed in the CMS-approved State Plan (SPA 16-030). TOD deed history: AB 139 (Stats. 2015, ch. 293) pilot to Jan. 1, 2021; SB 1305 (Stats. 2020, ch. 238) extended to Jan. 1, 2022; SB 315 (Stats. 2021, ch. 215) recast the part and extended it to Jan. 1, 2032 (Sec. 5600(c)); deeds signed before 2032 stay valid. SB 315 replaced former Sec. 5676 (return of property to the estate) with Sec. 5677 (beneficiary liable to the estate for an abated share of unsecured debts) and Sec. 5678 (voluntary return). Not the uniform act: California's deed comes from the Law Revision Commission's 2006 recommendation. Conflict: 22 CCR 50961 (last amended 2015) still reaches recipients 'by survival' and revocable remainders and claims against a surviving spouse's estate; the 2017 statute and State Plan override for deaths since 2017. TOD deed and revocable trust exposure through creditor statutes (Prob. Code 5672, 5677, 19001) is untested for the Medi-Cal claim. DHCS site returned 403; agency page read via Wayback (Aug. 2026 capture). No 2025 or 2026 amendment to Sec. 14009.5 found (mirror shows last update June 27, 2016). TOD deed effective date detail: 2016-01-01, AB 139, Stats. 2015, ch. 293; applies to transferors dying on or after that date." }, { "code": "CO", "name": "Colorado", "recovery_scope": "expanded_partial", "recovery_scope_note": "The recovery statute does not define estate; the Medicaid debt is a claim against the estate under the probate claims statute, Sec. 15-12-805(1) (C.R.S. 25.5-4-302(5)), and the rule (10 CCR 2505-10 Sec. 8.063) also speaks only of the estate. The one statutory expansion: property passing by beneficiary (TOD) deed is expressly subject to HCPF recovery, enforced through the nonprobate transferee liability statute (Sec. 15-15-407, Sec. 15-15-103). TEFRA liens on real property of permanently institutionalized recipients are authorized (Sec. 25.5-4-302(3); rule 8.063.13). The rule bars recovery while there is a surviving spouse; no provision found for recovery from the surviving spouse's estate.", "recovery_statute": "C.R.S. Sec. 25.5-4-302 (Recovery of assets); 10 CCR 2505-10 Sec. 8.063", "recovery_statute_url": "https://colorado.public.law/statutes/crs_25.5-4-302", "state_plan_4_17_a_url": "https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/CO/CO-14-001.pdf", "life_estate": "not_reachable", "life_estate_note": "No Colorado statute or rule adds life estates to the recoverable estate. A retained life estate ends at death, and because the grantor cannot revoke the remainder it is not a nonprobate transfer under Sec. 15-15-103(1)(a).", "life_estate_cite": "C.R.S. 25.5-4-302(5); Sec. 15-15-103(1)(a); 10 CCR 2505-10 Sec. 8.063", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Colorado authority for the deed was found. If used, the grantor's retained power to convey alone would likely make it a revocable transfer at death under Sec. 15-15-103(1)(a), so the remainder beneficiary could be liable for the Medicaid claim if the probate estate is insufficient.", "lady_bird_deed_cite": "C.R.S. Sec. 15-15-103(1)(a), (2)", "tod_deed": "reachable", "tod_deed_note": "The beneficiary deed statute says the grantee-beneficiary's interest is subject to any HCPF claim for recovery of medical assistance under Sec. 25.5-4-301 or 25.5-4-302, enforced under Sec. 15-15-103. The eligibility rule also makes an otherwise exempt home a countable resource once a beneficiary deed is recorded.", "tod_deed_cite": "C.R.S. Sec. 15-15-407(4); Sec. 15-15-103; 10 CCR 2505-10 Sec. 8.100.5.M (beneficiary deed makes home countable)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes outside probate, and Sec. 15-15-103(1)(b)(I) expressly excludes a survivorship interest in joint tenancy real estate from nonprobate transferee liability. A lien filed during life under Sec. 25.5-4-302(3) is a separate route.", "joint_tenancy_cite": "C.R.S. Sec. 15-15-103(1)(b)(I); Sec. 25.5-4-302(3), (5)", "revocable_trust": "unclear", "revocable_trust_note": "Trust property is not probate property, but Sec. 15-15-103 makes the trustee of a revocable trust liable for allowed claims against the probate estate (the Medicaid claim is one, Sec. 25.5-4-302(5)) to the extent the estate is insufficient. No HCPF rule found saying the department uses this route for trusts.", "revocable_trust_cite": "C.R.S. Sec. 15-15-103(1)(a), (2), (3)(b); Sec. 25.5-4-302(5)", "tod_deed_recognized": "yes", "tod_deed_statute": "C.R.S. Sec. 15-15-401 to 15-15-415 (beneficiary deed)", "tod_deed_effective": "2004-08-04", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Colorado statute, reported case or HCPF rule found recognizing an enhanced life estate deed. Searched the web for Colorado enhanced life estate and lady bird deed; only secondary sites and Q and A forums came up, which say Colorado does not use it.", "hardship_waiver_home": "No recovery from sale of the home if a sibling lived there at least 1 year before institutionalization, or a son or daughter lived there at least 2 years and provided care that kept the recipient at home, and has lived there continuously since (rule 8.063.16). Good cause waiver when heirs would otherwise become eligible for public assistance, when inheritance lets heirs leave assistance, or when the home is part of a business, including a working farm or ranch, that is the heirs' livelihood (rule 8.063.18). Statute allows compromise or waiver on good cause (Sec. 25.5-4-302(4)).", "recovery_exemptions_note": "For recipients 55 or older, recovery is limited to nursing facility, HCBS and related hospital and drug services; the optional recovery of other services is not made (rule 8.063.11(B); SPA CO 14-001 effective 2014-01-01). The rule states no recovery at all if there is a surviving spouse or a child under 21 or blind or disabled (8.063.15). Recovery only if cost effective (8.063.12). Long-term care partnership disregard (Sec. 25.5-4-302(7)). Recovery for assistance on or after July 1, 1992 (8.063.17).", "karp_2005_scope": "not_in_survey", "last_verified": "2026-09-23", "sources": "https://colorado.public.law/statutes/crs_25.5-4-302; https://colorado.public.law/statutes/crs_15-15-103; https://colorado.public.law/statutes/crs_15-15-401; https://colorado.public.law/statutes/crs_15-15-402; https://colorado.public.law/statutes/crs_15-15-407; https://www.law.cornell.edu/regulations/colorado/10-CCR-2505-10-8.063; https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=11946&fileName=10+CCR+2505-10+8.100; https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/CO/CO-14-001.pdf; https://hcpf.colorado.gov/medicaid-recoveries; https://www.healthfirstcolorado.gov/what-is-estate-recovery/; https://cherrycreektitle.com/insuring-beneficiary-deeds-in-colorado-and-how-this-may-affect-your-next-closing/", "confidence": "medium", "flags": "Official C.R.S. PDFs (leg.colorado.gov, content.leg.colorado.gov) and Justia returned HTTP 403; statute text is from colorado.public.law (a copy of the official 2024 C.R.S., current through fall 2025). The rule was read on the official SOS site (8.100) and LII (8.063). The TOD effective date and bill number (H.B. 04-1048, Aug 4, 2004) come from a title company article, not the session law (2004 Session Laws ch. 217 PDF returned 403). The retrieved SPA (CO 14-001) contains only Attachment 4.17 page 53a, not the estate definition page. The rule's bar on recovery when a spouse survives reads broader than the federal deferral; practice may be deferral. Beneficiary deed also makes an exempt home a countable resource for eligibility (rule 8.100.5.M), so it is a poor Medicaid planning tool in Colorado. No 2024 to 2026 estate recovery amendments found. TOD deed effective date detail: 2004-08-04, H.B. 04-1048." }, { "code": "CT", "name": "Connecticut", "recovery_scope": "expanded_partial", "recovery_scope_note": "The state has a claim against the deceased Medicaid beneficiary's estate, with priority over unsecured claims in the probate estate (C.G.S. Sec. 17b-95(a), (b)); estate is not defined to include non-probate assets. The only statutory reach beyond probate is annuities: sums due after death under an annuity bought with the beneficiary's assets are deemed part of the estate and payable by the annuity recipient (Sec. 17b-95(c)). For a house, recovery is in practice probate-only. Since July 1, 2022 the state may not recover medical assistance, including by lien or claim against property, unless federal law requires the recovery (Sec. 17b-93(a), P.A. 22-118). No provision found for recovery from the surviving spouse's estate.", "recovery_statute": "C.G.S. Sec. 17b-95 (claim against estate); Sec. 17b-93 (recovery limited to federally required)", "recovery_statute_url": "https://www.cga.ct.gov/current/pub/chap_319s.htm", "state_plan_4_17_a_url": "https://portal.ct.gov/-/media/departments-and-agencies/dss/upms/upm7---benefit-error-recovery/7525_10.doc", "life_estate": "not_reachable", "life_estate_note": "Claim runs only against the probate estate; a retained life estate ends at death and the remainder passes outside probate.", "life_estate_cite": "C.G.S. Sec. 17b-95(a), (b)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Connecticut authority for the deed was found. If one were used, the remainder would pass outside probate and outside the Sec. 17b-95 claim, and no Connecticut nonprobate transferee liability statute was found.", "lady_bird_deed_cite": "C.G.S. Sec. 17b-95(a)", "tod_deed": "n/a", "tod_deed_note": "Connecticut has no transfer on death deed statute for real property. Bills to adopt the Uniform Real Property Transfer on Death Act were introduced in 2025 (H.B. 5333, H.B. 6896) and 2026 (H.B. 5266); H.B. 5266 got a Judiciary hearing on 2/27/2026 and no further action.", "tod_deed_cite": "2026 H.B. 5266 bill status (cga.ct.gov)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes outside probate, and the Sec. 17b-95 claim runs against the estate only.", "joint_tenancy_cite": "C.G.S. Sec. 17b-95(a)", "revocable_trust": "not_reachable", "revocable_trust_note": "Trust property is not in the probate estate. Connecticut's Uniform Trust Code (ch. 802c) and decedents' estates chapter (ch. 802b) were searched and no section making revocable trust property liable for the settlor's estate claims was found; Sec. 45a-499fff covers only irrevocable trusts.", "revocable_trust_cite": "C.G.S. Sec. 17b-95(a); ch. 802c (Sec. 45a-499fff)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Connecticut statute, reported case or DSS rule found. Searched the web for Connecticut enhanced life estate and lady bird deed; only form sellers, Q and A forums and secondary sites came up, most saying Connecticut does not use it.", "hardship_waiver_home": "DSS policy allows waiver or deferral for an heir who is impoverished (assets under $2,000 single or $3,000 married, income under two times the medically needy limit) or who lived in the decedent's home continuously for 12 months or more and cannot afford other housing; the heir must not have received substantial gifts from the decedent. A deferral is secured by a personal undertaking such as a mortgage note (UPM 7525.10, effective 12/1/2003).", "recovery_exemptions_note": "The claim applies only to the extent what the surviving spouse, parent or dependent children would take is not needed for their support (Sec. 17b-95(a)). Money in an ABLE account is excluded (Sec. 17b-95(a), P.A. 23-137). Since July 1, 2022, only federally required recovery is made (Sec. 17b-93(a), P.A. 22-118); pre-2022 liens and claims not federally required were deemed released.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.cga.ct.gov/current/pub/chap_319s.htm; https://www.cga.ct.gov/current/pub/chap_802c.htm; https://www.cga.ct.gov/current/pub/chap_802b.htm; https://www.cga.ct.gov/current/pub/chap_319v.htm; https://portal.ct.gov/-/media/departments-and-agencies/dss/upms/upm7---benefit-error-recovery/7525_10.doc; https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&which_year=2026&bill_num=5266", "confidence": "high", "flags": "Classified expanded_partial only because of the annuity rule in Sec. 17b-95(c); for a house Connecticut is effectively probate-only, and popular lists that call Connecticut an expanded state were not confirmed by the statute. Sec. 17b-93(a) (P.A. 22-118) bars recovery by lien unless federally required; whether DSS still files TEFRA liens is unclear. UPM 7525.10 is dated 2003 and was read only through a WebFetch summary of the .doc file; it predates the 2022 amendments. No State Plan Attachment 4.17-A found; the field holds the UPM section. No Connecticut TOD deed act enacted through the 2026 session (H.B. 5266 died in Judiciary)." }, { "code": "DE", "name": "Delaware", "recovery_scope": "probate_only", "recovery_scope_note": "Estate means all real property, plus personal property that is an asset of the decedent's estate under the probate inventory chapter, 12 Del. C. ch. 19 (25 Del. C. Sec. 5001(c)); the manual repeats this (DSSM 20500.3). No statute or rule adds joint tenancy, life estates, trusts or other non-probate assets. Recovery applies to long-term care recipients 55 or older (DSSM 20500.1). TEFRA liens are created on real property of permanently institutionalized recipients 55 or older after notice and hearing (Sec. 5002). Recovery waits until the death of a surviving spouse who lived in the home (Sec. 5003(1)); no provision found for recovery from the surviving spouse's own estate.", "recovery_statute": "25 Del. C. Sec. 5001 to 5006 (Liens and Estate Recoveries)", "recovery_statute_url": "https://delcode.delaware.gov/title25/c050/index.html", "state_plan_4_17_a_url": "https://archive.regulations.delaware.gov/register/june2012/final/15%20DE%20Reg%201721%2006-01-12.htm", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death, so the decedent has no real property interest left and the remainder passes outside the estate as defined.", "life_estate_cite": "25 Del. C. Sec. 5001(c), (g)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Delaware authority for the deed was found. If one were used, the remainder would pass outside probate; Delaware's nonprobate creditor statute covers only TOD deeds.", "lady_bird_deed_cite": "25 Del. C. Sec. 5001(c)", "tod_deed": "unclear", "tod_deed_note": "TOD deed property is not probate property, but the Delaware TOD act lets the estate enforce allowed claims against the TOD property to the extent the probate estate is insufficient, if a proceeding starts within 8 months of death. If a probate estate is opened, TOD real estate must be listed on the probate inventory. No DMMA rule yet says the agency uses this route.", "tod_deed_cite": "25 Del. C. Sec. 215(a), (c); Sec. 218(d); 12 Del. C. Sec. 1905(a); 25 Del. C. Sec. 5001(c)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The decedent's interest ends at death and the survivor takes outside probate; nothing in the recovery statute or manual reaches survivorship property.", "joint_tenancy_cite": "25 Del. C. Sec. 5001(c); DSSM 20500.3", "revocable_trust": "not_reachable", "revocable_trust_note": "Trust property is outside the probate estate. No Delaware statute making revocable trust property liable for the settlor's estate claims was found in 12 Del. C. ch. 35, subch. III (the trust statute lets the trustee distribute after the settlor's death).", "revocable_trust_cite": "25 Del. C. Sec. 5001(c); 12 Del. C. Sec. 3546(b)", "tod_deed_recognized": "yes", "tod_deed_statute": "25 Del. C. Sec. 201 to 220 (Uniform Real Property Transfer on Death Act), 85 Del. Laws c. 212 (H.B. 147 substitute)", "tod_deed_effective": "2025-12-04", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Delaware statute, reported case or DMMA rule found. Searched the web for Delaware enhanced life estate and lady bird deed; only secondary sites and form sellers came up, which say Delaware does not recognize it.", "hardship_waiver_home": "No lien recovery against the home while a caregiver son or daughter (lived there 2 years before admission and provided care) or a sibling (lived there 1 year before admission) remains; other estate assets can still be pursued (DSSM 20500.5.2; statute Sec. 5003(2) also covers a minor child). Undue hardship waiver for a civil union partner, child, grandchild, parent or sibling who lived in the home 2 years before admission and receives public assistance with no other home, or has family income at or below 200 percent of poverty and resources of $3,000 or less; also no recovery if the co-owned real property is a business that supports that relative (DSSM 20500.5.3; 25 Del. C. Sec. 5005).", "recovery_exemptions_note": "Recovery only for long-term care recipients 55 or older (NF, HCBS and community LTC). Medicare Savings Program cost sharing on or after Jan 1, 2010 is exempt (DSSM 20500.1). Recovery deferred until death of a surviving spouse who lived in the home, and barred while a blind or disabled child who lived in the home survives (Sec. 5003; DSSM 20500.5.1). Recovery includes managed care capitation payments (State Plan Att. 4.17-A, 15 DE Reg. 1721, effective June 10, 2012).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://delcode.delaware.gov/title25/c050/index.html; https://delcode.delaware.gov/title12/c019/index.html; https://delcode.delaware.gov/title25/c002/index.html; https://legis.delaware.gov/SessionLaws/Chapter?id=42374; https://delcode.delaware.gov/title12/c035/sc03/index.html; https://www.law.cornell.edu/regulations/delaware/16-Del-Admin-Code-SS-20000-20500; https://archive.regulations.delaware.gov/register/october2012/final/16%20DE%20Reg%20423%2010-01-12.htm; https://archive.regulations.delaware.gov/register/june2012/final/15%20DE%20Reg%201721%2006-01-12.htm", "confidence": "high", "flags": "The statutory definition says estate means 'all real property' (not expressly limited to probate real estate) plus probate personal property; read with the definition of real property as property in which the individual has ownership rights, it does not reach interests that end at death, but the wording is unusual and untested here. New TOD act (85 Del. Laws c. 212, effective 2025-12-04) makes TOD property liable for estate claims when the probate estate is insufficient (Sec. 215) and requires it on the probate inventory, so TOD deeds may be more exposed than joint tenancy. The Attachment 4.17-A text was read in the 2012 register notice, not the CMS-approved PDF (medicaid.gov 403). No 2024 to 2026 amendments to ch. 50 found. TOD deed effective date detail: 2025-12-04, approved Sept 5, 2025; effective 90 days after enactment." }, { "code": "DC", "name": "District of Columbia", "recovery_scope": "probate_only", "recovery_scope_note": "29 DCMR 6799 defines estate as real and personal property and any interest in it owned by the decedent that does not pass at death to another person by the terms of the instrument under which it is held or by operation of law. This matches the probate code definition of property (D.C. Code Sec. 20-101(l)), and Attachment 4.17-A (TN 06-01, eff. 10/01/2005) says the estate is as defined in the District's probate law. The State Plan marks the pre-death (TEFRA) lien items N/A; the lien under 29 DCMR 6701.1 is imposed after death. No recovery from a surviving spouse's estate found. There is no Medicaid-specific estate recovery statute in the D.C. Code; the rules rest on the Medicaid plan authority (D.C. Code Sec. 1-307.02). D.C. Code Sec. 4-214.01 (preferred claim and lien) covers only Old Age Assistance and Aid to the Disabled, not Medicaid.", "recovery_statute": "29 DCMR 6700 to 6799 (Medicaid Program: Liens and Adjustments or Estate Recovery); D.C. Code Sec. 20-101(l)", "recovery_statute_url": "https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?ChapterNum=29-67", "state_plan_4_17_a_url": "https://dhcf.dc.gov/sites/default/files/dc/sites/dhcf/publication/attachments/DHCFStatePlanAttach4-17a.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes by the terms of the deed, so it is outside the estate as defined. It is not a nonprobate transfer the grantor could revoke, so D.C. Code Sec. 19-601.02 does not apply.", "life_estate_cite": "29 DCMR 6799; D.C. Code Sec. 20-101(l)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No D.C. authority for the deed was found. If valid, the house passes by the deed and is outside the rule's estate, but because the grantor could defeat the remainder acting alone, it may be a nonprobate transfer liable for allowed probate claims when the probate estate is insufficient. Untested.", "lady_bird_deed_cite": "29 DCMR 6799; D.C. Code Sec. 19-601.02(a), (b)", "tod_deed": "reachable", "tod_deed_note": "The house passes outside the probate estate, but a TOD deed beneficiary is liable for allowed claims against the transferor's probate estate to the extent the estate is insufficient. A proceeding must start within 1 year after death and requires a written demand on the personal representative.", "tod_deed_cite": "D.C. Code Sec. 19-604.15; Sec. 19-601.02(b), (g), (h); 29 DCMR 6799", "joint_tenancy": "not_reachable", "joint_tenancy_note": "A survivorship interest passes by operation of law and is outside the estate as defined. The nonprobate liability statute expressly excludes a survivorship interest in a joint tenancy of real estate.", "joint_tenancy_cite": "29 DCMR 6799; D.C. Code Sec. 19-601.02(a)", "revocable_trust": "reachable", "revocable_trust_note": "Trust property passes under the trust instrument, outside the estate as defined. But after the settlor's death, property of a trust revocable at death is subject to the settlor's creditors' claims, and the trustee is liable for allowed probate claims when the probate estate is insufficient, so the Medicaid claim can reach it.", "revocable_trust_cite": "D.C. Code Sec. 19-1305.05(a)(3); Sec. 19-601.02(b), (c)(2); 29 DCMR 6799", "tod_deed_recognized": "yes", "tod_deed_statute": "D.C. Code Sec. 19-604.01 to 19-604.19 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2013-03-19", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No D.C. statute, reported case, title standard or DHCF rule recognizing an enhanced life estate deed was found. Searched the web for D.C. life estate deeds with retained power to sell; results were secondary pages only.", "hardship_waiver_home": "No lien on the home while the surviving spouse, a child under 21 or blind or disabled, or a sibling with an equity interest who lived there at least 1 year before admission lawfully resides there (29 DCMR 6702.1). Undue hardship exists if heirs would become eligible for assistance, the home is the sole income-producing asset of a family business run there 12 months and giving 100 percent of an heir's livelihood, or recovery would deprive an heir of shelter they cannot otherwise afford (6703.1). Hardship request due within 15 business days of the notice (6704.3).", "recovery_exemptions_note": "Claims of $100 or less are not cost-effective and are waived (29 DCMR 6702.3; Attachment 4.17-A). Medicare cost sharing paid on or after Jan. 1, 2010 under the Medicare Savings Programs is not recovered (DHCF policy). Hardship waivers apply only to the share passing to the qualifying heir (6703.4).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?ChapterNum=29-67; https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?DownloadFile=9070555F-0000-CF51-B122-7A0CD10490D6; https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?DownloadFile=8070555F-0000-C91C-8849-5AC48E320006; https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?DownloadFile=8070555F-0000-C634-A1D7-B9F81FC34F45; https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?DownloadFile=8070555F-0000-CE58-8413-9855B005EBBF; https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?DownloadFile=8070555F-0000-CE72-A446-8B75E6D5BECD; https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?DownloadFile=9070555F-0000-C315-ACDA-92D9C408FFE9; https://dhcf.dc.gov/sites/default/files/dc/sites/dhcf/publication/attachments/DHCFStatePlanAttach4-17a.pdf; https://dhcf.dc.gov/sites/default/files/dc/sites/dhcf/release_content/attachments/Info%20on%20Estate%20Recovery%20for%20DHCF%20gov_final.pdf; https://dhcf.dc.gov/sites/default/files/dc/sites/dhcf/release_content/attachments/Estate%20Recovery%20Fact%20Sheet%20-%20Version%20Aug%2019%202015.pdf; https://code.dccouncil.gov/us/dc/council/code/sections/20-101; https://code.dccouncil.gov/us/dc/council/code/sections/19-604.01; https://code.dccouncil.gov/us/dc/council/code/sections/19-604.15; https://code.dccouncil.gov/us/dc/council/code/sections/19-601.02; https://code.dccouncil.gov/us/dc/council/code/sections/19-1305.05; https://code.dccouncil.gov/us/dc/council/code/sections/4-214.01; https://code.dccouncil.gov/us/dc/council/code/titles/4/chapters/6; https://app.cfo.dc.gov/services/fiscal_impact/pdf/spring09/Medicaid%20Estate%20Recovery.pdf", "confidence": "high", "flags": "Operative definition is in a regulation (29 DCMR 6799, 53 DCR 6353, Aug. 4, 2006), read on the official dcregs site; no Medicaid estate recovery statute exists in the D.C. Code. The rule text still names the former Medical Assistance Administration (MAA). Conflict on scope of services: 29 DCMR 6701.2 makes ALL State Plan services and premiums for recipients 55 and older recoverable, while the DHCF policy page describes recovery for nursing facility, HCBS waiver and related hospital and drug services. TOD and revocable trust exposure depends on a creditor proceeding against nonprobate transferees within 1 year of death (Sec. 19-601.02(h)); no DHCF guidance found on whether it uses it. DCMR text extracted from Word .doc files with tools/fetch_doc.py. TOD deed effective date detail: 2013-03-19, D.C. Law 19-230, 59 DCR 13606." }, { "code": "FL", "name": "Florida", "recovery_scope": "probate_only", "recovery_scope_note": "Recovery is made by AHCA filing a statement of claim against the estate in the probate proceeding under part VII of ch. 733 (Sec. 409.9101(2)); the Medicaid claim is a Class 3 claim (Sec. 733.707(1)(c)). No statute adopts the expanded federal definition. The debt is not enforced against property exempt from creditors under the constitution or laws of Florida (Sec. 409.9101(7)), which protects homestead that passes to the surviving spouse or heirs (Fla. Const. Art. X, Sec. 4(b)). One non-probate exception: a revocable trust is liable for estate claims when the probate estate is insufficient (Sec. 733.707(3)).", "recovery_statute": "Fla. Stat. Sec. 409.9101 (Medicaid Estate Recovery Act)", "recovery_statute_url": "http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0409/Sections/0409.9101.html", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes outside probate, and Florida recovers only through a claim in the probate estate.", "life_estate_cite": "Fla. Stat. Sec. 409.9101(2)", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "The home passes to the remainder beneficiaries at death outside probate, so the probate claim does not reach it; a homestead would also be exempt under Sec. 409.9101(7). DCF treats the deed as no transfer for eligibility.", "lady_bird_deed_cite": "Fla. Stat. Sec. 409.9101(2), (7); DCF ESS Program Policy Manual 1640.0613.01", "tod_deed": "n/a", "tod_deed_note": "Florida has no transfer-on-death deed statute for real property. The Florida Uniform TOD Security Registration Act covers securities and security accounts only.", "tod_deed_cite": "Fla. Stat. Secs. 711.50 to 711.512 (Florida Uniform TOD Security Registration Act; the definitions in Sec. 711.501 limit it to securities and security accounts)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "A joint tenancy with right of survivorship (which must be expressly stated) or a tenancy by the entirety passes to the survivor outside probate and outside the probate-only claim.", "joint_tenancy_cite": "Fla. Stat. Sec. 409.9101(2); Sec. 689.15", "revocable_trust": "reachable", "revocable_trust_note": "A house held in a revocable trust is reachable: after the settlor's death the trust is liable for the estate's obligations, including the Class 3 Medicaid claim, to the extent the probate estate is insufficient, and the trustee must pay. A protected homestead is the exception, but the homestead exemption protects it, not the trust; the exemption applies however the homestead passes.", "revocable_trust_cite": "Fla. Stat. Sec. 733.707(1)(c), (3), (3)(d); Sec. 736.05053(1); Sec. 736.1109(2); Sec. 409.9101(7); Fla. Const. Art. X, Sec. 4(b)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "case_law", "lady_bird_authority": "Common law: Oglesby v. Lee, 73 Fla. 39, 73 So. 840 (Fla. 1917) (deed reserving to grantor the right to resell held effective); Florida Bar Uniform Title Standards 6.10 to 6.12; DCF ESS Program Policy Manual 1640.0613.01 treats a lady bird deed or life estate with powers as no transfer. No statute creates the deed.", "hardship_waiver_home": "AHCA may not recover from an estate when recovery would cause undue hardship for the qualified heirs, and the personal representative or any heir may request a waiver. The agency considers whether an heir lives in the home, lived there at death and for the prior 12 months, and owns no other residence; whether an heir would be deprived of food, clothing, shelter or medical care; whether a sibling or child of the decedent lived with the recipient for at least 1 year before death and gave full-time care that delayed nursing home entry; and whether sale costs would equal or exceed the property's value. Loss of an expected inheritance alone is not hardship (Sec. 409.9101(8)).", "recovery_exemptions_note": "Recovery covers assistance paid after age 55 only (Sec. 409.9101(3)). The debt is not enforced at all if the recipient is survived by a spouse, a child under 21, or a blind or permanently and totally disabled child (Sec. 409.9101(6)). No enforcement against property exempt from creditors, including homestead passing to spouse or heirs (Sec. 409.9101(7); Fla. Const. Art. X, Sec. 4). Nonexempt real property that is not protected homestead is sold to pay the claim when there are no liquid assets, and real property is never transferred to the agency (Sec. 409.9101(10)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-28", "sources": "http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0409/Sections/0409.9101.html; http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0733/Sections/0733.707.html; http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0736/Sections/0736.05053.html; http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0711/Sections/0711.501.html; http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0732/Sections/0732.4015.html; http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0600-0699/0689/Sections/0689.15.html; http://www.leg.state.fl.us/statutes/index.cfm?submenu=3; https://static.case.law/fla/73/cases/0039-01.json; https://ffic.myflfamilies.com/manual/1630.pdf; https://www.flmedicaidtplrecovery.com/flmedicaidtplrecovery.com/estate/index.html; https://stepuplaw.com/florida-ladybird-deed/", "confidence": "high", "flags": "2026-09-28 correction: revocable_trust changed from not_reachable to reachable. The earlier cell treated the homestead exception as the trust's protection; Sec. 733.707(3) and Sec. 736.05053 make the trust liable, and a homestead is protected by Sec. 409.9101(7) and Art. X, Sec. 4 whatever the method. Revocable trust: the common statement that a living trust escapes Florida recovery is true only for homestead; Sec. 733.707(3) exposes a non-homestead house held in a revocable trust. Attachment 4.17-A not retrieved (ahca.myflorida.com returned 403). No 2025 or 2026 TOD deed bill found enacted. 2026-09-23 publication review: checked against the Florida statute text of Secs. 409.9101, 733.707, 736.05053, 736.1109, 689.15 and ch. 711, and against stepuplaw.com/florida-medicaid-estate-recovery/ and the lady bird deed page's Sources of Law. Hardship waiver wording corrected (the one-year requirement is residence with the recipient, not the length of care) and the Sec. 409.9101(6) survivor bar and (10) sale rule added; Sec. 736.1109(2) added to the revocable trust cite." }, { "code": "GA", "name": "Georgia", "recovery_scope": "expanded", "recovery_scope_note": "The statute (O.C.G.A. Sec. 49-4-147.1) authorizes a claim against the recipient's estate but does not define estate. The DCH rule defines estate as all real and personal property under the probate code, including property passing by joint tenancy, right of survivorship, life estate, trust, annuity, IRAs, homestead or any other arrangement (Ga. Comp. R. & Regs. 111-3-8-.02(7)). The DCH FAQ (Sept. 25, 2025) repeats this and adds tenants in common and transfer on death deeds. The claim may be filed against the estate or any person who has an interest in the deceased member's property (111-3-8-.04(1)). TEFRA liens on the home of members institutionalized 6 months or more (111-3-8-.07), and post-death liens on real and personal property. Program began May 3, 2006. No recovery from the surviving spouse's estate found; recovery waits until the spouse dies.", "recovery_statute": "O.C.G.A. Sec. 49-4-147.1; Ga. Comp. R. & Regs. 111-3-8-.01 to .08", "recovery_statute_url": "https://codes.findlaw.com/ga/title-49-social-services/ga-code-sect-49-4-147-1/", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The rule's estate definition names property passing by life estate, and DCH says property held with a life estate interest is subject to recovery, valued with the IRS life estate table at the month of death. The DFCS manual adds that a life estate does not exempt the home from recovery.", "life_estate_cite": "Ga. Comp. R. & Regs. 111-3-8-.02(7); DCH Estate Recovery FAQ (Sept. 25, 2025) Q3, Q10; DFCS ABD Medicaid Manual 2398", "lady_bird_deed": "reachable", "lady_bird_deed_note": "If Georgia recognizes the deed, the house passes by a life estate or 'other arrangement', both of which the rule's estate definition covers. Whether Georgia recognizes the deed was not established.", "lady_bird_deed_cite": "Ga. Comp. R. & Regs. 111-3-8-.02(7)", "tod_deed": "unclear", "tod_deed_note": "DCH lists transfer on death deeds as estate property subject to recovery. But the 2026 amendment says a TOD deed takes precedence and priority over all unsecured debts of the owner's estate filed upon death. The beneficiary still takes subject to liens recorded in the owner's lifetime, so a TEFRA lien survives. How the new priority rule affects the unsecured Medicaid claim is untested.", "tod_deed_cite": "O.C.G.A. Sec. 44-17-5(a) (as amended by HB 413 (2026)); Sec. 44-17-7; DCH Estate Recovery FAQ (Sept. 25, 2025) Q3; Ga. Comp. R. & Regs. 111-3-8-.02(7), .07(8)", "joint_tenancy": "reachable", "joint_tenancy_note": "The rule's estate definition names property passing by joint tenancy and right of survivorship. DCH says jointly owned property is reachable to the extent of the member's ownership interest.", "joint_tenancy_cite": "Ga. Comp. R. & Regs. 111-3-8-.02(7); DCH Estate Recovery FAQ (Sept. 25, 2025) Q3", "revocable_trust": "reachable", "revocable_trust_note": "The rule's estate definition names property passing by trust. A trust provision that denies Medicaid recovery is void.", "revocable_trust_cite": "Ga. Comp. R. & Regs. 111-3-8-.02(7), .04(7)", "tod_deed_recognized": "yes", "tod_deed_statute": "O.C.G.A. Sec. 44-17-1 to 44-17-7", "tod_deed_effective": "2024-07-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Georgia statute or reported case recognizing a life estate deed with a retained power to sell without the remainder's consent was found. The DFCS ABD Medicaid Manual 2322 says 'some states allow life estates with powers' and counts such a life estate at full equity value, but does not say Georgia recognizes it.", "hardship_waiver_home": "No hardship waiver at lien placement (111-3-8-.08(2)). Undue hardship exists if the asset is an income-producing farm that is an heir's sole income source with annual gross income of $25,000 or less (not merely rental), or recovery would make the applicant eligible for need-based assistance (111-3-8-.08(4)). Request within 30 days of notice. Home lien not enforced while a sibling with an equity interest (1 year) or caregiver child (2 years) lives there (111-3-8-.04(9)).", "recovery_exemptions_note": "Estates with gross value of $25,000 or less are exempt, and the first $25,000 of any estate is waived for deaths on or after July 1, 2018 (O.C.G.A. Sec. 49-4-147.1(d); 111-3-8-.04(18), .08(5)). No recovery for assistance paid before May 3, 2006 (Sec. 49-4-147.1(b)). A claim may be made only if the applicant signed a written acknowledgment of the estate recovery notice (Sec. 49-4-147.1(a)). Heirs may pay in installments (Sec. 49-4-147.1(c)). Recovery covers institutional care at any age and long-term care services at 55 or older (111-3-8-.04(2)).", "karp_2005_scope": "not_in_survey", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/ga/title-49-social-services/ga-code-sect-49-4-147-1/; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.01; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.02; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.03; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.04; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.05; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.06; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.07; https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-111-3-8-.08; https://medicaid.georgia.gov/programs/third-party-liability/medicaid-estate-recovery; https://medicaid.georgia.gov/document/document/estate-recovery-frequently-asked-questions-september-25-2025/download; https://medicaid.georgia.gov/document/document/estate-recovery-brochure-revision-12220260/download; https://pamms.dhs.ga.gov/dfcs/medicaid/2398/; https://pamms.dhs.ga.gov/dfcs/medicaid/2322/; https://www.legis.ga.gov/api/legislation/document/20232024/229112; https://www.billtrack50.com/billdetail/1690402; https://gov.georgia.gov/press-releases/2024-04-30/gov-kemp-signs-legislation-supporting-georgias-agriculture-industry; https://www.legis.ga.gov/api/legislation/document/20252026/249061; https://www.billtrack50.com/billdetail/1830797", "confidence": "medium", "flags": "Conflict with popular lists: several secondary sites call Georgia probate-only, but the DCH rule and the 2025 DCH FAQ define the estate to include joint tenancy, life estates, trusts and TOD deeds. The expansion is in the rule, not the statute; statute read on FindLaw (current as of 2024-03-28; Justia and rules.sos.ga.gov returned 403), rules read on the LII copy. The agency page says Ch. 111-3-8 was updated 08/05/25; LII shows the last amendment as 2023, so a 2025 rule change may not be reflected. TOD deed: SB 420 (2024) is a combined bill (foreign ownership of farmland plus TOD deeds); the TOD text and Sec. 4 effective date (July 1, 2024) are from the legis.ga.gov 'as passed' version; Act 496 and the 2024-04-30 signing from BillTrack50 and the Governor's release. The 2024 act had no creditor-claims section. HB 413 (2026) added the priority-over-unsecured-debts sentence to Sec. 44-17-5(a), effective on approval (signed 2026-04-22 per BillTrack50); its Act number (secondary sources say Act 379) was not confirmed. Not based on URPTODA. State Plan Attachment 4.17-A not searched. TOD deed effective date detail: 2024-07-01, SB 420, Act 496, Ga. L. 2024, signed 2024-04-30, Sec. 4); amended by HB 413 (2026), effective on signing 2026-04-22." }, { "code": "HI", "name": "Hawaii", "recovery_scope": "probate_only", "recovery_scope_note": "HRS Sec. 346-37(a) directs the department to file a claim against the estate of a deceased recipient (55+, or institutionalized); neither ch. 346 nor HAR 17-1705 defines estate to add non-probate assets, so the probate code meaning applies (HRS Sec. 560:1-201: property of the decedent subject to administration). HAR 17-1705-56(d): recovery from the estate or on sale of property under a TEFRA lien. TEFRA liens on real property of permanently institutionalized recipients: HRS Sec. 346-29.5 and HAR 17-1705-57. No recovery from the surviving spouse's estate found in the statute or rule.", "recovery_statute": "HRS Sec. 346-37; HRS Sec. 346-29.5 (liens); HAR Sec. 17-1705-56 and 17-1705-57", "recovery_statute_url": "https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0037.htm", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "Estate is the probate estate; a retained life estate ends at death and nothing passes through probate. A TEFRA lien recorded during life under HRS Sec. 346-29.5 attaches to interests in real property then owned, which is the only route found.", "life_estate_cite": "HRS Sec. 346-37(a); HRS Sec. 560:1-201; HRS Sec. 346-29.5", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Hawaii statute, case or Med-QUEST rule recognizing the deed was found. If given effect, the remainder would pass outside probate and outside a probate-only claim.", "lady_bird_deed_cite": "HRS Sec. 346-37(a)", "tod_deed": "reachable", "tod_deed_note": "Hawaii TOD act: to the extent the probate estate is insufficient to satisfy an allowed claim, the estate may enforce the liability against the TOD property; proceeding must start within 18 months of death. A Medicaid claim allowed in probate can reach the house this way.", "tod_deed_cite": "HRS Sec. 527-15", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship property passes outside probate; no Hawaii statute found making real property joint tenants liable for the decedent's claims (HRS Sec. 560:6-102 et seq. covers multiple-party accounts only).", "joint_tenancy_cite": "HRS Sec. 346-37(a); HRS Sec. 560:6-102", "revocable_trust": "reachable", "revocable_trust_note": "After the settlor's death, property of a trust revocable at death is subject to the settlor's creditors' claims to the extent the probate estate is inadequate, so a Medicaid claim can reach a trust-held house.", "revocable_trust_cite": "HRS Sec. 554D-505(a)(3)", "tod_deed_recognized": "yes", "tod_deed_statute": "HRS ch. 527 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2011-07-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "none", "lady_bird_authority": "No statute, reported case or Med-QUEST rule found; searched HRS ch. 346, HAR 17-1705 and web for Hawaii enhanced life estate or lady bird deed authority (only practitioner and form-vendor pages).", "hardship_waiver_home": "HAR Sec. 17-1705-56(e): recovery waived while the estate is a homestead of modest value occupied by survivors who lived there at least 3 months before institutionalization and gave care keeping the recipient at home, own no other real property, and have income at or below 100% FPL; also family farm or business that is survivors' sole income source. Lien not enforced for resident sibling (1 year) or caregiver child (2 years): HAR Sec. 17-1705-57(d); HRS Sec. 346-29.5.", "recovery_exemptions_note": "HRS Sec. 346-29.5 allows the department to compromise liens or claims when full collection would cause undue hardship or they are uncollectible. No state additions to the federal exemption list found.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0037.htm; https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0001.htm; https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0029_0005.htm; https://humanservices.hawaii.gov/wp-content/uploads/2013/10/HAR-17-1705-Medical-Assistance-Recovery.pdf; https://data.capitol.hawaii.gov/hrscurrent/Vol12_Ch0501-0588/HRS0560/HRS_0560-0001-0201.htm; https://data.capitol.hawaii.gov/hrscurrent/Vol12_Ch0501-0588/HRS0527/HRS_0527-0001.htm; https://data.capitol.hawaii.gov/hrscurrent/Vol12_Ch0501-0588/HRS0527/HRS_0527-0015.htm; https://data.capitol.hawaii.gov/sessions/sessionlaws/Years/SLH2011/SLH2011_Act173.pdf; https://data.capitol.hawaii.gov/hrscurrent/Vol12_Ch0501-0588/HRS0554D/HRS_0554D-0505.htm; https://data.capitol.hawaii.gov/hrscurrent/Vol12_Ch0501-0588/HRS0560/HRS_0560-0006-0102.htm", "confidence": "high", "flags": "Estate is undefined in HRS 346-37 and HAR 17-1705; probate_only is inferred from the statute's claim-against-the-estate language and the UPC definition, no explicit expansion found. HAR 17-1705 copy is the DHS unofficial compilation. State plan Attachment 4.17-A not found on medicaid.gov. HRS 346-37 history ends at L 2012, c 211; no 2024 to 2026 amendment found. Hawaii TOD act Act 173 (SB 105), L 2011, effective July 1, 2011." }, { "code": "ID", "name": "Idaho", "recovery_scope": "expanded", "recovery_scope_note": "Idaho Code Sec. 56-218(4) defines estate to include the probate estate plus any other property in which the individual had legal title or interest at death, including assets conveyed through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement. Recovery is also made from the estate of the recipient's spouse after both die (Sec. 56-218(1)); IDAPA 16.03.26.985.01 limits the spouse-estate claim to former community property, the recipient's share of separate property and jointly owned property. The claim is a preferred debt (Sec. 56-218(5)); the department may file a notice of lien against estate property and foreclose without probate in listed cases (Sec. 56-218(6)). Lifetime TEFRA liens under Sec. 56-218A. Transfers for less than adequate consideration are voidable (Sec. 56-218(2)).", "recovery_statute": "Idaho Code Sec. 56-218; IDAPA 16.03.26.981 to 16.03.26.985 (eff. July 1, 2025)", "recovery_statute_url": "https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-218/", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/ID-21-0009.pdf", "life_estate": "reachable", "life_estate_note": "The statutory estate expressly includes assets conveyed through a life estate, to the extent of the recipient's interest. Rule exclusion: not recovered if neither the recipient nor spouse ever owned the remainder, or if the life estate was created before July 1, 1995.", "life_estate_cite": "Idaho Code Sec. 56-218(4)(b); IDAPA 16.03.26.985.05", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Idaho authority recognizing the deed was found; if used, the grantor holds a life estate and owned the remainder, so the expanded definition (life estate or other arrangement) reaches it and the pre-1995 and never-owned-remainder exclusions do not apply.", "lady_bird_deed_cite": "Idaho Code Sec. 56-218(4)(b); IDAPA 16.03.26.985.05", "tod_deed": "n/a", "tod_deed_note": "Idaho has no real property TOD deed statute. 2026 S1399 (Uniform Real Property Transfer on Death Act) was referred to Senate Judiciary and Rules on 3/18/2026 and had no further action.", "tod_deed_cite": "2026 Idaho S1399 bill status (not enacted)", "joint_tenancy": "reachable", "joint_tenancy_note": "The statutory estate expressly includes assets conveyed to a survivor through joint tenancy or survivorship, to the extent of the recipient's interest.", "joint_tenancy_cite": "Idaho Code Sec. 56-218(4)(b)", "revocable_trust": "reachable", "revocable_trust_note": "The statutory estate expressly includes assets conveyed through a living trust; the rule also counts any trust in which the recipient had a beneficial interest as an estate asset.", "revocable_trust_cite": "Idaho Code Sec. 56-218(4)(b); IDAPA 16.03.26.984", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "none", "lady_bird_authority": "No Idaho statute, reported case or Medicaid rule found; searched Idaho Code 56-218, IDAPA 16.03.26 estate recovery rules, the Idaho state plan addendum and web for Idaho enhanced life estate or lady bird deed authority (only national secondary lists).", "hardship_waiver_home": "No home-specific waiver. Undue hardship waivers are considered when the estate is income-producing property that is the sole support of heirs, when payment would make heirs eligible for public assistance, or when the claim or whole estate is under $500; application within 90 days of death or 30 days of notice; no hardship if the recipient diverted assets (IDAPA 16.03.26.985.07; Idaho Code Sec. 56-218(7)). Lifetime lien on the home barred while a spouse, child under 21, blind or disabled child, or equity-holding sibling (1 year) lives there; lien not enforced while a resident sibling (1 year) or caregiver child (2 years) lives there (Sec. 56-218A(2), (5)).", "recovery_exemptions_note": "Restricted allotted land of tribal members excluded (IDAPA 16.03.26.985.04). No recovery to the extent need for aid resulted from a crime against the recipient (Sec. 56-218(1)(d)). Recovery extends to the surviving spouse's estate, a state expansion beyond probate of the recipient.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://web.archive.org/web/20260309114344id_/https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-218/; https://web.archive.org/web/2026id_/https://legislature.idaho.gov/statutesrules/idstat/Title56/T56CH2/SECT56-218A/; https://www.law.cornell.edu/regulations/idaho/IDAPA-16.03.26.981;https://www.law.cornell.edu/regulations/idaho/IDAPA-16.03.26.984; https://www.law.cornell.edu/regulations/idaho/IDAPA-16.03.26.985; https://www.medicaid.gov/medicaid/spa/downloads/ID-21-0009.pdf; https://web.archive.org/web/20260521052653id_/https://legislature.idaho.gov/sessioninfo/2026/legislation/S1399/", "confidence": "high", "flags": "legislature.idaho.gov refused connections today; statute and bill status read from Wayback Machine copies of the official pages (statute snapshot 2026-03-09, history ends 2008, ch. 182; bill snapshot 2026-05-21). Could not confirm no 2026 session amendment to 56-218 from the official site. Estate recovery rules moved to IDAPA 16.03.26 effective July 1, 2025 (temporary, Idaho Bulletin Vol. 25-6); read via LII copy. Secondary pages claim an Idaho TOD law effective July 2026; primary bill status shows S1399 died in committee." }, { "code": "IL", "name": "Illinois", "recovery_scope": "probate_only", "recovery_scope_note": "305 ILCS 5/5-13 defines estate as property 'included within the person's estate, as that term is used in the Probate Act of 1975'. The expanded definition (joint tenancy, tenancy in common, survivorship, life estate, living trust) applies only to decedents who received long-term care partnership insurance benefits with an asset disregard; 89 Ill. Adm. Code 102.210(a)(1) says the same. The claim also runs against the estate of the recipient's surviving spouse, regardless of order of death (Sec. 5-13; 102.210(b)). Liens are filed on the real property of AABD cash recipients and of AABD medical recipients in a medical institution 120 days or more (IDHS PM 23-09-01-b; 89 Ill. Adm. Code 102.200).", "recovery_statute": "305 ILCS 5/5-13; 89 Ill. Adm. Code 102.200, 102.210", "recovery_statute_url": "https://ilga.gov/documents/legislation/ilcs/documents/030500050K5-13.htm", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/IL-22-0028.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and is not part of the Probate Act estate. It is reachable only for long-term care partnership policyholders, whose estate expressly includes life estates. A lifetime lien on the life tenant's interest would end with the life estate.", "life_estate_cite": "305 ILCS 5/5-13; 89 Ill. Adm. Code 102.210(a)(1); IDHS PM 07-02-14", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Illinois authority for a life estate deed with a retained power to sell without the remainder's consent was found. If valid, the remainder passes outside the Probate Act estate and outside Sec. 5-13, but its status is untested.", "lady_bird_deed_cite": "305 ILCS 5/5-13", "tod_deed": "reachable", "tod_deed_note": "A TOD instrument passes outside probate, but the beneficiary is subject to creditor and statutory claims as a revocable trust beneficiary is under 760 ILCS 3/505, that is, to the extent the probate estate is inadequate. The HFS claim is a claim against the estate, so the house is exposed if the probate estate cannot pay it.", "tod_deed_cite": "755 ILCS 27/85; 760 ILCS 3/505(a)(5); 305 ILCS 5/5-13", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes by right of survivorship, outside the Probate Act estate. Joint tenancy is reachable only for long-term care partnership policyholders under the expanded definition.", "joint_tenancy_cite": "305 ILCS 5/5-13; 89 Ill. Adm. Code 102.210(a)(1)", "revocable_trust": "reachable", "revocable_trust_note": "Trust assets are outside the probate estate, but property of a trust revocable at death is subject to the settlor's creditors' claims to the extent the probate estate is inadequate, and the personal representative collects it into the probate estate. Exempt assets are excluded.", "revocable_trust_cite": "760 ILCS 3/505(a)(5); 305 ILCS 5/5-13", "tod_deed_recognized": "yes", "tod_deed_statute": "755 ILCS 27 (Real Property Transfer on Death Instrument Act)", "tod_deed_effective": "2012-01-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Illinois statute, reported case or HFS/IDHS rule recognizing an enhanced life estate deed was found. IDHS PM 07-02-14 addresses ordinary life estates only. Web search returned only form vendors and law firm pages.", "hardship_waiver_home": "HFS waives recovery if it would make an heir or beneficiary eligible for, or keep them on, SSI, TANF or SNAP (89 Ill. Adm. Code 102.210(g); State Plan Att. 4.17-A p. 3). HFS guide also lists a family business, farm or ranch that was the heirs' main income source for 12 months before death. A claim for income maintenance (cash) assistance is not enforced against the homestead while the spouse or a minor or disabled child lives there (102.210(e)).", "recovery_exemptions_note": "For deaths on or after July 1, 2022, HFS waives any claim against the first $25,000 of an estate (P.A. 102-1037, HB 4343; 89 Ill. Adm. Code 102.210(h); SPA 22-0028). Medicare cost sharing requested after Jan. 1, 2010 is exempt (102.210(b)(2)(D)). Recovery covers medical assistance at age 55 or older, or at any age for an institutionalized recipient. Assets disregarded under a qualified long-term care partnership policy are protected (102.210(f)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://web.archive.org/web/20260327085041/https://ilga.gov/documents/legislation/ilcs/documents/030500050K5-13.htm; https://www.law.cornell.edu/regulations/illinois/Ill-Admin-Code-tit-89-SS-102.200; https://www.law.cornell.edu/regulations/illinois/Ill-Admin-Code-tit-89-SS-102.210; https://web.archive.org/web/20260114220958/https://ilga.gov/documents/legislation/ilcs/documents/075500270K85.htm; https://web.archive.org/web/20250922001242/https://ilga.gov/documents/legislation/ilcs/documents/075500270K1.htm; https://web.archive.org/web/20251107230104/https://www.ilga.gov/documents/legislation/ilcs/documents/075500270K60.htm; https://web.archive.org/web/20250806083253/https://ilga.gov/Documents/legislation/ilcs/documents/076000030K505.htm; https://www.isba.org/ibj/2011/12/thetransferondeathinstrumentcomesto; https://www.dhs.state.il.us/page.aspx?item=14931; https://www.dhs.state.il.us/page.aspx?item=19171; https://hfs.illinois.gov/medicalclients/medicaidestaterecovery/guidetothemedicaidestaterecoveryprogram.html; https://www.medicaid.gov/medicaid/spa/downloads/IL-22-0028.pdf", "confidence": "high", "flags": "ilga.gov timed out from this machine; statute text was read from Wayback Machine snapshots of the official ilga.gov pages (2025 to 2026 captures), so it is official text but not a live read. The Sec. 5-13 snapshot shows source P.A. 99-143 and does not contain the $25,000 threshold from P.A. 102-1037, which may be codified elsewhere in the Public Aid Code. TOD effective date (P.A. 97-555, 2012-01-01) is from the ISBA Journal (Dec. 2011), not the session law; the Act is 'largely modeled' on URPTODA per ISBA but differs (two witnesses, acceptance requirement); ULC enactment list not read. HB 4824 (2025 to 2026) appeared in an estate recovery search; its content and status were not checked (LegiScan 403). Karp 2005 counted Illinois as going beyond probate; the current statute expands only for LTC partnership policyholders, though TOD and revocable trust property is reachable through the creditor statutes when the probate estate is short. TOD deed effective date detail: 2012-01-01, P.A. 97-555; amended P.A. 98-821 eff. 2015-01-01 and P.A. 102-68 eff. 2022-01-01." }, { "code": "IN", "name": "Indiana", "recovery_scope": "expanded", "recovery_scope_note": "IC 12-15-9-0.5 defines estate to include the probate estate, real property passing by joint tenancy with right of survivorship created after June 30, 2002, any property conveyed through a nonprobate transfer (as defined in IC 32-17-13-1), and certain annuities bought after May 1, 2005. Nonprobate transfer means a transfer at death where the decedent could, acting alone, revoke or withdraw the property; tenancy by the entireties survivorship and life insurance are excluded. 405 IAC 2-8-1(b) and State Plan Att. 4.17-A (TN 05-012) say the same. The plan provides for TEFRA liens on real property of permanently institutionalized recipients. The claim is a preferred claim (IC 12-15-9-1). Surviving spouse's estate: current IC 12-15-9-5 (FindLaw copy) bars a claim against it, though the 2005 State Plan page includes it.", "recovery_statute": "Ind. Code Sec. 12-15-9-0.5, 12-15-9-1, 12-15-9-2, 12-15-9-5; IC 32-17-13-1; 405 IAC 2-8-1", "recovery_statute_url": "https://iga.in.gov/laws/2025/ic/titles/12", "state_plan_4_17_a_url": "https://provider.indianamedicaid.com/ihcp/StatePlan/Attachments_and_Supplements/Section_4/4.17a.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate is not in the statutory list: it ends at death, is not a probate asset, and the life tenant cannot revoke the remainder, so it is not a nonprobate transfer. FSSA lists 'real property held by a Medicaid recipient that is subject to a life estate' among assets that cannot be recovered.", "life_estate_cite": "IC 12-15-9-0.5; IC 32-17-13-1(a); FSSA Medicaid Estate Recovery FAQ", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Indiana authority on an enhanced life estate deed was found. If the grantor keeps the power, acting alone, to sell and defeat the remainder, the transfer at death appears to fit the IC 32-17-13-1 nonprobate transfer definition and so the Medicaid estate, but no source applies it.", "lady_bird_deed_cite": "IC 12-15-9-0.5(a)(3); IC 32-17-13-1(a)", "tod_deed": "reachable", "tod_deed_note": "A transfer on death transfer under IC 32-17-14 is expressly a nonprobate transfer, and property conveyed by a nonprobate transfer is part of the Medicaid estate. FSSA says its 9-month claim deadline does not apply to assets passed by a TOD deed that were not reported to DFR.", "tod_deed_cite": "IC 12-15-9-0.5(a)(3); IC 32-17-13-1(e); IC 32-17-14-29; 405 IAC 2-8-1(b)(3)", "joint_tenancy": "reachable", "joint_tenancy_note": "Real property passing to a survivor by joint tenancy with right of survivorship is expressly in the estate if the joint tenancy was created after June 30, 2002, to the extent of the decedent's interest. Tenancy by the entireties survivorship is excluded. The IHCP Policy Manual 4705.00.00 still says jointly held property is not in the estate, which conflicts with the statute.", "joint_tenancy_cite": "IC 12-15-9-0.5(a)(2); IC 32-17-13-1(b)(1); 405 IAC 2-8-1(b)(2)", "revocable_trust": "reachable", "revocable_trust_note": "Property passing at death from a trust the decedent could revoke is a nonprobate transfer and part of the Medicaid estate. FSSA lists revocable trust assets transferred into the trust after May 1, 2002 as recoverable; nonprobate transfers made before May 1, 2002 are exempt.", "revocable_trust_cite": "IC 12-15-9-0.5(a)(3); IC 32-17-13-1(a); 405 IAC 2-8-1(b)(3), (e)(4)", "tod_deed_recognized": "yes", "tod_deed_statute": "Ind. Code 32-17-14 (Transfer on Death Property Act), Sec. 32-17-14-11", "tod_deed_effective": "2009-07-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Indiana statute, reported case or FSSA rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Searches returned only law firm and form pages.", "hardship_waiver_home": "No home-specific rule. Undue hardship waiver (claim suspended while hardship lasts) if recovery would make a beneficiary eligible for, or keep them on, public assistance, or would cause complete loss of an income-producing asset (such as a family farm) where the beneficiary has no other income and income at or below 100% of poverty; other compelling cases case by case. Applicant must be immediate family (spouse, child, grandchild, great-grandchild, parent, grandparent, sibling) except for good cause; file within 90 days (405 IAC 2-8-2). No claim is enforced against real estate while needed for the support of a surviving spouse or a dependent minor or disabled child (IC 12-15-9-2(1)).", "recovery_exemptions_note": "Personal effects, ornaments and keepsakes exempt (IC 12-15-9-2(3)). Nonprobate transfers made before May 1, 2002, and nonprobate assets found exempt for eligibility before then, are exempt; Indiana Long Term Care Partnership disregarded assets exempt (405 IAC 2-8-1(e)). Medicare cost sharing (QMB, SLMB, QI) not recovered (IHCP Manual 4705.00.00). Funeral expenses up to $3,500 paid ahead of the claim per FSSA (IC 12-14-17). Recovery covers Medicaid paid at 55 or older.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-9-0-5.html; https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-9-1.html; https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-9-2.html; https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-9-5.html; https://codes.findlaw.com/in/title-32-property/in-code-sect-32-17-13-1.html; https://codes.findlaw.com/in/title-32-property/in-code-sect-32-17-14-11/; https://codes.findlaw.com/in/title-32-property/in-code-sect-32-17-14-29/; https://codes.findlaw.com/in/title-32-property/in-code-sect-32-17-14-2/; https://www.law.cornell.edu/regulations/indiana/405-IAC-2-8-1; https://www.law.cornell.edu/regulations/indiana/405-IAC-2-8-2; https://www.in.gov/dA/cf98242e89/Medicaid_PM_4700.pdf?language_id=1; https://www.in.gov/fssa/ompp/medicaid-estate-recovery/; https://provider.indianamedicaid.com/ihcp/StatePlan/Attachments_and_Supplements/Section_4/4.17a.pdf", "confidence": "medium", "flags": "Official code site iga.in.gov is a JavaScript app (no text to scripts or WebFetch) and Justia returned 403, so statute text is a WebFetch extraction of FindLaw (current as of Jan. 1, 2026), not verbatim. The estate definition is confirmed by the official State Plan Att. 4.17-A and by 405 IAC 2-8-1 (LII). Conflicts: (1) IHCP Policy Manual 4705.00.00 says the estate excludes joint survivorship property and trust property, contrary to IC 12-15-9-0.5 and the FSSA FAQ; (2) FindLaw's IC 12-15-9-5 bars claims against the surviving spouse's estate, while State Plan TN 05-012 (2005) includes the spouse's estate and the manual says recovery after the spouse's death is limited to the recipient's probate estate; (3) 9-month claim deadline (IC 29-1-14-1): FSSA page says from July 1, 2025, manual says July 1, 2026; the enacting act was not identified. TOD act effective date from IC 32-17-14-2 applicability language and a secondary source; session law (P.L. number) not read. Indiana's TOD act is its own act, not URPTODA. Lady bird deed treatment untested. TOD deed effective date detail: 2009-07-01, Transfer on Death Property Act." }, { "code": "IA", "name": "Iowa", "recovery_scope": "expanded", "recovery_scope_note": "Iowa Code Sec. 249A.53(2)(c) defines the estate of a recipient, surviving spouse or surviving child as any real property, personal property or other asset in which the person had any legal title or interest at death, to the extent of that interest, 'including but not limited to interests in jointly held property, retained life estates, and interests in trusts'. All such assets are 'subject to probate' for collection (249A.53(2)(d)). Iowa also recovers from the estate of the surviving spouse (and of a blind or disabled child) at that person's death, to the extent they received the recipient's estate (249A.53(2)(b); 441 IAC 75.28(7)(h)). Homestead descending to issue is not exempt from the Medicaid debt (Sec. 561.19). Interest accrues from six months after death (249A.53(2)(e)).", "recovery_statute": "Iowa Code Sec. 249A.53(2); 441 IAC 75.28(7)", "recovery_statute_url": "https://www.legis.iowa.gov/docs/code/249A.53.pdf", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The statute expressly lists retained life estates as part of the estate, to the extent of the recipient's interest at death, and makes them subject to probate for collection.", "life_estate_cite": "Iowa Code Sec. 249A.53(2)(c), (d); 441 IAC 75.28(7)(a)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Iowa authority on enhanced life estate deeds was found. Whatever its validity, the grantor keeps a retained life estate and any other interest held at death, and the statute reaches retained life estates and any legal title or interest at death.", "lady_bird_deed_cite": "Iowa Code Sec. 249A.53(2)(c)", "tod_deed": "n/a", "tod_deed_note": "Iowa has no transfer-on-death deed statute for real estate. Chapter 633D covers securities only. HF 2422 (2026) was introduced and referred to Judiciary on Feb. 12, 2026 with no further action.", "tod_deed_cite": "Iowa Code Sec. 633D.1; HF 2422 (91st G.A.) bill history", "joint_tenancy": "reachable", "joint_tenancy_note": "The statute expressly includes interests in jointly held property, to the extent of the recipient's interest at death (for example a one-third joint interest).", "joint_tenancy_cite": "Iowa Code Sec. 249A.53(2)(c); 441 IAC 75.28(7)(a)", "revocable_trust": "reachable", "revocable_trust_note": "The statute expressly includes interests in trusts held at death, and a settlor of a revocable trust holds an interest in it until death.", "revocable_trust_cite": "Iowa Code Sec. 249A.53(2)(c); 441 IAC 75.28(7)(a)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Iowa statute, reported case or HHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Searches returned only law firm pages and cases on ordinary life estates.", "hardship_waiver_home": "No home-specific exemption: homestead passing to issue is expressly not exempt from the Medicaid debt (Sec. 561.19). Undue hardship waiver only if the heir's household income is under 200% of FPL, household resources do not exceed $10,000, and recovery would deprive the person of food, clothing, shelter or medical care so that life or health is endangered; apply within 30 days of notice (441 IAC 75.28(7)(g)). A waived amount becomes a debt of the waiver recipient when the hardship ends, or of their estate at death (249A.53(2)(b)(3)).", "recovery_exemptions_note": "Recovery covers assistance at 55 or older, or at any age for a resident of a nursing facility, ICF-ID or mental health institute who cannot be expected to return home (Sec. 249A.53(2)). Waiver for a surviving spouse or minor, blind or disabled child is a deferral: the amount becomes a debt of the spouse's or disabled child's estate, or of a minor child at age 21 (249A.53(2)(b)). Medicare cost sharing paid from Jan. 1, 2010 is not recovered; long-term care partnership disregarded assets exempt (441 IAC 75.28(7), (7)(i)). ABLE account balances are not recovered (249A.53(3)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.legis.iowa.gov/docs/code/249A.53.pdf; https://www.legis.iowa.gov/docs/code/561.19.pdf; https://www.legis.iowa.gov/docs/iac/rule/441.75.28.pdf; https://www.legis.iowa.gov/docs/code/633D.1.pdf; https://www.legis.iowa.gov/legislation/billTracking/billHistory?billName=HF%202422&ga=91; https://hhs.iowa.gov/medicaid/member-services/estate-recovery; https://www.calt.iastate.edu/article/home-held-joint-tenancy-medicaid-recipient-subject-estate-recovery-claim", "confidence": "high", "flags": "Iowa's estate is among the broadest: statute names joint property, retained life estates and trusts, and recovery continues from the surviving spouse's estate. Case law pointed to by secondary sources (not read in full; CourtListener blocked): In re Estate of Serovy, 711 N.W.2d 290 (Iowa 2006) (claim limited to the recipient's one-third joint interest, no forced sale of whole home); Health Mgmt. Sys. ex rel. Iowa DHS v. Laughead, 696 N.W.2d 312 (Iowa 2005) (life estate included). 441 IAC 75.28 was reissued by ARC 9763C, effective 2026-01-01. No TOD deed statute through 2026 (HF 2422 died in committee; HF 125 and HF 816 URPTODA bills reported by secondary sources, not checked). State Plan Attachment 4.17-A not found. Lady bird deed classed reachable from the statute's plain text, not from any case." }, { "code": "KS", "name": "Kansas", "recovery_scope": "expanded", "recovery_scope_note": "For assistance received on or after July 1, 2004 the claim applies to the 'medical assistance estate': all real and personal property and other assets in which the decedent had any legal title or interest immediately before or at death, expressly including joint tenancy, tenancy in common, survivorship, TOD deed, POD contract, life estate, trust, annuities or similar arrangement. Assistance before July 1, 2004 is limited to the probatable estate. Kansas also recovers from the surviving spouse's estate (K.S.A. 39-709(k)(2); K.A.R. 129-6-150(d)) and uses pre-death TEFRA liens on real property of permanently institutionalized recipients plus post-death liens filed within one year of death (K.S.A. 39-709(k)(4)).", "recovery_statute": "K.S.A. 39-709(k)(2) to (k)(3) (formerly 39-709(g), relettered by L. 2025, ch. 26); K.A.R. 129-6-150", "recovery_statute_url": "https://www.ksrevisor.gov/statutes/chapters/ch39/039_007_0009.html", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/KS-21-0016.pdf", "life_estate": "reachable", "life_estate_note": "The medical assistance estate expressly includes assets conveyed through a life estate, to the extent of the decedent's interest immediately before death.", "life_estate_cite": "K.S.A. 39-709(k)(3)(B); K.A.R. 129-6-150(g)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "If used, a retained enhanced life estate is an interest that ends at death; the statute reaches any legal title or interest at death, life estates and 'similar arrangement[s]'. No Kansas authority recognizing the deed was found.", "lady_bird_deed_cite": "K.S.A. 39-709(k)(3)(B); K.A.R. 129-6-150(g)", "tod_deed": "reachable", "tod_deed_note": "Statute lists TOD deeds in the medical assistance estate, and the TOD act itself says beneficiaries take subject to claims of the state of Kansas for medical assistance under K.S.A. 39-709.", "tod_deed_cite": "K.S.A. 39-709(k)(3)(B); K.S.A. 59-3504(b)", "joint_tenancy": "reachable", "joint_tenancy_note": "Joint tenancy and survivorship are listed; recovery limited to the decedent's fractional interest (KEESM 1725 example: half of a jointly owned house).", "joint_tenancy_cite": "K.S.A. 39-709(k)(3)(B); KEESM 1725", "revocable_trust": "reachable", "revocable_trust_note": "Assets conveyed through a 'trust' are expressly included in the medical assistance estate.", "revocable_trust_cite": "K.S.A. 39-709(k)(3)(B)", "tod_deed_recognized": "yes", "tod_deed_statute": "K.S.A. 59-3501 to 59-3507", "tod_deed_effective": "1997-07-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Kansas statute, reported case or KDHE rule found recognizing a life estate with retained power to convey; searched web for Kansas enhanced life estate / lady bird deed (only secondary sources).", "hardship_waiver_home": "Undue hardship waiver of claims and liens on request, case by case, weighing type of assets, family care that reduced Medicaid costs, impact on surviving family and on a family business (KEESM 1725). Liens on the home cannot be enforced while a child 20 or under, a blind or disabled adult child, or a sibling with one year prior residence lives in the home (K.S.A. 39-709(k)(5)).", "recovery_exemptions_note": "Claim limited to assistance paid at age 55 or older or while in long-term care (K.A.R. 129-6-150(b)); no claim for QMB, LMB or QWD only coverage (KEESM 1725); pre July 1, 2004 assistance only against the probatable estate; claim then filed against surviving spouse's estate.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.ksrevisor.gov/statutes/chapters/ch39/039_007_0009.html; https://www.ksrevisor.gov/statutes/chapters/ch59/059_035_0001.html; https://www.ksrevisor.gov/statutes/chapters/ch59/059_035_0004.html; https://www.ksrevisor.gov/statutes/chapters/ch59/059_035_0007.html; https://www.ksrevisor.gov/statutes/ksa_ch59.html; https://www.law.cornell.edu/regulations/kansas/K-A-R-129-6-150; https://khap.kdhe.ks.gov/KEESM/Jan_2020_Output/1725.htm; https://www.medicaid.gov/medicaid/spa/downloads/KS-21-0016.pdf", "confidence": "high", "flags": "39-709 was reorganized by L. 2025, ch. 26 (HB 2027), eff. July 1, 2025; estate recovery now in subsection (k), older sources cite (g). K.A.R. 129-6-150 read on Cornell LII copy, not the official KAR site. KEESM 1725 read from Jan 2020 output; newer manual version may exist. Kansas TOD act (1997) is its own act, not URPTODA. KS state plan Attachment 4.17-A (SPA 21-0016) describes procedure only." }, { "code": "KY", "name": "Kentucky", "recovery_scope": "expanded", "recovery_scope_note": "Estate means probate property plus all real and personal property or other assets in which the deceased recipient had legal title or interest at death, to the extent of that interest, whether conveyed through joint tenancy, tenancy in common survivorship, life estate, living trust or other arrangement. The expanded definition is in the regulation; the statute (KRS 205.520(3)) only authorizes the cabinet to comply with federal requirements by regulation. Recovery is limited to Medicaid paid during a 'period of institutionalization' (NF, ICF-IID and HCB/SCL/ABI/Michelle P. waiver services for recipients 55+, or permanently institutionalized recipients) plus related drug, hospital, physician and Medicare cost sharing costs and MCO capitation. No TEFRA lien provision appears in the regulation.", "recovery_statute": "907 KAR 1:585 Sec. 1(3), Sec. 2 (authority KRS 205.520(3))", "recovery_statute_url": "https://apps.legislature.ky.gov/law/kar/titles/907/001/585/", "state_plan_4_17_a_url": "https://www.chfs.ky.gov/agencies/dms/spa/36Att417APg12LiensAdjustmentsorRecoveries.pdf", "life_estate": "reachable", "life_estate_note": "Life estate is expressly listed in the regulatory definition of estate, to the extent of the recipient's interest at death.", "life_estate_cite": "907 KAR 1:585 Sec. 1(3)(b)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "If used, the retained life estate is an interest held at death, and the definition covers life estates and any 'other arrangement'. No Kentucky primary authority recognizing the deed was found.", "lady_bird_deed_cite": "907 KAR 1:585 Sec. 1(3)(b)", "tod_deed": "n/a", "tod_deed_note": "Kentucky has no real property TOD deed statute. URPTODA bills failed: 2024 HB 50 (recommitted Jan. 25, 2024) and 2026 SB 34 (passed Senate, last action Mar. 24, 2026 to House Local Government). If enacted later, the 'other arrangement' language would likely reach it.", "tod_deed_cite": "LRC bill records 24RS HB 50, 26RS SB 34", "joint_tenancy": "reachable", "joint_tenancy_note": "Joint tenancy and tenancy in common survivorship are expressly listed, to the extent of the recipient's interest.", "joint_tenancy_cite": "907 KAR 1:585 Sec. 1(3)(b)", "revocable_trust": "reachable", "revocable_trust_note": "Living trust assets are expressly listed in the regulatory definition of estate.", "revocable_trust_cite": "907 KAR 1:585 Sec. 1(3)(b)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Kentucky statute, reported case or DMS rule found recognizing a life estate with retained power to convey without remainder consent; searched web for Kentucky enhanced life estate / power to sell life estate deeds (only practitioner and form sites).", "hardship_waiver_home": "Undue hardship is defined narrowly: the asset is the sole income producing asset (e.g. family farm or business) conveyed to a surviving spouse, child or sibling; residential rental property does not qualify. Request within 30 days of notice. No hardship if the recipient illegally divested assets to avoid recovery. No home specific caregiver or sibling exemption found.", "recovery_exemptions_note": "No recovery if total date of death value of the estate subject to recovery is $10,000 or less or below administrative cost; case by case exemption for anticipated education or health care costs of an estate heir; LTC partnership protected resources exempt; recovery limited to institutional and waiver periods (907 KAR 1:585 Sec. 2, Sec. 3(2), (4), (5)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://apps.legislature.ky.gov/law/kar/titles/907/001/585/; https://apps.legislature.ky.gov/record/24rs/hb50.html; https://apps.legislature.ky.gov/record/26rs/sb34.html", "confidence": "high", "flags": "Expanded definition rests on regulation, not statute (read on official LRC site). 907 KAR 1:585 last certified 12-6-2019 with 7-year expiration 12/6/2026; watch for re-promulgation. Attachment 4.17-A located on chfs.ky.gov but returned 403 and was not read. Some web pages claim a Kentucky TOD deed statute (e.g. 'KRS 394B, 2020'); LRC records show the URPTODA bills did not pass through the 2026 session." }, { "code": "LA", "name": "Louisiana", "recovery_scope": "probate_only", "recovery_scope_note": "Statute directs LDH to recover 'from the succession estates' of recipients and only in instances mandated by 42 U.S.C. 1396p; the claim is a privilege on the succession estate ranking as an expense of last illness. The rule defines estate as the gross estate 'as determined by Louisiana succession law and any interest in any property', which is broader on its face, but the rule also works through succession pleadings and judgments of possession. No TEFRA lien or surviving spouse estate recovery provision found in the statute or rule.", "recovery_statute": "La. R.S. 46:153.4(D); LAC 50:I.8101, 8103", "recovery_statute_url": "https://www.legis.la.gov/Legis/LawPrint.aspx?d=207161", "state_plan_4_17_a_url": "https://ldh.la.gov/assets/medicaid/StatePlan/Sec4/Attachment4.17.pdf", "life_estate": "not_reachable", "life_estate_note": "Louisiana uses usufruct rather than a common law life estate. A usufruct expires at the usufructuary's death, and the naked owner's property is not part of the recipient's succession estate.", "life_estate_cite": "La. R.S. 46:153.4(D); La. Civ. Code art. 607", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "Closest analog is a usufruct with an express power to alienate (Civ. Code art. 568). It still ends at death and the property is outside the succession estate the statute targets.", "lady_bird_deed_cite": "La. R.S. 46:153.4(D); La. Civ. Code arts. 568, 607", "tod_deed": "n/a", "tod_deed_note": "No Louisiana transfer on death deed statute for immovable property was found.", "tod_deed_cite": "", "joint_tenancy": "n/a", "joint_tenancy_note": "Civil Code co-ownership is ownership in indivision; no right of survivorship provision was found, so a co-owner's share passes through the succession and is subject to recovery as succession property.", "joint_tenancy_cite": "La. Civ. Code art. 797", "revocable_trust": "unclear", "revocable_trust_note": "Trust assets are outside the succession estate the statute reaches, but no primary source was read on whether revocable trust property answers for the settlor's debts after death (a practitioner guide says revocable trusts give no creditor protection after death).", "revocable_trust_cite": "La. R.S. 46:153.4(D); La. R.S. 9:1721 et seq. (Trust Code, not read)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No lady bird deed as such. La. Civ. Code art. 568 lets a usufructuary alienate nonconsumable things if the right is expressly granted, a civil law analog; whether it is used with a reserved usufruct on donation of the home was not verified from primary sources.", "hardship_waiver_home": "First $15,000 or one half of the parish median homestead value, whichever is higher, is not subject to recovery. Recovery may be reduced for heirs' documented expenses to maintain the homestead while the recipient was in long term care or on HCBS. Undue hardship exists if an heir's family income is 300 percent of poverty or less; may also exist if the estate is an heir's sole income producing asset or recovery would make an heir eligible for public assistance.", "recovery_exemptions_note": "Recovery waived if not cost effective (expected recovery must exceed cost and be over $1,000); waived for undue hardship on any child of the decedent; no recovery of Medicare cost sharing, including for QMB Plus and SLMB Plus; LTC partnership disregard protected. Heir means a descendant in the first degree (LAC 50:I.8101, 8103).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.legis.la.gov/Legis/LawPrint.aspx?d=207161; https://www.law.cornell.edu/regulations/louisiana/La-Admin-Code-tit-50-SS-I-8101; https://www.law.cornell.edu/regulations/louisiana/La-Admin-Code-tit-50-SS-I-8103; https://www.law.cornell.edu/regulations/louisiana/La-Admin-Code-tit-50-SS-I-8105; https://www.legis.la.gov/Legis/LawPrint.aspx?d=110757; https://www.legis.la.gov/Legis/LawPrint.aspx?d=110801; https://www.legis.la.gov/Legis/LawPrint.aspx?d=110992", "confidence": "high", "flags": "Rule definition of estate ('and any interest in any property') is broader on its face than the statute's 'succession estates'; statute controls but LDH practice not verified. LDH state plan Attachment 4.17 and Eligibility Manual U-0000 returned 403 and were not read. LAC read on Cornell LII copy. TOD absence based on no statute found (secondary sources agree). Revocable trust creditor exposure unresolved." }, { "code": "ME", "name": "Maine", "recovery_scope": "expanded_partial", "recovery_scope_note": "Estate includes the probate estate plus any other real and personal property in which the recipient had any legal interest at death, to the extent of that interest, including assets passing by tenancy in common, survivorship, life estate, living trust, joint tenancy in personal property or other arrangement, 'but not including joint tenancy in real property'. Partial because joint tenancy real estate is carved out. Non-probate assets are pursued by a claim in any court of competent jurisdiction against the holder. Since Nov. 24, 2021 the claim is limited to nursing facility, HCBS and related hospital and drug costs (MBM Ch. VII Sec. 5.03, citing P.L. 2021, ch. 398). No TEFRA lien or surviving spouse estate provision found in the statute or rule.", "recovery_statute": "22 M.R.S. Sec. 14(2-I)(B), (F); 10-144 C.M.R. ch. 101, MaineCare Benefits Manual Ch. VII Sec. 5", "recovery_statute_url": "https://legislature.maine.gov/statutes/22/title22sec14.html", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/ME-21-0013.pdf", "life_estate": "reachable", "life_estate_note": "Life estate is expressly listed. The rule values the recoverable interest with the actuarial life estate table (Eligibility Manual Appendix E) at the member's age at death times fair market value, recovered from the remainderman.", "life_estate_cite": "22 M.R.S. Sec. 14(2-I)(F)(2); MBM Ch. VII Sec. 5.02-10", "lady_bird_deed": "reachable", "lady_bird_deed_note": "If used, a retained life estate with power to convey is a legal interest at death and falls under 'life estate' or 'other arrangement'. No Maine authority recognizing the deed was found.", "lady_bird_deed_cite": "22 M.R.S. Sec. 14(2-I)(F)(2)", "tod_deed": "reachable", "tod_deed_note": "Covered as an 'other arrangement' conveying an asset in which the recipient had a legal interest at death; in addition the TOD act makes the beneficiary liable for allowed claims against the probate estate to the extent provided in 18-C Sec. 6-102 (when the probate estate is insufficient).", "tod_deed_cite": "22 M.R.S. Sec. 14(2-I)(F)(2); 18-C M.R.S. Sec. 6-416, 6-102", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Joint tenancy in real property is expressly excluded from the recovery estate (joint tenancy in personal property is included), and survivorship interests in joint tenancy real estate are also excluded from nonprobate transferee liability.", "joint_tenancy_cite": "22 M.R.S. Sec. 14(2-I)(F)(2); 18-C M.R.S. Sec. 6-102(1)", "revocable_trust": "reachable", "revocable_trust_note": "Living trust assets are expressly included in the recovery estate.", "revocable_trust_cite": "22 M.R.S. Sec. 14(2-I)(F)(2); 18-C M.R.S. Sec. 6-102(3)(B)", "tod_deed_recognized": "yes", "tod_deed_statute": "18-C M.R.S. Sec. 6-401 to 6-420", "tod_deed_effective": "2019-09-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Maine statute, reported case or MaineCare rule found recognizing a life estate with retained power to convey; searched web for Maine enhanced life estate / lady bird deed (secondary sources only).", "hardship_waiver_home": "Hardship waiver for heirs with a beneficial interest who depend on estate assets: a business or working farm that was their sole livelihood, or household income and assets under 180 percent of poverty (denied if lack of income is the only basis and sale of the real property would net over $10,000). If the asset is the home, the applicant must have lived there two or more years before death and contributed significantly to upkeep. Separate care given exemption (applicant under 200 percent of poverty) of up to $32,000 per year for two years of in-home care (MBM Ch. VII Sec. 5.07, 5.08).", "recovery_exemptions_note": "Claim waived if collection costs are likely to exceed recovery (22 M.R.S. Sec. 14(2-I)(E)); ABLE accounts excluded; LTC partnership disregard; claim limited to NF, HCBS and related hospital and drug costs since Nov. 24, 2021; voluntary payment plans for heirs; joint tenancy real estate excluded by statute.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://legislature.maine.gov/statutes/22/title22sec14.html; https://www.maine.gov/sos/sites/maine.gov.sos/files/content/assets/c7s005.docx; https://legislature.maine.gov/statutes/18-C/title18-Cch6sec0.html; https://legislature.maine.gov/statutes/18-C/title18-Csec6-401.html; https://legislature.maine.gov/statutes/18-C/title18-Csec6-416.html; https://legislature.maine.gov/statutes/18-C/title18-Csec6-421.html; https://legislature.maine.gov/statutes/18-C/title18-Csec6-102.html; https://legislature.maine.gov/legis/bills/bills_129th/chapters/PUBLIC417.asp; https://www.medicaid.gov/medicaid/spa/downloads/ME-21-0013.pdf", "confidence": "high", "flags": "TOD act enacted by P.L. 2017, ch. 402 (new Probate Code 18-C); effective date moved from July 1, 2019 to Sept. 1, 2019 by P.L. 2019, ch. 417, Sec. B-14. State plan link is SPA 21-0013 (preprint page 53e, 4.17(b), effective July 1, 2021), not a separate Attachment 4.17-A. Rule notes a further SPA was pending for the disabled child timing rule. P.L. 2021, ch. 398 (services limitation) cited by the rule but not read." }, { "code": "MD", "name": "Maryland", "recovery_scope": "probate_only", "recovery_scope_note": "Statute authorizes a claim 'against the estate of a deceased Program recipient'; the regulation defines estate as property 'included within an individual's estate, as defined for purposes of State probate law'. Maryland also imposes pre-death TEFRA liens: the Department 'shall impose a lien' on real property of a long-term care patient who cannot reasonably be expected to return home, and recovers from the estate or on sale of the liened property (COMAR 10.09.24.15A-2(2), A-3(1)(b)); the manual says the lien also reaches tenancy by the entireties property. No recovery from a surviving spouse's estate provision found.", "recovery_statute": "Md. Code, Health-Gen. Sec. 15-121; COMAR 10.09.24.15A(4), A-2, A-3", "recovery_statute_url": "https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=15-121&enactments=false", "state_plan_4_17_a_url": "https://health.maryland.gov/mmcp/Medicaid%20Manual/Section%201500%20-Liens.pdf", "life_estate": "not_reachable", "life_estate_note": "A life estate ends at death and the remainder is not probate property, so it is outside the probate-law estate. A lifetime TEFRA lien could attach only to the recipient's own interest.", "life_estate_cite": "COMAR 10.09.24.15A(4)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "Outside the probate estate, but if the Department imposed a mandatory pre-death TEFRA lien on the institutionalized owner's real property, whether the lien survives a life estate with powers at death is not addressed in the sources read.", "lady_bird_deed_cite": "COMAR 10.09.24.15A(4), A-2(2), A-3(1)(b)", "tod_deed": "unclear", "tod_deed_note": "TOD property passes outside probate, and the new act has no URPTODA section 15 style creditor liability. But the beneficiary takes subject to all liens at death (Real Prop. Sec. 14-1009(b)), so a TEFRA lien imposed on a permanently institutionalized owner's home would follow the property.", "tod_deed_cite": "COMAR 10.09.24.15A(4), A-2(2); Md. Code, Real Prop. Sec. 14-1007, 14-1009(b) (2026 Md. Laws ch. 750/751)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship property passes outside the probate estate. The manual notes TEFRA liens may be placed on tenancy by the entireties real property during life; effect at death not addressed.", "joint_tenancy_cite": "COMAR 10.09.24.15A(4); MD Medical Assistance Manual Sec. 1500.8(b)", "revocable_trust": "unclear", "revocable_trust_note": "Not probate property, but Maryland Trust Act makes property of a trust revocable at death subject to claims of the settlor's creditors, subject to the Sec. 8-103 presentment limits; whether MDH uses this route was not found.", "revocable_trust_cite": "COMAR 10.09.24.15A(4); Md. Code, Est. & Trusts Sec. 14.5-508(a)(5), (b)", "tod_deed_recognized": "yes", "tod_deed_statute": "Md. Code, Real Prop. Sec. 14-1001 to 14-1014 (Maryland Transfer-on-Death Deed Act); Est. & Trusts Sec. 1-402", "tod_deed_effective": "2026-10-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "case_law", "lady_bird_authority": "Berrett v. Standard Fire Ins. Co., 166 Md. App. 321 (2005) (a life estate may be created with a power in the life tenant to dispose of the property; the remainder is then defeasible), citing Burke v. Burke, 204 Md. 637 (1954); 2026 Md. Laws ch. 750/751 Sec. 2 refers to 'existing law governing life estates with powers of alienation'.", "hardship_waiver_home": "Claim waived for substantial hardship: recovery would force sale of real property and remove a dependent (child or descendant, sibling, or parent or ancestor) who lived there at death, lived there continuously for at least 2 years before death, and cannot provide another residence (COMAR 10.09.24.15A(1), A(10), A-3(3); Health-Gen. Sec. 15-121(b)). TEFRA lien barred or not enforced while a sibling with equity interest (1 year residence) or a caregiver son or daughter (2 years residence) lives in the home.", "recovery_exemptions_note": "No recovery of Medicare premiums, copays or deductibles; LTC partnership benefits protected (COMAR 10.09.24.15A-3(4), (5)). Manual Sec. 1500.5 (rev. July 2012) says no recovery for QMB or SLMB only recipients.", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=15-121&enactments=false; https://dsd.maryland.gov/regulations/Pages/10.09.24.15.aspx; https://www.law.cornell.edu/regulations/maryland/COMAR-10-09-24-15; https://health.maryland.gov/mmcp/Medicaid%20Manual/Section%201500%20-Liens.pdf; https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0738?ys=2026RS; https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/sb0651?ys=2026RS; https://mgaleg.maryland.gov/2026RS/Chapters_noln/CH_751_hb0738e.pdf; https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=get§ion=14.5-508&enactments=false; https://www.peoples-law.org/transfer-death-and-life-estate-deeds; https://caselaw.findlaw.com/court/md-court-of-special-appeals/1390613.html", "confidence": "high", "flags": "TOD deed: 2026 Md. Laws ch. 751 (HB 738) and ch. 750 (SB 651, cross-file), approved May 26, 2026, effective Oct. 1, 2026; applies to TOD deeds made before, on or after that date if the transferor dies on or after it (Sec. 3). Uncodified Sec. 2 directs interpretation consistent with URPTODA, but the act omits a URPTODA Sec. 15 creditor liability section; enrolled title shows the bill was amended from a 'life estate deeds with powers' bill. Karp 2005 probate-only classification still holds. Berrett read via FindLaw WebFetch extraction (not official). Medical Assistance Manual Sec. 1500 is dated July 2012 and says recovery after age 65, conflicting with COMAR age 55; column holds manual URL because no Attachment 4.17-A was found. No 2024 to 2026 amendment to Health-Gen. Sec. 15-121 found." }, { "code": "MA", "name": "Massachusetts", "recovery_scope": "probate_only", "recovery_scope_note": "\"Estate\" means all real and personal property and other assets includable in the decedent's probate estate under the General Laws (c. 118E Sec. 31(c)); the regulation repeats this (130 CMR 515.011(A)(2)). For deaths on or after Aug. 1, 2024, recovery is limited to the federally mandated minimum: permanently institutionalized members of any age, and for age 55 and over only nursing facility, home and community-based and related hospital and drug services (Sec. 31(b 1/2), added by St. 2024, c. 197, Secs. 20 to 21). CommonHealth and PCA costs are exempt, subject to federal approval (Sec. 31(e)). The state uses lifetime liens (TEFRA type) on real property under c. 118E Sec. 34, repayable on sale during life (Sec. 31(d)). No recovery from the surviving spouse's estate found in the statute.", "recovery_statute": "M.G.L. c. 118E Sec. 31", "recovery_statute_url": "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter118E/Section31", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/MA-21-0017.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder is not part of the probate estate, which is the only estate MassHealth can recover from. A lifetime lien recorded under Sec. 34 before the transfer could still bind the property.", "life_estate_cite": "M.G.L. c. 118E Sec. 31(c); 130 CMR 515.011(A)(2)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Massachusetts statute or case recognizing a life estate deed with a retained power to sell was found. If such a deed were valid, the remainder would pass outside probate and outside the probate-only claim.", "lady_bird_deed_cite": "M.G.L. c. 118E Sec. 31(c)", "tod_deed": "n/a", "tod_deed_note": "Massachusetts has no transfer-on-death deed statute for real property; no enacted TOD deed act was found.", "tod_deed_cite": "", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The decedent's interest passes to the surviving joint tenant by survivorship, outside the probate estate that defines the recovery estate.", "joint_tenancy_cite": "M.G.L. c. 118E Sec. 31(c)", "revocable_trust": "reachable", "revocable_trust_note": "Although recovery is probate-only, property of a trust revocable at the settlor's death is subject to claims of the settlor's creditors to the extent the probate estate is inadequate, which plausibly lets the MassHealth claim reach a house in a revocable trust.", "revocable_trust_cite": "M.G.L. c. 203E Sec. 505(a)(3); c. 118E Sec. 31(c)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No primary authority found. Searched for Massachusetts statutes, cases and MassHealth rules on life estate deeds with a retained power to sell; only practitioner pages were found, which say MassHealth treats such a reserved power like a revocable trust for eligibility (130 CMR 520.022 counts revocable trust assets), not verified in a primary source.", "hardship_waiver_home": "Waivers for claims on or after May 14, 2021: (1) residence and financial hardship: sale of real property needed to pay the claim, and an heir who lived there continuously 2 years before institutionalization or death, still lives there, inherited an interest, is not forced to sell, and has family income at or below 133% FPL; (2) care provided: heir or devisee who lived in the home 2 years, gave care that avoided facility admission, still lives there and inherited an interest by will or intestacy; (3) income based: heirs under 400% FPL, up to $50,000 per heir (130 CMR 515.011(D); State Plan Att. 4.17-A, TN 21-0017). During life, lien repayment is deferred while a sibling (1 year prior residence) or caregiver child (2 years) lives in the home (c. 118E Sec. 31(d)).", "recovery_exemptions_note": "No recovery where the probate petition certifies total estate assets of $25,000 or less, for deaths on or after May 14, 2021 (130 CMR 515.011(B)(2)). Long-term-care insurance exception (130 CMR 515.011(B)(1)). Premiums paid after age 55 offset the claim for deaths on or after Dec. 31, 2016 (515.011(A)(1)(c)). For deaths on or after Aug. 1, 2024, only federally mandated services are recovered; CommonHealth and PCA costs exempt subject to federal approval (c. 118E Sec. 31(b 1/2), (e)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/ma/part-i-administration-of-the-government-ch-1-182/ma-gen-laws-ch-118e-sect-31/; https://www.law.cornell.edu/regulations/massachusetts/130-CMR-515-011; https://www.law.cornell.edu/regulations/massachusetts/130-CMR-520-022; https://codes.findlaw.com/ma/part-ii-real-and-personal-property-and-domestic-relations-ch-183-210/ma-gen-laws-ch-203e-sect-505/; https://www.medicaid.gov/medicaid/spa/downloads/MA-21-0017.pdf; https://massnaela.com/wp-content/uploads/2024/09/Summary-of-estate-recovery-in-the-LTC-Act-9.10.24.pdf; https://www.masslegalservices.org/content/summary-masshealth-estate-recovery-changes-2024", "confidence": "medium", "flags": "malegislature.gov timed out and Justia returned 403, so statute text is from the FindLaw copy (current as of Jan. 1, 2025) and the regulation from the LII copy; hence medium. 2024 amendment: St. 2024, c. 197 (Long-Term Care Act), signed Sept. 6, 2024, effective Dec. 5, 2024, applies to deaths on or after Aug. 1, 2024 (session law details from MLRI/MassNAELA summary, not the session law itself). The LII copy of 130 CMR 515.011(A)(1) still describes the pre-2024 scope (all services after 55). State Plan TN 21-0017 item 9 still describes notice procedures for non-probate assets in which the member had legal title or interest, apparently a remnant of the brief 2003 expansion that secondary sources say was repealed in 2004; statute and regulation both limit the estate to probate. The 2003 expansion and 2004 repeal were not verified in session laws. TOD deed absence and lady bird status rest on search, not a primary negative source. Note for coordinator: data/sources/ULC-urptoda.txt was accidentally overwritten by this researcher and refetched from the ULC community page (enactment list is JS-loaded and not captured)." }, { "code": "MI", "name": "Michigan", "recovery_scope": "probate_only", "recovery_scope_note": "\"Estate\" means property and assets in the estate subject to probate administration under article III of EPIC (MCL 700.3101 to 700.3988), and assets otherwise subject to claims under MCL 700.3805(3) (revocable trusts and other nonprobate transfers liable for a probate deficiency) are expressly not part of the estate (MCL 400.112h(a)). The Michigan Supreme Court read the program as limited to the probate estate, so avoiding probate avoids recovery (In re Rasmer Estate, 501 Mich 18 (2017)). The program (MMERP, 2007 PA 74) was approved by CMS in May 2011, effective July 1, 2010, and implemented July 1, 2011 (Rasmer). No TEFRA liens (MCL 400.112g(9); State Plan Att. 4.17-A). Recovery from a spouse's estate is left to CMS approval (MCL 400.112g(3)(c)); none found in the state plan. The state plan adds an expanded (1396p(b)(4)(B)) definition only for decedents with Long-Term Care Partnership asset disregards.", "recovery_statute": "MCL 400.112g to 400.112k (definition in MCL 400.112h)", "recovery_statute_url": "https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-400-112h", "state_plan_4_17_a_url": "https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/MI/MI-16-0005.pdf", "life_estate": "not_reachable", "life_estate_note": "The life estate ends at death and the remainder passes outside probate administration, which is the only estate the program reaches. Exception in the state plan: decedents who received Long-Term Care Partnership asset disregards.", "life_estate_cite": "MCL 400.112h(a); State Plan Att. 4.17-A item 3 (TN 16-0005)", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "The home passes to the remainder beneficiaries at death without probate, and recovery is limited to the probate estate; the Supreme Court named Lady Bird deeds as a probate-avoidance method that avoids the program.", "lady_bird_deed_cite": "MCL 400.112h(a); In re Rasmer Estate, 501 Mich 18 (2017), slip op. p. 23 and n. 18", "tod_deed": "n/a", "tod_deed_note": "Michigan has no transfer-on-death deed statute for real property; none found enacted through 2026. The state plan lists TOD deeds only inside the Partnership-only expanded definition.", "tod_deed_cite": "", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship property passes to the surviving joint owner outside probate administration, so it is outside the recovery estate (except for Partnership-policy decedents under the state plan).", "joint_tenancy_cite": "MCL 400.112h(a); State Plan Att. 4.17-A item 3", "revocable_trust": "not_reachable", "revocable_trust_note": "Unlike most probate-only states, Michigan's definition expressly excludes assets that are subject to claims only through MCL 700.3805(3), which is the route that makes revocable trust property (MCL 700.7605) liable when the probate estate is short.", "revocable_trust_cite": "MCL 400.112h(a); MCL 700.3805(3); MCL 700.7605(1)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "case_law", "lady_bird_authority": "No statute creates it. In re Rasmer Estate, 501 Mich 18 (2017), n. 18 (describing Lady Bird deeds as a probate-avoidance tool, citing Black's Law Dictionary) and Bill & Dena Brown Trust v Garcia, 312 Mich App 684, 687 n 2 (2015) (describing a Lady Bird deed). Recognition is by description in dicta and long practice, not a holding on validity. MDHHS manuals BEM 400 and 405 (2026) treat life estates but do not mention Lady Bird deeds.", "hardship_waiver_home": "Statute requires a hardship exemption for the portion of the homestead value up to 50% of the average home price in the county at death, and for the primary income-producing asset of survivors such as a family farm or business, with a presumption of no hardship if assets were diverted to avoid recovery (MCL 400.112g(3)(e)). The state plan adds a means test (income under 200% FPL, resources up to $10,000) and a discretionary exemption for a survivor who lived in the home 2 years before death and gave care that kept the recipient out of an institution. No recovery from the home while a spouse, child under 21 or blind or disabled, caretaker relative (2 years' residence and care) or sibling with an equity interest (1 year) lawfully resides there (MCL 400.112g(6)).", "recovery_exemptions_note": "No recovery when costs exceed the recovery or it is not in the state's economic interest (MCL 400.112g(4)); no interest charged (MCL 400.112g(8)); no TEFRA liens (MCL 400.112g(9)). State plan recovers all services for recipients 55 and over except Medicare cost-sharing. Program applies to recipients who began benefits after Sept. 30, 2007, with recovery for amounts paid from July 1, 2010 (Rasmer).", "karp_2005_scope": "not_in_survey", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/mi/chapter-400-social-services/mi-comp-laws-400-112g.html; https://codes.findlaw.com/mi/chapter-400-social-services/mi-comp-laws-400-112h.html; https://codes.findlaw.com/mi/chapter-700-estates-and-protected-individuals-code/mi-comp-laws-700-7605.html; https://codes.findlaw.com/mi/chapter-700-estates-and-protected-individuals-code/mi-comp-laws-700-3805.html; https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/MI/MI-16-0005.pdf; https://www.courts.michigan.gov/49f49a/siteassets/case-documents/opinions-orders/msc-term-opinions-(manually-curated)/16-17/153356.pdf; https://mdhhs-pres-prod.michigan.gov/olmweb/EX/BP/Public/BEM/405.pdf; https://mdhhs-pres-prod.michigan.gov/olmweb/EXF/BP/Public/BEM/400.pdf; https://www.plunkettcooney.com/tax-law-estate-plans-probate-business-succession/Michigan-lady-bird-deed", "confidence": "medium", "flags": "legislature.mi.gov failed TLS certificate verification and Justia returned 403, so statute text is from FindLaw copies (current as of Jan. 1, 2025) via WebFetch; the state plan and Rasmer independently quote the probate-only definition. State plan TN 16-0005 (effective Jan. 1, 2016) says that for Long-Term Care Partnership decedents the estate includes non-probate assets (joint tenancy, life estate, living trust, TOD deed); this expansion was not seen in the FindLaw text of MCL 400.112h. No 2024 to 2026 estate recovery or TOD deed act found; bill search on the legislature site was not possible. Lady bird recognition rests on dicta, not a holding." }, { "code": "MN", "name": "Minnesota", "recovery_scope": "expanded", "recovery_scope_note": "Sec. 256B.15, subd. 1a(b) defines the estate as the probate estate plus real property held as life tenant or joint tenant with right of survivorship, beneficiary-form securities and multiple-party accounts (to the extent they become part of the probate estate), and 'assets conveyed to a survivor, heir, or assign of the person through survivorship, living trust, transfer-on-death of title or deed, or other arrangements'. Life estate and joint tenancy interests continue after death for recovery (subd. 1, 1f to 1j), but only for interests established on or after Aug. 1, 2003 (subd. 1(d)). Minnesota also files claims in the surviving spouse's estate (subd. 1a(a), (c); subd. 2b). Pre-death real property liens under Secs. 514.980 to 514.985 and post-death notices of potential claim that become 20-year liens (subd. 1c, 1f) are used.", "recovery_statute": "Minn. Stat. Sec. 256B.15", "recovery_statute_url": "https://www.revisor.mn.gov/statutes/cite/256B.15", "state_plan_4_17_a_url": "https://hcopub.dhs.state.mn.us/hcpmstd/19_50.htm", "life_estate": "reachable", "life_estate_note": "A retained life estate established on or after Aug. 1, 2003 does not end at death for recovery purposes; the estate's share is the life estate value from the Life Estate Mortality Table at the recipient's age at death, and the court can compel remainderpersons to liquidate it.", "life_estate_cite": "Minn. Stat. Sec. 256B.15, subd. 1(a)(3), (d); subd. 1a(b)(2); subd. 1g; subd. 1h(b); subd. 1i(c)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Minnesota authority for the enhanced life estate deed was found. If used, the grantor holds at least a life estate, which is in the recovery estate, and 'other arrangements' passing assets at death are also included.", "lady_bird_deed_cite": "Minn. Stat. Sec. 256B.15, subd. 1a(b)(2), (5)", "tod_deed": "reachable", "tod_deed_note": "The recovery estate expressly includes property passing by transfer on death deed, and the TOD act makes the beneficiary liable to account to the state or county for a Sec. 256B.15 claim left unpaid by the estate, up to the value received. The beneficiary must record a county clearance certificate.", "tod_deed_cite": "Minn. Stat. Sec. 256B.15, subd. 1a(b)(5), subd. 1i(a); Sec. 507.071, subd. 3, 20, 23", "joint_tenancy": "reachable", "joint_tenancy_note": "A joint tenancy interest established on or after Aug. 1, 2003 continues after death, valued as the recipient's fractional share as if held in common. Exception: a homestead held in joint tenancy with the surviving spouse who lives there is not continued.", "joint_tenancy_cite": "Minn. Stat. Sec. 256B.15, subd. 1(a)(3), (6), (d); subd. 1a(b)(2), (5); subd. 1h(b)", "revocable_trust": "reachable", "revocable_trust_note": "Assets passing through a living trust are listed in the statutory estate. DHS says revocable or irrevocable does not matter if the recipient funded the trust and was a beneficiary.", "revocable_trust_cite": "Minn. Stat. Sec. 256B.15, subd. 1a(b)(5); DHS MA Estate Recovery Manual SRU-020103", "tod_deed_recognized": "yes", "tod_deed_statute": "Minn. Stat. Sec. 507.071", "tod_deed_effective": "2008-08-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No statute, reported case, title standard or DHS manual provision recognizing a life estate deed with a retained power to sell without the remainder's consent was found. The DHS eligibility manual (EPM 2.3.3.2.7.4.3) says a life estate owner cannot sell the property or the remainder. Web searches returned only practitioner and form sites. Sec. 507.071, subd. 17 preserves other methods of postponing ownership until death.", "hardship_waiver_home": "Any person entitled to notice may seek full or partial waiver for undue hardship (subd. 5). If a hardship waiver is approved and a non-spouse co-owner has lived in the home for at least 180 days before death and it is their tax homestead, recovery is deferred until they leave or the property is sold or transferred (subd. 5(b)). The DHS manual lists as factors a homestead the applicant has occupied as the only dwelling for 180 days, and income-producing assets such as a working farm that is the applicant's sole livelihood.", "recovery_exemptions_note": "Claims are filed but deferred while a surviving spouse or a child under 21, blind or disabled lives (subd. 1i(f), 3). A sibling with 1 year of prior residence, or a child or grandchild who lived there 2 years and gave care that delayed institutionalization: claim paid first from nonhomestead property, with a lien on the homestead not enforced while they live there (subd. 4; subd. 1j(d)). Medicare cost sharing excluded (subd. 1(c)). State-funded Alternative Care is recovered (subd. 1(b), 2(a)). The state also recovers from the non-recipient surviving spouse's estate, limited to marital or jointly owned property (subd. 2(b)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.revisor.mn.gov/statutes/cite/256B.15; https://www.revisor.mn.gov/laws/2026/0/88/; https://www.revisor.mn.gov/laws/2017/0/46/; https://www.revisor.mn.gov/statutes/cite/507.071; https://www.revisor.mn.gov/laws/2008/0/341/; https://www.revisor.mn.gov/laws/2024/0/91/; https://hcopub.dhs.state.mn.us/hcpmstd/19_50.htm; https://hcopub.dhs.state.mn.us/epm/2_3_3_2_7_4_3.htm; https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=SRU-020103", "confidence": "high", "flags": "2026 c. 88, art. 1, sec. 128 (S.F. 4244, signed 2026-05-12, revisor's technical corrections bill) amended only subd. 1h(f), changing the partition cross-reference from ch. 558 to ch. 558A; no substantive change to recovery scope. 2017 c. 46 removed the 'on or after January 1, 2014' limits from subd. 1a(e) and 2. Pre-Aug. 2003 life estates and joint tenancies are outside the continuation rules (subd. 1(d), 7). In re Estate of Barg, 752 N.W.2d 52 (Minn. 2008) reportedly held subd. 2 preempted in part for recovery from a surviving spouse's estate (secondary sources only; not read). DHS estate recovery manual page read only via WebFetch (Radware CAPTCHA to scripts). TOD act amended 2024 c. 91 and 2025 c. 38 (technical and insurance changes; creditor subd. 3 still names Sec. 256B.15). Attachment 4.17-A not found; the state_plan column holds the DHS manual section. TOD deed effective date detail: 2008-08-01, Laws 2008, ch. 341, art. 2, sec. 5; applies to deeds recorded on or after that date." }, { "code": "MS", "name": "Mississippi", "recovery_scope": "probate_only", "recovery_scope_note": "The Division of Medicaid is noticed as a creditor against the estate of the deceased recipient under the probate claim statute, Sec. 91-7-145, and recovers 'in accordance with applicable federal law' (Sec. 43-13-317(1), (2)). The statute does not define estate or adopt the expanded federal option; In re Estate of Darby, 68 So. 3d 702 (Miss. Ct. App. 2011), held it does not expand the definition, so recovery reaches assets passing through probate. Homestead that descends to a surviving spouse, children or grandchildren passes free of the decedent's debts under Sec. 91-1-19 and 91-1-21 and is not reachable (Darby). The state plan says Mississippi has no lien law, so no TEFRA liens. The claim is waived outright if there is a surviving spouse, so there is no later recovery from the spouse's estate.", "recovery_statute": "Miss. Code Ann. Sec. 43-13-317 (as amended by SB 2396, Laws 2025, ch. 362)", "recovery_statute_url": "https://billstatus.ls.state.ms.us/documents/2025/html/SB/2300-2399/SB2396SG.htm", "state_plan_4_17_a_url": "https://medicaid.ms.gov/wp-content/uploads/2014/01/Attachment_4.17-A.pdf", "life_estate": "not_reachable", "life_estate_note": "The life estate ends at death and the remainder passes outside probate. The Medicaid rule also states that ownership of life estate interests is not subject to estate recovery.", "life_estate_cite": "Miss. Code Ann. Sec. 43-13-317; 23 Miss. Admin. Code Pt. 306, R. 1.8(D); Pt. 103, R. 2.5(B)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Mississippi authority for a life estate deed with a retained power to sell was found. If valid, the remainder would pass outside probate and outside the probate claim, and the rule excludes life estate interests, but its status is untested.", "lady_bird_deed_cite": "Miss. Code Ann. Sec. 43-13-317; 23 Miss. Admin. Code Pt. 306, R. 1.8(D)", "tod_deed": "not_reachable", "tod_deed_note": "The TOD property passes to the beneficiary outside probate. Mississippi's act omits the uniform act's creditor liability section: the beneficiary takes subject only to liens and interests existing at the transferor's death, and Mississippi has no Medicaid lien law.", "tod_deed_cite": "Miss. Code Ann. Sec. 91-27-29 (SB 2851, Laws 2020, Sec. 15); Sec. 43-13-317; Attachment 4.17-A item 1", "joint_tenancy": "not_reachable", "joint_tenancy_note": "On a joint tenant's death the survivor becomes sole owner by survivorship, outside the probate estate the Medicaid claim is filed against. The rule and state plan define estate property to include property owned by 'shared ownership', but recovery is still by a probate creditor claim and Darby says the estate is not expanded.", "joint_tenancy_cite": "Miss. Code Ann. Sec. 43-13-317(1); 23 Miss. Admin. Code Pt. 103, R. 2.3(A)(2); Pt. 306, R. 1.8(D); In re Estate of Darby, 68 So. 3d 702 (Miss. Ct. App. 2011)", "revocable_trust": "unclear", "revocable_trust_note": "The Medicaid rule says property transferred into a trust is not subject to estate recovery. But since July 1, 2020, property of a trust that was revocable at the settlor's death is subject to claims of the settlor's creditors (Sec. 91-8-504(a)(6)), so a Medicaid creditor claim could arguably reach it. No text reconciling the two was found.", "revocable_trust_cite": "23 Miss. Admin. Code Pt. 306, R. 1.8(D); Miss. Code Ann. Sec. 91-8-504(a)(6) (SB 2851, Laws 2020, Sec. 62)", "tod_deed_recognized": "yes", "tod_deed_statute": "Miss. Code Ann. Sec. 91-27-1 to 91-27-37 (Mississippi Real Property Transfer-On-Death Act)", "tod_deed_effective": "2020-07-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Mississippi statute, reported case or Division of Medicaid rule recognizing an enhanced life estate deed was found. The Medicaid resource rule (Pt. 103, R. 2.5(B)) covers ordinary and conditional life estates only. Web searches returned only secondary pages.", "hardship_waiver_home": "Undue hardship exempts recovery where a blood relative lived in the home at least one continuous year before the recipient entered a nursing facility or HCBS waiver, gave care that delayed or avoided nursing facility entry, and has no other residence; or the property is a family income source such as a family farm (Pt. 306, R. 1.8(H)). The 1995 state plan also lists an estate of $5,000 or less with no burial funds and an estate of modest value.", "recovery_exemptions_note": "State additions: the claim is waived, not just deferred, if there is a surviving spouse or a surviving dependent child under 21 or blind or disabled (Sec. 43-13-317(2); the rule adds 'living in the home'). Recovery is limited to nursing facility, HCBS and related hospital and drug services for recipients 55 or older. Homestead descending to spouse, children or grandchildren is exempt (Darby). Mississippi ABLE accounts are excluded from July 1, 2025 (Sec. 43-13-317(3)). American Indian and Alaska Native trust and reservation property is exempt (R. 1.8(I)). Recovery is not pursued below $2,000 where protracted litigation is needed (state plan).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://billstatus.ls.state.ms.us/documents/2025/html/SB/2300-2399/SB2396SG.htm; https://billstatus.ls.state.ms.us/2025/pdf/history/SB/SB2396.xml; https://billstatus.ls.state.ms.us/documents/2020/html/SB/2800-2899/SB2851SG.htm; https://medicaid.ms.gov/medicaid-coverage/member-services/estate-recovery/; https://medicaid.ms.gov/wp-content/uploads/2023/09/Title-23-Part-306-Third-Party-Recovery-eff.-9.1.23.pdf; https://medicaid.ms.gov/wp-content/uploads/2025/12/Title-23-Part-103-Resources-eff-12.01.25.pdf; https://medicaid.ms.gov/wp-content/uploads/2014/01/Attachment_4.17-A.pdf; https://courts.ms.gov/Images/Opinions/CO67682.pdf; https://medicaid.ms.gov/providers/administrative-code/", "confidence": "high", "flags": "Statute text read from the official legislature session laws (SB 2396 of 2025 for Sec. 43-13-317; SB 2851 of 2020 for the TOD act and Sec. 91-8-504), not from a codified compilation (Justia and FindLaw returned 403). Bill status code-section lists show no other enacted change to Sec. 43-13-317, 91-27-29 or 91-8-504 from 2021 to 2026. Revocable trust: conflict between R. 1.8(D) (trust property not subject to recovery) and Sec. 91-8-504(a)(6) (revocable trust liable for settlor's creditors after death). Joint tenancy: rule's 'shared ownership' wording could be read to reach survivorship property; no case found. TOD act follows the URPTODA structure but its short title omits 'Uniform' and it omits the uniform creditor section 15; the 2020 'Uniform' bill (HB 729) died; ULC list not checked. The statute waives recovery for any surviving spouse or dependent, while the rule requires them to be living in the home. The state plan on the DOM site is the 1995 version (TN 95-13). TOD deed effective date detail: 2020-07-01, SB 2851, 2020 Regular Session, Sec. 1 to 19 and 92." }, { "code": "MO", "name": "Missouri", "recovery_scope": "probate_only", "recovery_scope_note": "Sec. 473.398.1 makes Medicaid paid a debt due 'from the estate of the decedent', collected under the probate code (chs. 472 to 475), and no statute adopts the expanded federal definition. But the Nonprobate Transfers Law lets a creditor sue recipients of nonprobate transfers for claims the probate estate cannot pay (Sec. 461.300), and the court of appeals held the State may use Sec. 461.300 for Medicaid estate recovery (Jones, 2009). So beneficiary deeds, joint tenancy and revocable trusts are reachable through that route, but a plain life estate is not. Sec. 473.399 claims against the surviving spouse's estate were held preempted by federal law (In re Estate of Bruce, 260 S.W.3d 398 (Mo. App. W.D. 2008)). TEFRA liens are used for permanently institutionalized recipients (DSS memo IM-42, 2013).", "recovery_statute": "Mo. Rev. Stat. Sec. 473.398; Sec. 461.300", "recovery_statute_url": "https://revisor.mo.gov/main/OneSection.aspx?section=473.398", "state_plan_4_17_a_url": "https://dssmanuals.mo.gov/mo-healthnet-for-the-aged-blind-and-disabled/0880-000-00/0880-005-00/", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder was conveyed during life, so nothing passes through the probate estate or by a nonprobate transfer at death. No Missouri statute continues the life estate for recovery.", "life_estate_cite": "Mo. Rev. Stat. Sec. 473.398.1; Sec. 461.300.10(4)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Missouri authority for the enhanced life estate deed was found. The home passes outside probate, but if the grantor's retained power to sell made it subject to the grantor's debts before death, it could be a 'recoverable transfer' under Sec. 461.300; no case decides this.", "lady_bird_deed_cite": "Mo. Rev. Stat. Sec. 461.300.1, .10(4); Sec. 461.025.2", "tod_deed": "reachable", "tod_deed_note": "A beneficiary deed is a nonprobate transfer under Secs. 461.003 to 461.081, so the beneficiary must account for unpaid estate claims. Jones (2009) applied this to a home passed by beneficiary deed to recover Medicaid. The action must be brought within 18 months of death.", "tod_deed_cite": "Mo. Rev. Stat. Sec. 461.025; Sec. 461.300.1, .2, .10(4); State v. Knight (In re Estate of Jones), No. WD 69310 (Mo. App. W.D. Jan. 13, 2009)", "joint_tenancy": "reachable", "joint_tenancy_note": "The survivor of a joint tenancy that was subject to the decedent's debts before death must account under Sec. 461.300, but only to the extent of the decedent's contribution to its value, and only for claims the probate estate cannot pay.", "joint_tenancy_cite": "Mo. Rev. Stat. Sec. 461.300.1, .8", "revocable_trust": "reachable", "revocable_trust_note": "Revocable trust property is subject to the settlor's creditors during life, so trust recipients must account under Sec. 461.300 for unpaid claims. The trustee can cut this off by publishing a notice to creditors; claims not presented within 6 months are barred.", "revocable_trust_cite": "Mo. Rev. Stat. Sec. 461.300.8; Sec. 456.5-505", "tod_deed_recognized": "yes", "tod_deed_statute": "Mo. Rev. Stat. Sec. 461.025 (beneficiary deed)", "tod_deed_effective": "1989-08-28", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Missouri statute, reported case or MO HealthNet rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Sec. 461.025.2 says the beneficiary deed statute does not preclude other lawful conveyances that postpone enjoyment until the owner's death.", "hardship_waiver_home": "By statute, no claim is filed or allowed if collection would adversely affect the surviving spouse's or dependents' need for reasonable care and support from the estate, or if collection costs exceed the claim (Sec. 473.398.3). No home-specific hardship rule (modest homestead, caregiver child) was found in the statute or the DSS manual.", "recovery_exemptions_note": "MO HealthNet claim is paid after administration costs, exempt property, family and homestead allowances and funeral expenses (DSS manual 0880.005.00, citing Sec. 473.397). A probate estate of a MO HealthNet enrollee cannot close without an MHD release (Sec. 473.398.6). No recovery for QMB or SLMB only (DSS manual 0880.005.00).", "karp_2005_scope": "not_in_survey", "last_verified": "2026-09-23", "sources": "https://revisor.mo.gov/main/OneSection.aspx?section=473.398; https://revisor.mo.gov/main/OneSection.aspx?section=473.399; https://revisor.mo.gov/main/OneSection.aspx?section=461.300; https://revisor.mo.gov/main/OneSection.aspx?section=461.025; https://revisor.mo.gov/main/OneSection.aspx?section=461.005; https://revisor.mo.gov/main/OneSection.aspx?section=461.081; https://revisor.mo.gov/main/OneSection.aspx?section=456.5-505; https://dssmanuals.mo.gov/mo-healthnet-for-the-aged-blind-and-disabled/0880-000-00/0880-005-00/; https://dssmanuals.mo.gov/wp-content/themes/mogovwp_dssmanuals/public/memos/memos_13/im42_13.html; https://caselaw.findlaw.com/court/mo-court-of-appeals/1486940.html; https://www.senate.mo.gov/BillTracking/Bills/BillInformation?year=2026&billid=5550732", "confidence": "high", "flags": "Classified probate_only because the recovery statute reaches only the probate estate, but the Sec. 461.300 accounting route makes TOD, joint tenancy and revocable trust property reachable in practice; popular lists that say Missouri cannot reach a beneficiary deed are wrong. The Jones opinion was read only through a WebFetch summary; the revisor annotation cites it as 280 S.W.3d 647 and marks it 'Mo.banc', while FindLaw shows a Western District opinion (WD 69310, Jan. 13, 2009). Bruce and Shuh (2008) come from revisor annotations only. The DSS manual calls the Medicaid debt a class 7 claim under Sec. 473.397, while Sec. 473.398.2 says sixth or eighth class. 2026 SB 1683 (would have limited recovery, added a $50,000 small-estate exemption, and repealed TEFRA liens for deaths on or after Aug. 28, 2026) shows a last action of referral to the Senate Families, Seniors and Health Committee, so it appears not to have passed. Attachment 4.17-A not found; the state_plan column holds the DSS manual section. Karp 2005 did not survey Missouri. TOD deed effective date detail: 1989-08-28, L. 1989 H.B. 145; Sec. 461.081 applies the Nonprobate Transfers Law to designations made on and after Aug. 28, 1989." }, { "code": "MT", "name": "Montana", "recovery_scope": "expanded", "recovery_scope_note": "MCA Sec. 53-6-167(1) requires a claim against the probate estate, and Sec. 53-6-167(2) and (5)(a) let the department claim against anyone who received property of the recipient 'by distribution or survival', defined as any real or personal property in which the recipient had any right, title, or interest immediately before death, expressly including joint tenancy, right of survivorship, conveyance subject to life estate, and living trust. Action under (2) must be brought within 3 years of the later of death or closing of the estate (Sec. 53-6-167(4)(b)). Montana also imposes TEFRA-type liens on real property of permanently institutionalized recipients, and the DPHHS brochure states recovery may be made from the surviving spouse's estate, limited to property the spouse received from the recipient.", "recovery_statute": "MCA Sec. 53-6-167", "recovery_statute_url": "https://mca.legmt.gov/bills/mca/title_0530/chapter_0060/part_0010/section_0670/0530-0060-0010-0670.html", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "Statute lists property passing through 'conveyance by the recipient subject to life estate' as property received by survival, so the remainder interest can be pursued against the remainder holder.", "life_estate_cite": "MCA Sec. 53-6-167(2), (5)(a)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Montana primary authority recognizing the deed was found; if used, the recipient's retained life estate and power over the property are an 'interest immediately prior to the time of death' and a 'conveyance subject to life estate', both within the recovery definition.", "lady_bird_deed_cite": "MCA Sec. 53-6-167(5)(a)", "tod_deed": "reachable", "tod_deed_note": "Transferor keeps full ownership until death, so the house is property in which the recipient had title immediately before death that passes to a beneficiary by 'other arrangement'. Separately, Sec. 72-6-414 makes the TOD beneficiary liable for allowed claims against the probate estate to the extent provided in Sec. 72-6-112.", "tod_deed_cite": "MCA Sec. 53-6-167(5)(a); MCA Sec. 72-6-414; MCA Sec. 72-6-112", "joint_tenancy": "reachable", "joint_tenancy_note": "Statute expressly names joint tenancy and right of survivorship; DPHHS brochure gives worked examples recovering the decedent's share from a surviving joint tenant.", "joint_tenancy_cite": "MCA Sec. 53-6-167(5)(a)", "revocable_trust": "reachable", "revocable_trust_note": "Statute expressly names 'living trust'; Sec. 72-6-112 also makes a trustee of a revocable trust liable for probate estate claims when the estate is insufficient.", "revocable_trust_cite": "MCA Sec. 53-6-167(5)(a); MCA Sec. 72-6-112(3)(b)", "tod_deed_recognized": "yes", "tod_deed_statute": "MCA Sec. 72-6-401 to 72-6-418 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2019-10-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Montana statute, case, or DPHHS rule recognizing an enhanced life estate deed was found (searched MCA, DPHHS estate recovery materials, web). Secondary sites say Montana does not recognize it; not verified in primary sources.", "hardship_waiver_home": "ARM 37.82.431(4): undue hardship if heir depends on a business including a working farm or ranch for sole livelihood; if an aged, blind or disabled relative lived continuously in the decedent's home 1 year or more before death, still lives there, and would have significant difficulty finding other housing or financing; if a relative lived in the home 1 year or more and has no other shelter; or if property is needed for necessities. No hardship if created by estate planning to avoid recovery (ARM 37.82.431(5)). Statutory basis MCA Sec. 53-6-167(8).", "recovery_exemptions_note": "DPHHS brochure: no recovery from Tribal trust property or income from it, and no lien on Tribal trust property. Department may waive recovery that is not cost-effective (MCA Sec. 53-6-167(7)). Recovery reduced by value of property already penalized as a transfer under MCA Sec. 53-6-166 (Sec. 53-6-167(2)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://mca.legmt.gov/bills/mca/title_0530/chapter_0060/part_0010/section_0670/0530-0060-0010-0670.html; https://mca.legmt.gov/bills/mca/title_0720/chapter_0060/part_0040/sections_index.html; https://mca.legmt.gov/bills/mca/title_0720/chapter_0060/part_0040/section_0010/0720-0060-0040-0010.html; https://mca.legmt.gov/bills/mca/title_0720/chapter_0060/part_0040/section_0140/0720-0060-0040-0140.html; https://mca.legmt.gov/bills/mca/title_0720/chapter_0060/part_0040/section_0170/0720-0060-0040-0170.html; https://mca.legmt.gov/bills/mca/title_0720/chapter_0060/part_0010/section_0120/0720-0060-0010-0120.html; https://mca.legmt.gov/bills/mca/title_0720/chapter_0060/part_0010/section_0210/0720-0060-0010-0210.html; https://www.law.cornell.edu/regulations/montana/Mont-Admin-r-37.82.431; https://dphhs.mt.gov/assets/sltc/ADRC/sltc011mtmedicaidlienestaterecoveryprog.pdf", "confidence": "high", "flags": "Coordinator hint MCA 72-6-121 is repealed (Sec. 105, Ch. 313, L. 2019); current TOD deed law is MCA Part 72-6-4. Effective date Oct 1, 2019 inferred from MCA Sec. 72-6-417 (beneficiary deeds recorded before Oct 1, 2019 deemed TOD deeds); session law not read. Recovery statute last amended Ch. 153, L. 2009; no 2024 to 2026 amendment shown in MCA 2025. Spouse estate recovery and liens described from DPHHS brochure (undated), statute sections not read. ARM 37.82.431 read via Cornell LII copy (rules.mt.gov returned no text). State plan 4.17-A not found. TOD deed effective date detail: 2019-10-01, Ch. 313, L. 2019); earlier beneficiary deed statute MCA Sec. 72-6-121 enacted Ch. 258, L. 2007, repealed 2019." }, { "code": "NE", "name": "Nebraska", "recovery_scope": "expanded", "recovery_scope_note": "Estate means any real estate, personal property or other asset in which the recipient had any legal title or interest at or immediately before death, and expressly includes assets passing through joint tenancy, tenancy in common, transfer on death deed, survivorship, remainder conveyance, retained life estate, living trust, revocable trust, insurance, annuities and retirement accounts (Neb. Rev. Stat. Sec. 68-919(4)(b)(i)). Exclusions: retained life estate deeds recorded before Aug. 24, 2017, life estate interests more than 60 months after the deed was recorded (12 months with a caregiver relative), burial funds, and federally exempt pensions (Sec. 68-919(4)(b)(ii)). The debt arises during life but is held in abeyance until death; DHHS may not foreclose a lien on the home while a qualifying sibling or caregiver adult child lives there (Sec. 68-919(2)). Recovery waits until the surviving spouse dies; assets designated for the community spouse are shielded from recovery for later assistance (Sec. 68-923(4)).", "recovery_statute": "Neb. Rev. Stat. Sec. 68-919; 471 Neb. Admin. Code ch. 38", "recovery_statute_url": "https://nebraskalegislature.gov/laws/statutes.php?statute=68-919", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The estate includes assets transferred through retention of a life estate or conveyance of a remainder. But the statute excludes deeds recorded before Aug. 24, 2017 and life estate interests more than 60 months after the deed was recorded (12 months if a caregiver relative lived with the recipient), so an older life estate deed is outside recovery.", "life_estate_cite": "Neb. Rev. Stat. Sec. 68-919(4)(b)(i)(B), (4)(b)(ii)(B), (C), (E)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Nebraska authority recognizing the deed was found. If used, it is a retained life estate plus a remainder conveyance, both named in the recovery definition, and the grantor keeps an interest at death. The 60-month life estate exclusion may apply to it; that is untested.", "lady_bird_deed_cite": "Neb. Rev. Stat. Sec. 68-919(4)(b)(i), (4)(b)(ii)(C)", "tod_deed": "reachable", "tod_deed_note": "TOD deeds are named in the recovery definition. The TOD act separately makes the beneficiary personally liable, up to the property's value, for Medicaid reimbursement left unpaid after the probate estate, and every TOD deed must carry a statutory warning saying so and that DHHS may require revocation for eligibility.", "tod_deed_cite": "Neb. Rev. Stat. Sec. 68-919(4)(b)(i)(B); Sec. 76-3417; Sec. 76-3418 (Laws 2012, LB536, Sec. 18); Sec. 76-3410(b)", "joint_tenancy": "reachable", "joint_tenancy_note": "Assets passing to a survivor through joint tenancy or survivorship are expressly in the recovery estate, to the extent of the recipient's interest at death.", "joint_tenancy_cite": "Neb. Rev. Stat. Sec. 68-919(4)(b)(i), (i)(B)", "revocable_trust": "reachable", "revocable_trust_note": "Assets passing through a revocable trust or living trust that became irrevocable at death are expressly in the recovery estate; a successor trustee may ask DHHS to certify whether reimbursement is due.", "revocable_trust_cite": "Neb. Rev. Stat. Sec. 68-919(4)(b)(i)(A), (B), (4)(c)", "tod_deed_recognized": "yes", "tod_deed_statute": "Neb. Rev. Stat. Sec. 76-3401 to 76-3424 (Nebraska Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2013-01-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Nebraska statute, reported case or DHHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Searches of Nebraska statutes and case law returned only secondary pages.", "hardship_waiver_home": "DHHS may waive or compromise for undue hardship (Sec. 68-919(6)). Rule criteria: an heir who lived in the recipient's home for 2 years before nursing home entry (or before recoverable services) and gave unreimbursed care that delayed it; payment would make an heir eligible for public assistance; waiver would let an heir leave public assistance; or other cases at DHHS discretion. Waivers are called 'rare and extraordinary' and are denied if assets were diverted to avoid recovery (471 NAC 38-004). No foreclosure of a home lien while a qualifying sibling or caregiver adult child lives there; a physician's attestation suffices to show the care (Sec. 68-919(2)).", "recovery_exemptions_note": "Recovery covers assistance at 55 or older, or during permanent institutionalization at any age, and includes no interest (Sec. 68-919(1), (3)). Nursing facility room and board is recoverable (In re Estate of Vollmann, 296 Neb. 659 (2017)). Assets designated for the community spouse are protected (Sec. 68-923(4)). Five-year limitations period runs from the last of the recipient's death, spouse's death, youngest child turning 21, or end of an adult child's disability (Sec. 68-919(4)(d)).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "http://web.archive.org/web/20260511063234/https://www.nebraskalegislature.gov/laws/statutes.php?statute=68-919; http://web.archive.org/web/20260613022447/https://www.nebraskalegislature.gov/laws/statutes.php?statute=68-923; http://web.archive.org/web/20260118011518/https://nebraskalegislature.gov/laws/statutes.php?statute=76-3401; http://web.archive.org/web/20260427014850/https://nebraskalegislature.gov/laws/statutes.php?statute=76-3415; http://web.archive.org/web/20260422013859/https://nebraskalegislature.gov/laws/statutes.php?statute=76-3419; https://codes.findlaw.com/ne/chapter-76-real-property/ne-rev-st-sect-76-3417/; https://revenue.nebraska.gov/sites/default/files/doc/info/legislation/2012/LB536.pdf; http://web.archive.org/web/20251224033249/https://nebraskalegislature.gov/FloorDocs/109/PDF/Slip/LB422.pdf; http://web.archive.org/web/20260109104040/https://www.nebraskalegislature.gov/FloorDocs/109/PDF/Slip/LB641.pdf; https://www.law.cornell.edu/regulations/nebraska/471-Neb-Admin-Code-ch-38-SS-004", "confidence": "high", "flags": "nebraskalegislature.gov timed out for scripts and refused WebFetch; statute text read from Wayback captures of the official pages (68-919 captured 2026-05-11, including Laws 2025, LB641). Differs from Karp 2005 (probate only); 68-919 history lists Laws 2004 LB1005, 2017 LB268 and 2019 LB593 (changes retroactive to Aug. 30, 2015), but which act first adopted the expanded definition was not traced. A secondary search summary says Nebraska is probate-only; the statute text contradicts it. LB641 (approved May 20, 2025) amended 68-919 (renumbered (2) into (2)(a) and (b) with physician attestation, and the certification procedure); its operative date was not confirmed. Sec. 76-3418 (Medicaid liability of TOD beneficiary) was read in the 2012 session law (LB536 Sec. 18), not in current code; 76-3417 current text read via FindLaw WebFetch summary. LB422 (approved May 30, 2025) added an insurance warning for TOD deeds made after its effective date and extended the act to 76-3424. Life estate 60-month exclusion versus the separate 'conveyance of a remainder interest' clause may conflict; untested. Attachment 4.17-A not found. TOD deed effective date detail: 2013-01-01, Laws 2012, LB536, operative Jan. 1, 2013; approved Apr. 5, 2012." }, { "code": "NV", "name": "Nevada", "recovery_scope": "expanded", "recovery_scope_note": "The Authority (formerly the Department) must recover from the 'undivided estate' and from any recipient of money or property from it (NRS 422.29302(1)). 'Undivided estate' covers the probate estate plus any property in which the recipient had an interest or legal title immediately before or at death, expressly including assets passing by joint tenancy, tenancy in common, survivorship, life estate, living trust, annuity, declaration of homestead or other arrangement (NRS 422.054). Pre-death TEFRA liens on real property of permanently institutionalized recipients are authorized, with no lien while a spouse, minor or disabled child, or co-owner sibling (1 year in home) lives there; a lien on the undivided estate may also be sought after death (NRS 422.29306). Recovery waits until the surviving spouse dies, and after that may be taken from persons who received the property, which reaches property that passed to the spouse (NRS 422.29302(2)).", "recovery_statute": "NRS 422.054; NRS 422.29302; NRS 422.29306", "recovery_statute_url": "https://www.leg.state.nv.us/NRS/NRS-422.html", "state_plan_4_17_a_url": "https://dhcfp.nv.gov/uploadedFiles/dhcfpnvgov/content/Resources/AdminSupport/Manuals/MSP/Sec4/Section4-17LiensRecoveries.pdf", "life_estate": "reachable", "life_estate_note": "The undivided estate expressly includes assets conveyed to a survivor or heir through a life estate, and the Medicaid Operations Manual lists a reserved life estate. How the Authority values an ordinary retained life estate that ends at death was not found.", "life_estate_cite": "NRS 422.054; MOM Sec. 802.2", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Nevada authority for the deed was found, but if used it is a life estate arrangement in which the owner keeps full control until death, which falls within the undivided estate ('life estate ... or other arrangement'; interest held immediately before death).", "lady_bird_deed_cite": "NRS 422.054; NRS 422.29302(1)", "tod_deed": "reachable", "tod_deed_note": "The deed upon death act says it must not be construed to limit Medicaid recovery. Beneficiaries must mail notice to the Department of Health and Human Services after death; without that notice the property stays subject to recovery and a lien under NRS 422.29306. The property is also inside the undivided estate because the owner held title immediately before death.", "tod_deed_cite": "NRS 111.693; NRS 111.689(1), (3)(b), (5), (6); NRS 422.054", "joint_tenancy": "reachable", "joint_tenancy_note": "The undivided estate expressly includes assets passing to a survivor through joint tenancy or survivorship, to the extent of the recipient's interest.", "joint_tenancy_cite": "NRS 422.054; MOM Sec. 802.2", "revocable_trust": "reachable", "revocable_trust_note": "The undivided estate expressly includes assets conveyed through a living trust; the manual lists trust assets.", "revocable_trust_cite": "NRS 422.054; MOM Sec. 802.2", "tod_deed_recognized": "yes", "tod_deed_statute": "NRS 111.655 to 111.699 (deed upon death; Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2011-10-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Nevada statute, reported case or Medicaid rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Web search found only secondary pages, which say Nevada uses the deed upon death instead.", "hardship_waiver_home": "Undue hardship means severe financial duress or a significant compromise to health care or shelter needs. Waiver criteria: the asset is the applicant's sole income-producing asset; recovery would make the applicant eligible for public assistance; or a doctor-verified condition. Other factors for a partial or temporary waiver include a caregiver who lived in the home at least 2 years before death or institutionalization and gave care that kept the recipient at home. No waiver when the hardship was created by estate planning to avoid recovery. Apply within 30 days of notice (MOM Sec. 803.13, 803.14). No lien while a co-owner sibling lives in the home (NRS 422.29306(2)(c)).", "recovery_exemptions_note": "Director may decline to file a claim for undue hardship to the spouse or other survivors (NRS 422.29302(5)). Recovery limited to Medicaid paid after Oct. 1, 1993 (NRS 422.29302(7)). Long-term care partnership disregard is protected, and Medicare cost sharing is protected (State Plan 4.17). American Indian and Alaska Native trust and related property exempt (MOM Sec. 803.11).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://web.archive.org/web/20260703235910id_/https://www.leg.state.nv.us/nrs/NRS-422.html; https://nevada.public.law/statutes/nrs_422.054; https://nevada.public.law/statutes/nrs_422.29302; https://nevada.public.law/statutes/nrs_422.29304; https://nevada.public.law/statutes/nrs_422.29306; https://web.archive.org/web/20251228034856id_/https://www.leg.state.nv.us/nrs/nrs-111.html; https://nevada.public.law/statutes/nrs_111.655; https://nevada.public.law/statutes/nrs_111.685; https://nevada.public.law/statutes/nrs_111.689; https://nevada.public.law/statutes/nrs_111.691; https://nevada.public.law/statutes/nrs_111.693; https://web.archive.org/web/2024id_/https://www.leg.state.nv.us/statutes/76th2011/Stats201111.html; https://web.archive.org/web/20250201205727id_/https://dhcfp.nv.gov/uploadedFiles/dhcfpnvgov/content/Providers/PI/MOM%20Chapter%20800.pdf; https://web.archive.org/web/2025id_/https://dhcfp.nv.gov/uploadedFiles/dhcfpnvgov/content/Resources/AdminSupport/Manuals/MSP/Sec4/Section4-17LiensRecoveries.pdf; https://www.nevadamedicaid.nv.gov/programs/medicaid-estate-recovery/", "confidence": "high", "flags": "Official NRS pages return 403 to scripts; statute text read from Wayback captures of leg.state.nv.us (NRS 422 captured 2026-07-03; NRS 111 captured 2025-12-28). The current NRS 422 text says 'Authority' (Nevada Health Authority) where older copies say 'Department'; the substantive recovery text is unchanged since 2003 per the history notes. NRS 111.689 was amended in 2021 (Stats. 2021, p. 995) to add beneficiary notice to DHHS and creditors and the Medicaid lien rule; the nevada.public.law copy is stale and omits this. The state plan pages found are the Sec. 4.17 preprint pages (TN 95-011 and later), not a separate Attachment 4.17-A. The MOM Chapter 800 read is MTL 02/19 (Dec. 28, 2018); the manual PDF URL now redirects, so read via Wayback. Popular lists often call Nevada's lady bird deed unavailable; no primary source either way. TOD deed effective date detail: 2011-10-01, Stats. 2011, ch. 258, SB 88, approved 2011-06-04; replaced the earlier deed upon death statute, NRS 111.109." }, { "code": "NH", "name": "New Hampshire", "recovery_scope": "expanded", "recovery_scope_note": "The estate of every recipient is liable for medical assistance and DHHS files a claim against it (RSA 167:14, II). For recovery of medical assistance the estate also includes all property held at death in joint tenancy with right of survivorship or in a life estate, for title or interest established on or after July 1, 2005 (RSA 167:14-a, VI(a)), and all property in a revocable trust is subject to recovery (RSA 167:14-a, V). DHHS says the recoverable estate includes assets that pass outside probate. Pre-death TEFRA liens are allowed on real property of permanently institutionalized recipients, with no lien if a spouse, minor or disabled child, or equity-holding sibling lives in the home (RSA 167:16-a, I to III). The spouse's estate is liable only for cash assistance (OAA, ANB, APTD), not medical assistance (RSA 167:14, I; DHHS page).", "recovery_statute": "N.H. RSA 167:14, 167:14-a (V), (VI), 167:16-a; N.H. Admin. Code He-W 895", "recovery_statute_url": "https://gc.nh.gov/rsa/html/XII/167/167-14-a.htm", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The Medicaid estate includes property the recipient held in a life estate at death, for interests established on or after July 1, 2005, limited to the value of the recipient's interest. The remainderman gets notice of the claim and must pay or agree to pay; a remainderman who paid value for the remainder may claim hardship.", "life_estate_cite": "N.H. RSA 167:14-a, VI(a), (b); He-W 895.04(f)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No New Hampshire authority recognizing the deed was found. If used, the grantor holds a life estate at death, which RSA 167:14-a, VI(a) brings into the recovery estate (interests created on or after July 1, 2005).", "lady_bird_deed_cite": "N.H. RSA 167:14-a, VI(a)", "tod_deed": "reachable", "tod_deed_note": "The TOD deed passes the house outside probate and is not named in RSA 167:14-a. But the beneficiary takes subject to estate creditor claims, and the estate may enforce an allowed claim against the TOD property to the extent the probate estate is insufficient, if administration is opened within 2 years of death.", "tod_deed_cite": "N.H. RSA 563-D:13, II; 563-D:16, I to III; RSA 167:14, II", "joint_tenancy": "reachable", "joint_tenancy_note": "The Medicaid estate includes property held in joint tenancy with right of survivorship at death (interests established on or after July 1, 2005), limited to the recipient's ownership interest and not reaching any interest a non-recipient owner bought at fair market value. Surviving joint owners get notice and must pay or agree to pay; DHHS may sue in superior or probate court.", "joint_tenancy_cite": "N.H. RSA 167:14-a, VI(a), (b)", "revocable_trust": "reachable", "revocable_trust_note": "By statute all property, real or personal, in a revocable trust is subject to recovery; at the grantor's death DHHS sends the trustee a statement of the amount owed. No date limit applies to trusts.", "revocable_trust_cite": "N.H. RSA 167:14-a, V", "tod_deed_recognized": "yes", "tod_deed_statute": "N.H. RSA 563-D (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2024-07-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No New Hampshire statute, reported case or DHHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Searches of NH case law and DHHS materials returned only secondary pages, some saying the deed is not used in New Hampshire.", "hardship_waiver_home": "Recovery is waived for undue hardship to an heir or if not cost effective (He-W 895.03). Home-related grounds: an adult child or grandchild who lived in the home and gave care for at least 2 years before admission that kept the recipient at home, and still lives there; a sibling who lived there at least 1 year before admission and still lives there; a business or farm at the heir's primary residence producing over 50% of the heir's livelihood; and a remainderman or surviving joint tenant who paid value for the interest (He-W 895.04(a), (d), (e), (f)).", "recovery_exemptions_note": "Recovery only for assistance received at age 55 or older, after the death of any surviving spouse (RSA 167:16-a, IV). Joint tenancy and life estate recovery reaches only interests created on or after July 1, 2005, and never an interest a non-recipient bought at fair market value (RSA 167:14-a, VI(a)).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "http://web.archive.org/web/20260702175041/https://gc.nh.gov/rsa/html/XII/167/167-14-a.htm; http://web.archive.org/web/20250702011125/https://gc.nh.gov/rsa/html/XII/167/167-14.htm; http://web.archive.org/web/20220526233107/https://gencourt.state.nh.us/rsa/html/XII/167/167-16-a.htm; http://web.archive.org/web/20250914173218/https://gc.nh.gov/rsa/html/LVI/563-D/563-D-mrg.htm; http://web.archive.org/web/20251031042252/https://www.dhhs.nh.gov/doing-business-dhhs/legal-services/estate-recoveries; https://www.law.cornell.edu/regulations/new-hampshire/N-H-Admin-Code-SS-He-W-895.04; https://www.law.cornell.edu/regulations/new-hampshire/N-H-Admin-Code-SS-He-W-895.03", "confidence": "high", "flags": "Official legislature and DHHS sites return 403 to scripts and WebFetch; statute text was read from Wayback Machine captures of the official gc.nh.gov / gencourt pages (167:14-a captured 2026-07-02, 167:14 captured 2025-07-02, 167:16-a captured 2022-05-26, so any 2022 to 2026 amendment of 167:16-a would be missed). Differs from Karp 2005 (probate only): expansion by Laws 2005, ch. 175 and 177 (RSA 167:14-a history), JT and life estates from July 1, 2005. The 'established on or after July 1, 2005' clause may be read as applying only to life estates or to both JT and life estates. TOD deed act enacted by Laws 2024, 1:1 (HB 68), eff. July 1, 2024; RSA 563-D:22 added by Laws 2025, 114:1, eff. Aug. 22, 2025. Popular lists that omit New Hampshire from TOD deed states are out of date. Attachment 4.17-A not found (medicaid.gov PDFs blocked). TOD deed effective date detail: 2024-07-01, Laws 2024, 1:1, HB 68." }, { "code": "NJ", "name": "New Jersey", "recovery_scope": "expanded", "recovery_scope_note": "N.J.S.A. 30:4D-7.2(a)(3) defines estate to include the probate estate (N.J.S. 3B:1-1) plus any other real and personal property in which the recipient had any legal title or interest at death, to the extent of that interest, including assets conveyed through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement. N.J.A.C. 10:49-14.1(l) repeats this for deaths on or after April 1, 1995 and adds sale proceeds still held by the survivor. Recovery covers ALL Medicaid services received at 55 or older, including managed care capitation (Medicaid Communication 17-15). The lien is filed after death; no pre-death TEFRA lien is described. Recovery is deferred, not lost, while a spouse or minor or disabled child survives: DMAHS recovers from remaining estate assets when the exception ends (Communication 17-15).", "recovery_statute": "N.J.S.A. 30:4D-7.2; N.J.A.C. 10:49-14.1", "recovery_statute_url": "https://codes.findlaw.com/nj/title-30-institutions-and-agencies/nj-st-sect-30-4d-7-2/", "state_plan_4_17_a_url": "https://www.nj.gov/humanservices/dmahs/documents/providers-stakeholders/resources/medicaid/2020/17-15%20Recoveries%20from%20Estates%20of%20Deceased%20Medicaid%20Beneficiaries%20and%20Former%20Medicaid%20Beneficiaries.2.2020.pdf", "life_estate": "not_reachable", "life_estate_note": "Although the statute lists life estates, the rule excludes a life estate that expired at the recipient's death, and defines the reachable life estate as one created upon the recipient's death. A traditional retained life estate therefore is not reached.", "life_estate_cite": "N.J.A.C. 10:49-14.1(l)2.i, (n)1; N.J.S.A. 30:4D-7.2(a)(3)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No New Jersey authority for the deed was found. If valid, the retained life estate part would be excluded under (n)1, but the retained power to sell arguably is an interest held at death under the broad 'any legal title or interest' and 'other arrangement' language. Untested.", "lady_bird_deed_cite": "N.J.S.A. 30:4D-7.2(a)(3); N.J.A.C. 10:49-14.1(l)2, (n)1", "tod_deed": "n/a", "tod_deed_note": "New Jersey has no transfer-on-death deed statute. S3679 (Uniform Real Property Transfer on Death Act, 2026) was reported from Senate committee with amendments on 05/11/2026 but is not enacted.", "tod_deed_cite": "S3679 / A1819 (2026 to 2027 session), pending", "joint_tenancy": "reachable", "joint_tenancy_note": "The statute names joint tenancy, tenancy in common and survivorship. The rule says a lien for a recipient who held a joint tenancy with right of survivorship or a tenancy by the entirety encumbers all of the property.", "joint_tenancy_cite": "N.J.S.A. 30:4D-7.2(a)(3); N.J.A.C. 10:49-14.1(l)2, (m)", "revocable_trust": "reachable", "revocable_trust_note": "The statute names living trusts, and the rule defines 'other arrangement' to include any trust in which the recipient had an interest at death. Only discretionary third-party trusts holding none of the recipient's assets are excluded.", "revocable_trust_cite": "N.J.S.A. 30:4D-7.2(a)(3); N.J.A.C. 10:49-14.1(l)2.ii, (n)2 to 3", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No New Jersey statute, reported case, title standard or DMAHS rule recognizing an enhanced life estate deed was found. Web search returned only law firm pages, which say New Jersey has no statute.", "hardship_waiver_home": "Home deferral: if a family member lived continuously in the recipient's home before death and it was and remains the family member's primary residence, DMAHS may record a lien but will not enforce it until the home is sold or the family member dies or moves out (N.J.A.C. 10:49-14.1(g)). Undue hardship waiver is narrow: only if the estate is the survivors' sole income-producing asset and recovery would likely put them on public assistance or Medicaid, with a presumption against hardship created by estate planning; request due within 20 days of notice (10:49-14.1(h)).", "recovery_exemptions_note": "Recovery is not pursued against property held by a bona fide purchaser for fair market value (10:49-14.1(k)). Nazi persecution reparations and restitution are excluded from the estate (30:4D-7.2(a)(3)). Medicare Savings Program cost sharing is exempt since Jan. 1, 2010, and the state-funded HCEP and JACC programs are exempt (Communication 17-15). The Division may skip claims that are not cost-effective (10:49-14.1(i)). Claims must be filed within 3 years of written notice of death (10:49-14.1(d)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/nj/title-30-institutions-and-agencies/nj-st-sect-30-4d-7-2/; https://www.law.cornell.edu/regulations/new-jersey/N-J-A-C-10-49-14-1; https://www.nj.gov/humanservices/dmahs/documents/providers-stakeholders/resources/medicaid/2020/17-15%20Recoveries%20from%20Estates%20of%20Deceased%20Medicaid%20Beneficiaries%20and%20Former%20Medicaid%20Beneficiaries.2.2020.pdf; https://www.nj.gov/humanservices/dmahs/documents/individuals-families/The_NJ_Medicaid_Program_and_Estate_Recovery_What_You_Should_Know.pdf; https://www.billtrack50.com/billdetail/1975968; https://www.billtrack50.com/billdetail/1931683", "confidence": "medium", "flags": "Statute text read from FindLaw (current as of Jan. 1, 2024); official NJ legislature sites timed out and Justia returned 403. Rule read from LII copy. Pending bills: S3010 (2026, reintroduced) would limit recovery to the federal minimum and a probate-only estate; referred to Senate Health committee 01/13/2026, not enacted. S3679 TOD deed act reported from committee 05/11/2026, not enacted; if enacted, check its creditor section. Communication 17-15 cites the estate definition as 10:49-14.1(e)2, but the current rule has it at (l)2. No CMS Attachment 4.17-A found; the state_plan URL is the DMAHS Medicaid Communication 17-15 instead." }, { "code": "NM", "name": "New Mexico", "recovery_scope": "probate_only", "recovery_scope_note": "Medicaid Estate Recovery Act defines estate as property subject to probate or administration under the Uniform Probate Code (NMSA Sec. 27-2A-3(B)); the rule repeats this (8.200.430.19 NMAC). Recovery covers nursing facility, HCBS and related hospital and drug services for recipients 55 or older, and permanently institutionalized recipients (Sec. 27-2A-4). No TEFRA lien or surviving spouse estate recovery found in the statute or rule. Caveat: UPC nonprobate transferee liability (Sec. 45-6-102) can pull some nonprobate transfers back to pay allowed claims against a probate estate.", "recovery_statute": "NMSA 1978 Sec. 27-2A-1 to 27-2A-9 (definition of estate at Sec. 27-2A-3(B))", "recovery_statute_url": "https://codes.findlaw.com/nm/chapter-27-public-assistance/nm-st-sect-27-2a-3.html", "state_plan_4_17_a_url": "https://www.law.cornell.edu/regulations/new-mexico/N-M-Admin-Code-SS-8.200.430.19_v2", "life_estate": "not_reachable", "life_estate_note": "Estate is limited to the probate estate; a retained life estate ends at death and the remainder was conveyed during life, so nothing passes through probate and it is not a transfer effective at death under Sec. 45-6-102.", "life_estate_cite": "NMSA Sec. 27-2A-3(B); 8.200.430.19 NMAC", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No New Mexico authority for the deed was found. The property would pass outside probate, but because the grantor keeps the power to convey alone, a claim could arguably be pursued against the remainder beneficiary under the UPC nonprobate transferee liability section if a probate estate is opened.", "lady_bird_deed_cite": "NMSA Sec. 27-2A-3(B); Sec. 45-6-102(A), (B)", "tod_deed": "reachable", "tod_deed_note": "TOD deed property is not probate property, but the TOD act makes the beneficiary liable for allowed claims against the transferor's probate estate to the extent the estate is insufficient, via Sec. 45-6-102. The Medicaid claim is a claim against the probate estate, so the house is exposed. This needs a probate estate, a demand on the personal representative and a proceeding within one year of death. No HCA rule found saying the agency uses this route.", "tod_deed_cite": "NMSA Sec. 45-6-415; Sec. 45-6-102(B), (G), (H); Sec. 27-2A-3(B)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship interest passes outside probate, and Sec. 45-6-102(A) expressly excludes a joint tenancy in real estate from nonprobate transferee liability.", "joint_tenancy_cite": "NMSA Sec. 27-2A-3(B); Sec. 45-6-102(A)", "revocable_trust": "unclear", "revocable_trust_note": "Trust assets are not probate property, but Sec. 45-6-102 makes the trustee of a revocable trust liable for allowed claims against an insufficient probate estate, with the trust second in priority. This needs a probate estate and a proceeding within one year of death.", "revocable_trust_cite": "NMSA Sec. 45-6-102(B), (C)(2), (D); Sec. 27-2A-3(B)", "tod_deed_recognized": "yes", "tod_deed_statute": "NMSA 1978 Sec. 45-6-401 to 45-6-417 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2001", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No New Mexico statute, reported case or HCA rule found. Searched the web for New Mexico enhanced life estate and lady bird deed; only form sellers and secondary sites came up.", "hardship_waiver_home": "Undue hardship waiver causes include a homestead worth 50 percent or less of the average home price in the county, heirs who would need or could leave needs-based aid, and estate assets that are the heir's sole income source (8.200.430.19 NMAC, Subsec. F(2)). The department may also compromise, settle or waive recovery when it is in the state's best interest (NMSA Sec. 27-2A-5(C)).", "recovery_exemptions_note": "Recovery only for services at 55 or older (NF, HCBS, related hospital and drugs) or permanent institutionalization. Medicare Savings Program cost sharing is exempt unless the person was also in a NF or HCBS category. Broad Native American property exemptions. Long-term care partnership disregard is protected (Sec. 27-2A-4(B)). Recovery limited to services on or after Oct 1, 1993, with an exception for pre-1993 NF services at 65 or older.", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/nm/chapter-27-public-assistance/nm-st-sect-27-2a-3.html; https://codes.findlaw.com/nm/chapter-27-public-assistance/nm-st-sect-27-2a-4.html; https://codes.findlaw.com/nm/chapter-27-public-assistance/nm-st-sect-27-2a-5.html; https://codes.findlaw.com/nm/chapter-27-public-assistance/nm-st-sect-27-2a-7.html; https://www.law.cornell.edu/regulations/new-mexico/N-M-Admin-Code-SS-8.200.430.19_v2; https://www.law.cornell.edu/regulations/new-mexico/N-M-Admin-Code-SS-8.200.430.20; https://codes.findlaw.com/nm/chapter-45-uniform-probate-code/nm-st-sect-45-6-401.html; https://codes.findlaw.com/nm/chapter-45-uniform-probate-code/nm-st-sect-45-6-415.html; https://codes.findlaw.com/nm/chapter-45-uniform-probate-code/nm-st-sect-45-6-102.html; https://web.archive.org/web/2016/https://law.justia.com/codes/new-mexico/2006/nmrc/jd_45-6-401-fda9.html", "confidence": "medium", "flags": "The official sites (nmonesource.com, nmlegis.gov, hca.nm.gov) and Justia returned HTTP 403, so statute text is a FindLaw copy via WebFetch (current as of Jan 1, 2024). The TOD session law history (Laws 2001 ch. 236; Laws 2013 ch. 38; 2014-01-01 date for Sec. 45-6-416) comes from Justia search snippets, not a page read; the effective date of the other 2013 sections is not verified. The rule was renumbered from 8.200.430.20 to 8.200.430.19 NMAC (LII shows effective 11/1/2024). Whether HCA uses Sec. 45-6-102 or Sec. 45-6-415 against TOD or trust beneficiaries is not addressed in the rule. Some popular lists name New Mexico as a lady bird deed state 'by statute'; no such statute was found (they appear to mean the TOD deed act). State Plan Attachment 4.17-A not found; the field holds the NMAC rule. TOD deed effective date detail: 2001, original non-uniform TOD deed, former Sec. 45-6-401, Laws 2001 ch. 236); uniform act Laws 2013 ch. 38 (form section effective 2014-01-01." }, { "code": "NY", "name": "New York", "recovery_scope": "probate_only", "recovery_scope_note": "Soc. Serv. Law Sec. 369(6) defines estate as property 'passing under the terms of a valid will or by intestacy'. New York elected the expanded definition by Ch. 59, L. 2011 (recoveries on or after Sept. 8, 2011, per 11 OHIP/ADM-8). Secondary sources say Part D, Sec. 56 of Ch. 56, L. 2012 repealed it, and the current statute text is probate-only. Pre-death TEFRA liens are allowed on real property of permanently institutionalized recipients, with no lien if a spouse, minor or disabled child, or equity-holding sibling lives there (Sec. 369(2)(a)). No recovery from the surviving spouse's estate found.", "recovery_statute": "N.Y. Soc. Serv. Law Sec. 369(2), (5), (6); 18 NYCRR 360-7.11", "recovery_statute_url": "https://www.nysenate.gov/legislation/laws/SOS/369", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "Under the current probate-only definition, a retained life estate ends at death and does not pass by will or intestacy. Life estates were expressly recoverable only while the 2011 expanded definition was in force (2011 to 2012). A pre-death lien on the life tenant's interest would end with the life estate.", "life_estate_cite": "N.Y. Soc. Serv. Law Sec. 369(6); 11 OHIP/ADM-8 (historical)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No New York authority for a life estate deed with a retained power to sell without the remainder's consent was found. If it is valid, the remainder passes outside the will or intestacy and outside Sec. 369(6), but its status is untested.", "lady_bird_deed_cite": "N.Y. Soc. Serv. Law Sec. 369(6)", "tod_deed": "reachable", "tod_deed_note": "A TOD deed passes outside probate, but RPL Sec. 424(14) lets the estate enforce allowed claims against the TOD property if the probate estate is insufficient. The Medicaid claim is a claim against the estate, so the house is exposed if a proceeding starts within 18 months of death.", "tod_deed_cite": "N.Y. Real Prop. Law Sec. 424(14)(a) to (c); Soc. Serv. Law Sec. 369(6)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivorship interest passes by operation of law, not by will or intestacy, so it is outside the Sec. 369(6) estate. It was recoverable only under the repealed 2011 expanded definition.", "joint_tenancy_cite": "N.Y. Soc. Serv. Law Sec. 369(6)", "revocable_trust": "unclear", "revocable_trust_note": "Trust assets pass outside will or intestacy, so they are outside the Sec. 369(6) estate. But the Medicaid rule lets a district sue a trustee for the grantor's beneficial interest in any trust established other than by will, and a self-settled trust is void as against the creator's creditors. How this applies after death is not settled in any text read.", "revocable_trust_cite": "N.Y. Soc. Serv. Law Sec. 369(6); 18 NYCRR 360-7.11(b)(4); EPTL Sec. 7-3.1", "tod_deed_recognized": "yes", "tod_deed_statute": "N.Y. Real Prop. Law Sec. 424", "tod_deed_effective": "2024-07-19", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No New York statute, reported case or DOH directive recognizing an enhanced life estate deed was found. The web search turned up only secondary law firm pages on ordinary life estate deeds.", "hardship_waiver_home": "Recovery must be waived for undue hardship under DOH rules using federal criteria (Soc. Serv. Law Sec. 369(5)). A home under lien is protected while a sibling who lived there a year before admission, or a child who lived there two years and gave care that delayed institutionalization, keeps living there (Sec. 369(2); 18 NYCRR 360-7.11(b)(3)). The 2011 DOH directive listed a family farm or business that is the sole income source, and real property of modest value, as hardship examples.", "recovery_exemptions_note": "Medicare Savings Program cost sharing is exempt from recovery (GIS 10 MA/008, cited in 11 OHIP/ADM-8). Long-term care partnership: Total Asset Protection policyholders are excluded, and Dollar-for-Dollar plans protect a set amount. American Indian and Alaska Native property and reparations payments are exempt (11 OHIP/ADM-8, citing 02 OMM/ADM-3).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://www.nysenate.gov/legislation/laws/SOS/369; https://www.law.cornell.edu/regulations/new-york/18-NYCRR-360-7.11; https://www.health.ny.gov/health_care/medicaid/publications/adm/11adm8.htm; https://newyork.public.law/laws/n.y._real_property_law_section_424; https://www.nysenate.gov/legislation/laws/RPP/424; https://www.nysenate.gov/legislation/bills/2023/S8306/amendment/C; https://www.nysenate.gov/legislation/laws/EPT/7-3.1; https://nysba.org/new-york-now-allows-transfer-on-death-deeds-but-should-you-use-them/", "confidence": "high", "flags": "Statute text was read on nysenate.gov through WebFetch (scripts get 403), so it is not a verbatim save. The 2012 repeal (Part D, Sec. 56, Ch. 56, L. 2012) is confirmed only by secondary sources, plus the current probate-only text of Sec. 369(6). The LII copy of 18 NYCRR 360-7.11 is stale: it still says recovery applies at age 65, while the statute says 55. TOD: the July 19, 2024 effective date comes from secondary sources (consistent with a 90-day clause); the Part O effective clause was not visible. nysenate.gov shows Sec. 424 revisions on 2024-05-31 and 2024-07-26, so there may have been a chapter amendment; its chapter number was not found. Sec. 424 follows the URPTODA structure (creditor subdivision mirrors uniform Sec. 15) but has a two-witness requirement; the ULC enactment list was not checked. OMIG estate recovery page returned 403. Revocable trust treatment after death is unresolved. TOD deed effective date detail: 2024-07-19, Ch. 56, L. 2024, Part O; signed 2024-04-20." }, { "code": "NC", "name": "North Carolina", "recovery_scope": "probate_only", "recovery_scope_note": "Estate means property 'considered assets of the estate available for the discharge of debt pursuant to G.S. 28A-15-1' (Sec. 108A-70.5(b)(2)). DHHS is a sixth-class creditor with all estate creditor rights, including the right to serve as personal representative or collector (Sec. 108A-70.5(b)(2), (c)). Exception: for recipients who used a qualified long-term care partnership policy, the estate also includes joint tenancy, tenancy in common, survivorship, life estate, living trust and other interests held at death. Revocable trust property is liable for estate claims if the probate estate is short (Sec. 36C-5-505(a)(3)). No TEFRA lien or spouse estate recovery found in the texts read.", "recovery_statute": "N.C. Gen. Stat. Sec. 108A-70.5", "recovery_statute_url": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_108A/GS_108A-70.5.html", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/NC-25-0011.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death, so nothing is left for the probate estate under Sec. 28A-15-1. It is reachable only for long-term care partnership policy recipients, whose estate definition expressly includes life estates.", "life_estate_cite": "N.C. Gen. Stat. Sec. 108A-70.5(b)(2); Sec. 28A-15-1", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "The remainder passes at death outside the probate estate, and no NC statute makes a remainder beneficiary liable for estate claims. The Medicaid manual counts the property as the owner's resource during life, but that is an eligibility rule, not a recovery rule. Partnership policy recipients are the exception.", "lady_bird_deed_cite": "N.C. Gen. Stat. Sec. 108A-70.5(b)(2); NC Medicaid Manual MA-2240 Sec. X.C.6", "tod_deed": "n/a", "tod_deed_note": "North Carolina has no transfer on death deed statute for real property. URPTODA bills (S 368 in 2021, S 160 in 2023) did not pass.", "tod_deed_cite": "UNC School of Government Legislative Reporting Service, S 368 (2021)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes by right of survivorship outside the probate estate. Reachable only for partnership policy recipients, whose estate definition names joint tenancy and survivorship.", "joint_tenancy_cite": "N.C. Gen. Stat. Sec. 108A-70.5(b)(2); Sec. 28A-15-1", "revocable_trust": "reachable", "revocable_trust_note": "After the settlor dies, property of a trust that was revocable at death is subject to the settlor's creditors' claims to the extent the probate estate cannot pay them. DHHS is an estate creditor with all creditor rights.", "revocable_trust_cite": "N.C. Gen. Stat. Sec. 36C-5-505(a)(3); Sec. 108A-70.5(b)(2), (c)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "agency_rule", "lady_bird_authority": "NC Medicaid ABD Manual MA-2240, Sec. X.C.6 'Ladybird Deed or Life Estate with Powers' (revised 06/30/2026, Change No. 09-26). It treats the full equity as the owner's resource and as no transfer, because the life tenant can end the life estate. No NC statute or reported case found; practitioners rely on common law.", "hardship_waiver_home": "State Plan Att. 4.17-A (SPA 25-0011) allows a waiver or deferral for a qualified applicant who lived on the property 12 months before death and since, with household income under 200 percent FPL and assets under $25,000 (death on or after Jan 1, 2023, CPI-indexed every 5 years from 2025). It also covers a tenant in common owning 25 percent or more for 24 months where the property is worth under $100,000 (indexed), or estate property that is the sole income source. The relief lasts only while the applicant qualifies. Recovery is waived as not cost-effective unless gross estate assets are $50,000 or more, the claim is $10,000 or more and expected recovery is $5,000 or more.", "recovery_exemptions_note": "Cost-effectiveness floor ($50,000 gross estate, $10,000 claim, $5,000 expected recovery; CPI-indexed) under State Plan Att. 4.17-A item 6. Recovery reduced by the eugenics compensation resource disregard (Sec. 108A-70.5(f)). Partnership policy asset disregard (Sec. 108A-70.4). Protections for Indians under ARRA Sec. 5006 (Att. 4.17-A).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/nc/chapter-108a-social-services/nc-gen-st-sect-108a-70-5.html; https://codes.findlaw.com/nc/chapter-28a-administration-of-decedents-estates/nc-gen-st-sect-28a-15-1.html; https://codes.findlaw.com/nc/chapter-36c-north-carolina-uniform-trust-code/nc-gen-st-sect-36c-5-505.html; https://www.medicaid.gov/medicaid/spa/downloads/NC-25-0011.pdf; https://policies.ncdhhs.gov/wp-content/uploads/MA-2240-Transfer-of-Assets-ADA-Tested.pdf; https://policies.ncdhhs.gov/divisional-a-m/health-benefits-nc-medicaid/adult-medicaid/abd-policies-manuals/; https://lrs.sog.unc.edu/bill/transfer-death-deeds", "confidence": "medium", "flags": "ncleg.gov returned 403, so statute text is a FindLaw copy via WebFetch. The scope is probate-only for most recipients but expanded for long-term care partnership policy recipients (Sec. 108A-70.5(b)(2)); the coordinator may prefer expanded_partial. The TOD 'no' rests on UNC LRS bill history and secondary sites; the S 160 (2023) status is from search snippets. Practitioner blogs disagree over whether the Sept 2025 manual update helps or ends ladybird planning. The current manual (rev. 06/30/2026) counts the full equity as a resource, which matters for eligibility unless the home exclusion applies. Some popular lists omit NC as a ladybird state." }, { "code": "ND", "name": "North Dakota", "recovery_scope": "expanded", "recovery_scope_note": "N.D.C.C. Sec. 50-24.1-07 makes the Medicaid claim a preferred claim against the decedent's estate but does not define estate. The North Dakota Supreme Court holds that the broad language of Sec. 50-24.1-07 fully implements federal law and reads it with the 42 U.S.C. 1396p(b)(4)(B) definition, which includes assets passing by joint tenancy, survivorship, life estate, living trust or other arrangement (In re Estate of Krueger, 2019 ND 42, paras. 4, 11; In re Estate of Thompson, 1998 ND 226). The state recovers from the surviving spouse's estate: all assets in the spouse's estate are presumed to be assets in which the recipient had an interest (Sec. 50-24.1-07(5)), limited to assets traceable to the recipient. Personal representatives must send the department copies of probate, heirship and joint tenancy tax clearance filings (Sec. 50-24.1-07(3)). No TEFRA lien statute found in ch. 50-24.1.", "recovery_statute": "N.D. Cent. Code Sec. 50-24.1-07", "recovery_statute_url": "https://ndlegis.gov/cencode/t50c24-1.pdf", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "The HHS Estate Recovery Policy Manual (effective Dec. 1, 2024) says life estates are not generally subject to estate recovery. This is agency policy; the federal definition the Supreme Court applies lists life estates, so the state could claim one.", "life_estate_cite": "ND HHS Estate Recovery Policy Manual Sec. 4.7; In re Estate of Krueger, 2019 ND 42, para. 4", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No North Dakota authority on enhanced life estate deeds was found. The manual's life estate policy might apply, but a retained power to sell is closer to full ownership at death, which the federal definition reaches.", "lady_bird_deed_cite": "ND HHS Estate Recovery Policy Manual Sec. 4.7; In re Estate of Krueger, 2019 ND 42", "tod_deed": "reachable", "tod_deed_note": "The recipient holds full title until death, so the house falls within the federal expanded definition the court applies. The TOD act also lets the estate enforce allowed claims against TOD property when the probate estate is insufficient (not against later purchasers or lenders for value).", "tod_deed_cite": "N.D. Cent. Code Sec. 30.1-32.1-12; Sec. 50-24.1-07; In re Estate of Krueger, 2019 ND 42", "joint_tenancy": "reachable", "joint_tenancy_note": "Recovery reaches the deceased recipient's fractional share of joint tenancy property (50 percent of a home held with a spouse), including when the claim is made against the surviving spouse's estate.", "joint_tenancy_cite": "In re Estate of Krueger, 2019 ND 42, paras. 11, 12; N.D. Cent. Code Sec. 50-24.1-07(3), (5)", "revocable_trust": "reachable", "revocable_trust_note": "Living trusts are within the federal definition the court applies, and the HHS manual states trusts may be subject to estate recovery.", "revocable_trust_cite": "In re Estate of Krueger, 2019 ND 42, para. 4; ND HHS Estate Recovery Policy Manual Sec. 4.6", "tod_deed_recognized": "yes", "tod_deed_statute": "N.D. Cent. Code ch. 30.1-32.1 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2011-08-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No North Dakota statute, reported case or HHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Searched web for North Dakota enhanced life estate, power to sell and lady bird deed authority; results were secondary pages only.", "hardship_waiver_home": "No home-specific hardship rule. North Dakota limits undue hardship claims to surviving spouses, children under 21 and adult children with disabilities (HHS Estate Recovery Policy Manual Sec. 2.2). Family members may buy estate property at fair market value or pay the claim instead of selling (Sec. 5.4).", "recovery_exemptions_note": "No claim for Medicaid expansion enrollees (Sec. 50-24.1-37) covered through a private carrier (Sec. 50-24.1-07(2)(b)). Long-term care partnership disregard (Sec. 50-24.1-07(6)). Funeral expenses up to $3,500 and other listed claims are paid before the Medicaid claim (Sec. 50-24.1-07(1)). Memorial funds and named-beneficiary insurance, annuities and retirement accounts are not subject to recovery; certain Native American property is exempt (HHS manual Secs. 2.1(f), 3.3, 4.5). A claim is not pursued against the share passing to an adult disabled child until that child dies (manual Sec. 2.1(d)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://ndlegis.gov/cencode/t50c24-1.pdf; https://ndlegis.gov/cencode/t30-1c32-1.pdf; https://ndlegis.gov/cencode/t30-1c31.pdf; https://www.hhs.nd.gov/healthcare-coverage/medicaid/estate-recovery; https://www.hhs.nd.gov/sites/default/files/documents/legal/estate-recovery-policy-manual-exclusion.pdf; https://www.nd.gov/dhs/policymanuals/45001/Printed%20Docuemntation/Medicaid%20Estate%20Recovery%20Print%201-7-11%20done.pdf; https://caselaw.findlaw.com/court/nd-supreme-court/1982232.html; https://ndlegis.gov/assembly/61-2009/regular/bill-text/JQUL0100.pdf; https://ndlegis.gov/assembly/69-2025/regular/bill-overview/bo2029.html", "confidence": "medium", "flags": "Statute text read on ndlegis.gov, but the statute does not define estate; the expanded scope rests on case law (Krueger read via FindLaw through WebFetch, not verbatim; ndcourts.gov and Justia returned 403). Conflict: the HHS manual (effective 12/1/2024) says life estates are not generally subject to recovery, while the court applies the federal definition that lists life estates. 2025: SB 2029 (signed May 2, 2025) amended Sec. 50-24.1-07(1) (claim priorities, guardianship office claims under ch. 54-68); no 2023 to 2026 change to the scope of estate found. State plan amendment ND-10-008 on medicaid.gov was located but could not be read (403 to script, unreadable PDF via WebFetch). TOD effective date from the act's applicability clause (transferors dying on or after Aug. 1, 2011); session law chapter not read." }, { "code": "OH", "name": "Ohio", "recovery_scope": "expanded", "recovery_scope_note": "Estate includes probate assets plus any other real and personal property in which the individual had any legal title or interest at death, including assets passing by joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement (Sec. 5162.21(A)(1)(b)). 'Time of death' is defined so that interests ending at death are still counted (Sec. 5162.21(A)(5)). Courts apply this to life estates and allow direct claims against remaindermen when no probate estate is opened (Phillips v. McCarthy, 2016-Ohio-2994; Miracle, 2015-Ohio-1516). TEFRA liens are allowed on real property of permanently institutionalized recipients and their spouses, including property held jointly with the spouse (Sec. 5162.211(B)). There is no general statutory recovery from a surviving spouse's estate, but recovery may be made on sale of spouse property under a lien (Sec. 5162.21(B)(1)).", "recovery_statute": "Ohio Rev. Code Sec. 5162.21, Sec. 5162.211; Ohio Admin. Code 5160:1-2-07", "recovery_statute_url": "https://codes.ohio.gov/ohio-revised-code/section-5162.21", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The statute names life estates, and the Twelfth District held that a recipient's life estate survives death for recovery purposes. The amount recoverable is limited to the value of the decedent's life estate, not the remainder.", "life_estate_cite": "Ohio Rev. Code Sec. 5162.21(A)(1)(b), (A)(5); Phillips v. McCarthy, 2016-Ohio-2994, paras. 18, 22 (12th Dist.)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Ohio authority recognizing the deed was found. If one is used, the grantor's retained life estate and power over the property are an interest held at death, and the statute reaches life estates and any 'other arrangement'.", "lady_bird_deed_cite": "Ohio Rev. Code Sec. 5162.21(A)(1)(b), (A)(5)", "tod_deed": "reachable", "tod_deed_note": "The owner holds full title until death and the beneficiary takes only the interest held at death, so the property is an asset in which the recipient had legal title at death and passes by an 'other arrangement'. The TOD statute has no creditor section of its own; it preserves existing liens (Sec. 5302.23(B)(8)).", "tod_deed_cite": "Ohio Rev. Code Sec. 5162.21(A)(1)(b); Sec. 5302.23(B)(7)(a), (B)(8)", "joint_tenancy": "reachable", "joint_tenancy_note": "Joint tenancy and survivorship are expressly listed; recovery is limited to the decedent's interest. A TEFRA lien may also attach to real property held jointly with the spouse.", "joint_tenancy_cite": "Ohio Rev. Code Sec. 5162.21(A)(1)(b); Sec. 5162.211(B)", "revocable_trust": "reachable", "revocable_trust_note": "'Living trust' is expressly listed in the recovery definition of estate.", "revocable_trust_cite": "Ohio Rev. Code Sec. 5162.21(A)(1)(b); Ohio Admin. Code 5160:1-2-07(B)(1)(b)", "tod_deed_recognized": "yes", "tod_deed_statute": "Ohio Rev. Code Sec. 5302.22, 5302.222, 5302.23 (transfer on death designation affidavit)", "tod_deed_effective": "2000", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Ohio statute, reported case or Medicaid rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. The Medicaid life estate rule (Ohio Admin. Code 5160:1-3-05.17) says only the life tenant's own interest can be sold and does not address retained powers. Searches returned only practitioner Q and A pages.", "hardship_waiver_home": "Discretionary waiver case by case: sole income-producing asset such as a family farm or business with limited income; survivor would go on public assistance; loss of food, shelter or clothing; survivor's substantial financial contributions creating an equity interest; survivor 65 or older or totally disabled and financially dependent on the proceeds. No waiver where the hardship was created by estate planning to avoid recovery. Request within 30 days of the AGO claim notice. No home recovery under a lien while a qualifying sibling (1 year) or caregiver child (2 years) lives there.", "recovery_exemptions_note": "Recovery for non-institutionalized people covers services after age 55, excluding Medicare premium assistance paid on or after Jan. 1, 2010 (5160:1-2-07(C)(2)). No lien on the home while a sibling with an equity interest lives there (5162.211(C)(3)). Long-term care partnership disregard, government reparation payments, and American Indian and Alaska Native property are exempt (5160:1-2-07(G), (J)). Recovery is presented by the Ohio Attorney General, who may take a payment plan, note or lien instead of forcing a sale (5160:1-2-07(E), (F)).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://codes.ohio.gov/ohio-revised-code/section-5162.21; https://codes.ohio.gov/ohio-revised-code/section-5162.211; https://codes.ohio.gov/ohio-administrative-code/rule-5160:1-2-07; https://codes.ohio.gov/ohio-administrative-code/rule-5160:1-3-05.17; https://codes.ohio.gov/ohio-revised-code/section-5302.22; https://codes.ohio.gov/ohio-revised-code/section-5302.23; https://dam.assets.ohio.gov/image/upload/tax.ohio.gov/government/sb_124_aud_memo_tod.pdf; http://www.supremecourt.ohio.gov/rod/docs/pdf/12/2016/2016-Ohio-2994.pdf; https://www.supremecourt.ohio.gov/rod/docs/pdf/3/2020/2020-Ohio-6924.pdf; https://www.ohiosenate.gov/legislation/136/hb318", "confidence": "high", "flags": "Ohio government sites (codes.ohio.gov, supremecourt.ohio.gov, legislature) timed out or refused connections from this machine. Their text was read verbatim through Wayback Machine snapshots of the official pages (statute snapshot 2026-05-11, still showing the 2013 H.B. 59 version). Karp 2005 listed Ohio as probate-only; the expansion came in 2005 (H.B. 66, per Phillips). Pending: H.B. 318 (136th G.A., introduced June 2025) would amend 5162.21 and 5162.211, reportedly capping home liens. It was still 'As Introduced' in House Medicaid Committee in the March 2026 snapshot; final status not confirmed. State Plan 4.17-A not retrieved. The 2000 original TOD deed date comes from secondary sources. TOD deed effective date detail: 2000, original TOD deed, month not verified in a primary source); current affidavit form 2009-12-28 (Am. Sub. S.B. 124, 128th G.A." }, { "code": "OK", "name": "Oklahoma", "recovery_scope": "probate_only", "recovery_scope_note": "OHCA rules define the recoverable estate as property included in the member's estate as defined by Title 58 (probate code); no statute or rule adopts the expanded definition. Oklahoma also uses a TEFRA-type homestead lien (63 O.S. Sec. 5051.3) on nursing facility or ICF/IID residents not expected to return home; the lien survives conveyance, succession or inheritance, severs a joint tenancy, and may be enforced before or after death. No recovery from the surviving spouse's estate found in the rules.", "recovery_statute": "63 O.S. Sec. 5051.3 (homestead lien); OAC 317:35-19-4 and 317:35-9-15 (estate recovery, estate defined by Title 58)", "recovery_statute_url": "https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf", "state_plan_4_17_a_url": "https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-assistance-for-adults-and-children-eligibility/nursing-facility-services/medicaid-recovery.html", "life_estate": "not_reachable", "life_estate_note": "Estate is the Title 58 probate estate; a retained life estate ends at death and the remainder passes outside probate. Caveat: a homestead lien filed while the recipient owned the fee stays on the property after conveyance.", "life_estate_cite": "OAC 317:35-19-4(c)(2); 63 O.S. Sec. 5051.3(F)(2)", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "If given effect, the remainder passes outside the Title 58 estate, so estate recovery cannot reach it; no Oklahoma primary authority recognizing the deed was found. Same homestead lien caveat applies.", "lady_bird_deed_cite": "OAC 317:35-19-4(c)(2)", "tod_deed": "unclear", "tod_deed_note": "TOD property passes outside probate, so it is outside the Title 58 estate claim. But the beneficiary takes subject to all liens the owner was subject to during life, so a recorded OHCA homestead lien follows the house.", "tod_deed_cite": "58 O.S. Sec. 1255(A); 63 O.S. Sec. 5051.3(F)(2); OAC 317:35-19-4(c)(2)", "joint_tenancy": "unclear", "joint_tenancy_note": "Survivorship property is outside the probate estate claim, but a filed OHCA homestead lien severs the joint tenancy and is enforceable to the extent of the recipient's ownership share.", "joint_tenancy_cite": "63 O.S. Sec. 5051.3(F)(5); OAC 317:35-19-4(c)(2)", "revocable_trust": "unclear", "revocable_trust_note": "Trust assets are outside the Title 58 estate, but the Oklahoma Uniform Trust Code (eff. Nov. 1, 2025) makes property of a trust revocable at death subject to the settlor's creditors' claims to the extent the probate estate is inadequate. Whether OHCA uses this is untested.", "revocable_trust_cite": "60 O.S. Sec. 1605.1(A)(2) (Laws 2025, c. 254, Sec. 36); OAC 317:35-19-4(c)(2)", "tod_deed_recognized": "yes", "tod_deed_statute": "58 O.S. Sec. 1251 to 1258 (Nontestamentary Transfer of Property Act)", "tod_deed_effective": "2008-11-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Oklahoma statute, reported case or OHCA rule found recognizing an enhanced life estate deed; searched web for Oklahoma lady bird / enhanced life estate authority and reviewed OHCA recovery rules. Only practitioner pages found.", "hardship_waiver_home": "No lien while home is lawful residence of a sibling with an equity interest who lived there 1 year before admission; lien not enforced while such sibling or a caregiver son or daughter (lived there 2 years before admission and provided care that delayed institutionalization) lives there. General undue hardship waiver (deprivation of necessities). Up to $6,000 of sale proceeds may be set aside for funeral. (63 O.S. Sec. 5051.3(D), (F)(1), (J); OAC 317:35-19-4(b)(3), (b)(5))", "recovery_exemptions_note": "Lien enforcement barred while a surviving spouse (until death or abandonment of homestead), child 20 or under, or disabled adult child resides in the home. Long-Term Care Partnership disregard protected from recovery. (63 O.S. Sec. 5051.3(D), (F); OAC 317:35-19-4(b)(1)(B), (c)(5))", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf; https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os58.pdf; https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os60.pdf; https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os56.pdf; https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-assistance-for-adults-and-children-eligibility/nursing-facility-services/medicaid-recovery.html; https://oklahoma.gov/ohca/policies-and-rules/xpolicy/medical-assistance-for-adults-and-children-eligibility/icf-iid--hcbw-iid--and-individuals-age-65-or-older-in-mental-hea/medicaid-recovery-program/medicaid-recovery.html", "confidence": "high", "flags": "Coordinator hint '63 O.S. 5051.3' is the homestead lien statute, not an estate definition; the estate definition (Title 58) is in OAC rules 317:35-19-4(c)(2) and 317:35-9-15(c)(2) (latter revised 09-01-25). OSCN was unreachable; statutes read from the Legislature's compiled title PDFs. No 2024 to 2026 recovery amendment found; new Oklahoma Uniform Trust Code, Laws 2025 c. 254, eff. Nov. 1, 2025, adds revocable trust creditor liability. No CMS Attachment 4.17-A located; URL field holds the OAC rule page. Lien survives TOD transfer and severs joint tenancy, so the house can be reached in lien cases despite probate-only estate recovery." }, { "code": "OR", "name": "Oregon", "recovery_scope": "expanded", "recovery_scope_note": "ORS 416.350(6)(a) defines estate as all real and personal property in which the decedent had any legal title or interest at death, including assets conveyed to a survivor, heir or assign through joint tenancy, tenancy in common, survivorship, life estate, living trust or other similar arrangement. Recovery may be made from the estate or from any recipient of property held at death, including the estate of the surviving spouse (Sec. 416.350(2)); the claim against the spouse's estate is limited to what the spouse received from the recipient by probate or operation of law (OAR 461-135-0835(4)(d)). For assistance paid on or after Oct. 1, 2013, the claim covers only costs paid while the state paid for nursing facility, home and community based care or state plan personal care for a recipient 55 or older (OAR 461-135-0835(4)(f)(D)). Transfers without adequate consideration are voidable under ORS 411.620 (Sec. 416.350(2)). No pre-death TEFRA lien statute found in the texts read.", "recovery_statute": "Or. Rev. Stat. Sec. 416.350; OAR 461-135-0832, 461-135-0835", "recovery_statute_url": "https://www.oregonlegislature.gov/bills_laws/ors/ors416.html", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "Life estates are named in the statutory and rule definitions of estate. The life estate is valued as of the moment before death using life estate tables, regardless of when it was created (State Dept. of Human Services v. Willingham, 206 Or App 156 (2006)), and the remainder holder bears the burden of proving the decedent's interest.", "life_estate_cite": "Or. Rev. Stat. Sec. 416.350(4), (6)(a); OAR 461-135-0832; OAR 461-135-0845", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Oregon rule addresses an enhanced life estate deed, but the estate definition covers any life estate or other similar arrangement in which the recipient had legal title or beneficial interest at death, which on its text includes a retained life estate with powers.", "lady_bird_deed_cite": "Or. Rev. Stat. Sec. 416.350(6)(a); OAR 461-135-0832", "tod_deed": "reachable", "tod_deed_note": "The rule definition of estate expressly lists property conveyed by transfer on death deed, and the transferor's interest is presumed to be 100 percent. Separately, ORS 93.973 lets the probate estate enforce allowed claims against TOD property within 18 months of death if the probate estate is insufficient.", "tod_deed_cite": "OAR 461-135-0832 (estate def. (f)); OAR 461-135-0845; Or. Rev. Stat. Sec. 93.973", "joint_tenancy": "reachable", "joint_tenancy_note": "Joint tenancy, tenancy by the entirety and survivorship arrangements are named in the statutory and rule definitions of estate. The decedent's share is valued under OAR 461-135-0845.", "joint_tenancy_cite": "Or. Rev. Stat. Sec. 416.350(6)(a); OAR 461-135-0832; OAR 461-135-0845", "revocable_trust": "reachable", "revocable_trust_note": "Living trusts are named in the statutory and rule definitions of estate, so a house held in the recipient's revocable trust at death is subject to the claim.", "revocable_trust_cite": "Or. Rev. Stat. Sec. 416.350(6)(a); OAR 461-135-0832", "tod_deed_recognized": "yes", "tod_deed_statute": "Or. Rev. Stat. Sec. 93.948 to 93.985", "tod_deed_effective": "2012-01-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Oregon statute, reported case or DHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Searched web for Oregon enhanced life estate and lady bird deed authority; OAR 461-145-0310 (life estates, eligibility) is silent on retained powers. Results were secondary pages only.", "hardship_waiver_home": "The department may waive all or part of a claim, or take a mortgage or trust deed instead of enforcing it, if enforcement would make the applicant eligible for assistance or homeless. No waiver if the hardship was created by estate planning to avoid recovery (OAR 461-135-0841). No statutory home-specific exemption: SB 1029 (2025), which would have barred recovery against a home when a caregiving child lived there and gave care for 2 years, died in committee upon adjournment on June 28, 2025.", "recovery_exemptions_note": "For assistance paid on or after Oct. 1, 2013, only long-term care, home and community based care and state plan personal care costs for recipients 55 or older are recoverable; Medicare cost sharing paid on or after Jan. 1, 2010 is excluded (OAR 461-135-0835(4)(f)). Qualified long-term care partnership benefits are disregarded (ORS 416.350(5); OAR 461-135-0835(4)(a)). No recovery to the extent the need for aid resulted from a crime against the recipient (ORS 416.350(3)). ABLE accounts are protected (ORS 178.380). Separate rule for American Indian and Alaska Native tribal members (OAR 461-135-0837).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://oregon.public.law/statutes/ors_416.350; https://oregon.public.law/statutes/ors_416.351; https://secure.sos.state.or.us/oard/view.action?ruleNumber=461-135-0832; https://oregon.public.law/rules/oar_461-135-0832; https://oregon.public.law/rules/oar_461-135-0835; https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=316581; https://oregon.public.law/rules/oar_461-135-0841; https://oregon.public.law/rules/oar_461-135-0845; https://oregon.public.law/rules/oar_461-145-0310; https://oregon.public.law/statutes/ors_93.948; https://oregon.public.law/statutes/ors_93.973; https://www.oregon.gov/oha/hsd/ohp/pages/payment-recovery.aspx; https://www.oregon.gov/odhs/financial-recovery/pages/estate-recovery.aspx; https://fastdemocracy.com/bill-search/or/2025/bills/ORB00021083/; https://www.virtualunderwriter.com/bulletins/2013/7/bl132037195500000072", "confidence": "medium", "flags": "oregonlegislature.gov and olis.oregonlegislature.gov were unreachable from both the script and WebFetch (timeouts, connection refused), so ORS text was read on the oregon.public.law mirror (2023 edition plus 2024 changes); the 2025 ORS edition was not read. The estate definition in OAR 461-135-0832 was read on the official Secretary of State site via WebFetch (not verbatim). 2023 to 2025 legislation: SB 1029 (2025) would have exempted the home when survived by a caregiving child and removed the voidable transfer clause, subject to CMS approval; it passed Senate Human Services with amendments (A-engrossed) on Apr. 15, 2025, went to Ways and Means, and was in committee upon adjournment June 28, 2025 (status from FastDemocracy, not OLIS). Some law firm pages say a caregiver exception was 'confirmed in 2025 legislation'; that conflicts with the bill's recorded status. No other 2023 to 2026 estate recovery bill found (2026 HB 4156 is unrelated EMS funding). TOD deed effective date 2012-01-01 is from a Stewart Title underwriting bulletin; the official 2011 ch. 212 page was unreachable. OAR 461-135-0835 last amended effective 10/01/2024 (SSP 55-2024). TOD deed effective date detail: 2012-01-01, Or. Laws 2011, ch. 212." }, { "code": "PA", "name": "Pennsylvania", "recovery_scope": "probate_only", "recovery_scope_note": "62 P.S. Sec. 1412(a) requires recovery from the probate estate and lets DHS, with the Governor's approval, expand recovery by regulation to other property in which the individual had legal title or interest at death. DHS has not done so. The regulation limits estate property to property subject to administration by the personal representative, whether administered or not (55 Pa. Code Sec. 258.3(a)), and DHS said in 1999 that it elected the federal minimum program. Recovery covers nursing facility, home and community based, and related hospital and drug services from age 55. No TEFRA lien or recovery from a surviving spouse's estate was found in the texts read; collection is postponed until the spouse dies (Sec. 258.7).", "recovery_statute": "62 P.S. Sec. 1412 (Public Welfare Code Sec. 1412); 55 Pa. Code Ch. 258", "recovery_statute_url": "https://www.palegis.us/statutes/unconsolidated/law-information/view-statute?txtType=HTM&yr=1967&sessInd=0&smthLwInd=0&act=21&chpt=14&sctn=12&subsctn=0", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and is not administered by the personal representative, so it is outside the estate property defined by regulation.", "life_estate_cite": "55 Pa. Code Sec. 258.3(a); 62 P.S. Sec. 1412(a)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Pennsylvania authority on a life estate deed with a retained power to sell was found. If it is valid, the house passes to the remainder beneficiaries outside administration and outside the Sec. 258.3(a) estate, but its validity in Pennsylvania is untested.", "lady_bird_deed_cite": "55 Pa. Code Sec. 258.3(a)", "tod_deed": "n/a", "tod_deed_note": "Pennsylvania has no transfer-on-death deed statute. H.B. 2124 of 2026 (Uniform Real Property Transfer on Death Act) was introduced Jan. 9, 2026 and reprinted Aug. 13, 2026, but it has not been enacted.", "tod_deed_cite": "H.B. 2124, 2025-2026 Sess. (pending)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The regulation expressly excludes property held with another as joint tenants with right of survivorship or as tenants by the entireties.", "joint_tenancy_cite": "55 Pa. Code Sec. 258.3(b)", "revocable_trust": "unclear", "revocable_trust_note": "The DHS rule says assets placed in trust before death are not subject to the claim unless payable to the estate. But the later trust code makes revocable trust property liable after death for the settlor's creditors when the probate estate is inadequate, and the DHS claim is a creditor claim. No text read resolves the conflict.", "revocable_trust_cite": "55 Pa. Code Sec. 258.3(d); 20 Pa.C.S. Sec. 7745(3)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Pennsylvania statute, reported case or DHS rule recognizing an enhanced life estate deed was found. Searches returned only law firm pages, which disagree on whether the deed works in Pennsylvania.", "hardship_waiver_home": "DHS permanently waives its claim on the primary residence for a person who lived there continuously at least 2 years before nursing facility care (or during 2 years of home and community services), has no other permanent residence, and gave the decedent at least 2 years of care or support. It also waives for an income-producing asset (family farm, business or rental) that is the household's primary income source for a spouse, child, parent, sibling or grandchild, and credits reasonable home maintenance costs (55 Pa. Code Sec. 258.10(b) to (e)). Collection is postponed while a sibling with an equity interest who lived in the home 1 year before death stays there (Sec. 258.7(a)(4)).", "recovery_exemptions_note": "Recovery is limited to nursing facility, home and community based, and related hospital and drug services from age 55, for services on or after Aug. 15, 1994 (Sec. 258.1). Claims are waived for administered estates of $2,400 or less gross value if there is an heir (Sec. 258.10(f)). Life insurance payable directly to a beneficiary is not reached (Sec. 258.3(c)). Native American and Alaska Native property is exempt (Sec. 258.3(g)).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://codes.findlaw.com/pa/title-62-ps-poor-persons-and-public-welfare/pa-st-sect-62-1412/; https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter258/s258.1.html&d=reduce; https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter258/s258.3.html&d=reduce; https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter258/s258.7.html&d=reduce; https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter258/s258.9.html&d=reduce; https://www.pacodeandbulletin.gov/Display/pacode?file=%2Fsecure%2Fpacode%2Fdata%2F055%2Fchapter258%2Fs258.10.html; https://www.pacodeandbulletin.gov/Display/pabull?file=/secure/pabulletin/data/vol29/29-30/1179.html; https://codes.findlaw.com/pa/title-20-pacsa-decedents-estates-and-fiduciaries/pa-csa-sect-20-7745/; https://www.pa.gov/agencies/dhs/resources/for-residents/estate-recovery; https://www.billtrack50.com/billdetail/1925010", "confidence": "medium", "flags": "The regulations (55 Pa. Code Ch. 258) were read on the official PA Code site (current through July 4, 2026). The statute, 62 P.S. Sec. 1412, and 20 Pa.C.S. Sec. 7745 were read only through a WebFetch extraction of FindLaw, because palegis.us refused connections and Justia returned 403. The statute gives DHS standing authority to expand to non-probate assets by regulation, so the scope could change without legislation. Revocable trust treatment conflicts: Sec. 258.3(d) (1999 rule) against the UTC Sec. 7745(3). TOD: H.B. 2124 (URPTODA) passed House Judiciary 26-0 on Feb. 4, 2026 (secondary source), with a corrective reprint on Aug. 13, 2026 (Printer's No. 3818); not enacted as of this check. State Plan 4.17-A not retrieved." }, { "code": "RI", "name": "Rhode Island", "recovery_scope": "probate_only", "recovery_scope_note": "Recovery is by a lien on the estate, defined as real and personal property 'included or includable within the individual's probate estate', whether or not probate is opened (R.I. Gen. Laws Sec. 40-8-15(a)(1), (a)(2)). The EOHHS rule says property passing by operation of law or under a contract, deed, annuity, trust agreement or other instrument that needs no probate is excluded from the lien (210-RICR-10-00-4.4(B)). The lien attaches to real property only when a statement of claim is recorded in land evidence records (Sec. 40-8-15(e)). No pre-death TEFRA lien: the lien arises on death. Heirs and others who receive distributions are personally liable to the extent of the distribution (Sec. 40-8-15(g)).", "recovery_statute": "R.I. Gen. Laws Sec. 40-8-15; 210-RICR-10-00-4", "recovery_statute_url": "https://webserver.rilegislature.gov/Statutes/TITLE40/40-8/40-8-15.htm", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes by deed, not through probate, so it is outside the probate-only lien. The EOHHS rule expressly excludes property passing under a deed.", "life_estate_cite": "R.I. Gen. Laws Sec. 40-8-15(a)(2); 210-RICR-10-00-4.4(B)", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "At death the house passes to the remainder beneficiary without probate, outside the probate-only lien. But for deeds made on or after July 1, 2014 the home is not an excluded resource for Medicaid eligibility unless the owner conveys the remainder back to himself or herself, so the deed mainly helps people who never need Medicaid long-term care or whose deed predates July 1, 2014.", "lady_bird_deed_cite": "R.I. Gen. Laws Sec. 40-8-15(a)(2); Sec. 40-8-3.1; 210-RICR-10-00-4.4(B); 210-RICR-50-00-6.9", "tod_deed": "n/a", "tod_deed_note": "Rhode Island has no transfer-on-death deed statute. The Uniform Real Property TOD Act has been filed each year (2024 S 2027, 2025 S 0141, 2026 S 2050) but the Title 33 chapter list as of September 2026 shows no such chapter.", "tod_deed_cite": "2026 S 2050 (not enacted); R.I. Gen. Laws Title 33 index", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes by operation of law, outside the probate estate, and the EOHHS rule expressly excludes property passing by operation of law from the lien.", "joint_tenancy_cite": "R.I. Gen. Laws Sec. 40-8-15(a)(2); 210-RICR-10-00-4.4(B)", "revocable_trust": "not_reachable", "revocable_trust_note": "Trust property passes under the trust agreement, not through probate, and the EOHHS rule expressly lists trust agreements among excluded instruments. No Rhode Island statute making revocable trust property liable for the settlor's estate claims (UTC Sec. 505 type) was found.", "revocable_trust_cite": "R.I. Gen. Laws Sec. 40-8-15(a)(2); 210-RICR-10-00-4.4(B)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "statute", "lady_bird_authority": "R.I. Gen. Laws Sec. 34-4-2.1 (reservation of life estate with enhanced powers to sell, convey or mortgage without the remainder holder's consent; P.L. 2014, ch. 145, art. 19, Sec. 1). Medicaid treatment: Sec. 40-8-3.1 (P.L. 2014, ch. 145, art. 19, Sec. 3) and 210-RICR-50-00-6.9 (home not excluded for deeds on or after July 1, 2014; deeds recorded on or before June 30, 2014 do not cause ineligibility).", "hardship_waiver_home": "EOHHS must waive in whole or in part for undue hardship under federal criteria (Sec. 40-8-15(f)). The rule lets an heir delay (postpone) enforcement against the home if the heir lived there as a principal residence on the date of death and for 24 months before, has gross income at or below 250% of the federal poverty level and assets within Medically Needy limits; also case by case if the heir would be homeless or lose a livelihood. The deferral lasts while the heir lives there (210-RICR-10-00-4.12 to 4.15).", "recovery_exemptions_note": "Beyond deferral, the lien never attaches if the recipient is survived by a spouse, child under 21, or blind or disabled child, so there is no later recovery from the surviving spouse's estate (Sec. 40-8-15(a)(1); 210-RICR-10-00-4.6). Recovery covers all Medicaid paid at age 55 or older, not just long-term care. Long-term care partnership benefits paid are disregarded (210-RICR-10-00-4.7).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "http://web.archive.org/web/20260731122452/https://webserver.rilegislature.gov/Statutes/TITLE40/40-8/40-8-15.htm; https://rules.sos.ri.gov/regulations/part/210-10-00-4; https://risos-apa-production-public.s3.amazonaws.com/EOHHS/REG_11841_20211214161030.pdf; http://web.archive.org/web/20250402042357/https://webserver.rilegislature.gov//statutes/TITLE34/34-4/34-4-2.1.htm; http://web.archive.org/web/20250331192543/https://webserver.rilegislature.gov//statutes/TITLE40/40-8/40-8-3.1.htm; https://www.law.cornell.edu/regulations/rhode-island/210-RICR-50-00-6.9; http://web.archive.org/web/20260425194410/https://webserver.rilegislature.gov/BillText/BillText26/SenateText26/S2050.pdf; http://web.archive.org/web/20260917172437/https://webserver.rilegislature.gov/Statutes/TITLE33/INDEX.HTM; http://web.archive.org/web/20251213231040/https://webserver.rilegislature.gov/Statutes/TITLE34/INDEX.HTM", "confidence": "high", "flags": "Official legislature site timed out for scripts; statute text read from Wayback captures of webserver.rilegislature.gov (40-8-15 captured 2026-07-31). Rhode Island is one of the few states with a lady bird deed statute (2014), which popular 'five lady bird states' lists omit. TOD deed: 2026 S 2050 was held for further study in Senate Judiciary (April 28, 2026) per secondary tracker; status after June 2026 not confirmed from the legislature, but the Title 33 index captured 2026-09-17 shows no TOD chapter. Revocable trust: Rhode Island does not appear to have a UTC Sec. 505 equivalent (secondary search only; Title 18 index not read), so common-law creditor rights against a revocable trust are untested. Attachment 4.17-A not found." }, { "code": "SC", "name": "South Carolina", "recovery_scope": "probate_only", "recovery_scope_note": "Sec. 43-7-460(F)(1) defines estate as property 'included within the individual's estate as defined in Section 62-1-201(11)', the Probate Code definition, and the claim is a probate claim with the priority set by Sec. 62-3-805(a)(2)(ii). South Carolina did not adopt the expanded federal option. Recovery is deferred until the surviving spouse dies (Sec. 43-7-460(B)); no recovery from the spouse's own estate was found. No pre-death lien statute was found; Attachment 4.17-A pages on liens were not read. One non-probate exception: a revocable trust is liable for estate claims when the probate estate is inadequate (Sec. 62-7-505(a)(3)).", "recovery_statute": "S.C. Code Ann. Sec. 43-7-460", "recovery_statute_url": "https://www.scstatehouse.gov/code/t43c007.php", "state_plan_4_17_a_url": "https://www.medicaid.gov/medicaid/spa/downloads/SC-25-0008.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes outside the probate estate, which is all Sec. 43-7-460 reaches.", "life_estate_cite": "S.C. Code Ann. Sec. 43-7-460(F)(1); Sec. 62-1-201(11)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No South Carolina authority recognizes a deed reserving to the grantor a power to sell without the remainder's consent; a bill to create one (H. 4264) is still in committee. If valid, the remainder would pass outside probate, but whether the deed works is untested.", "lady_bird_deed_cite": "S.C. Code Ann. Sec. 43-7-460(F)(1); H. 4264 (2025 to 2026 session, not enacted)", "tod_deed": "n/a", "tod_deed_note": "South Carolina has no transfer-on-death deed for real property. Its TOD statute covers only titled personal property (vehicles, mobile homes, watercraft, outboard motors), effective July 1, 2025. Real property TOD bills (H. 5189 of 2024, S. 49 of 2025 to 2026) died or remain in committee.", "tod_deed_cite": "S.C. Code Ann. Sec. 62-6-401 (2024 Act No. 200, eff. July 1, 2025); S. 49 (2025 to 2026)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "On a joint tenant's death the entire interest vests in the surviving joint tenant by statute, outside the probate estate that the Medicaid claim is limited to.", "joint_tenancy_cite": "S.C. Code Ann. Sec. 27-7-40(a)(i), (ii); Sec. 43-7-460(F)(1)", "revocable_trust": "reachable", "revocable_trust_note": "Property in a revocable trust at the settlor's death is subject to the settlor's creditors' claims to the extent the probate estate is inadequate, so a house in a revocable trust can be used to pay the Medicaid claim if the probate estate falls short.", "revocable_trust_cite": "S.C. Code Ann. Sec. 62-7-505(a)(3); Sec. 43-7-460(E); Sec. 62-3-805(a)(2)(ii)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No statute or reported case recognizing a life estate deed with a retained power to sell was found. A practitioner blog (letstalkdirtsc.com, 2023) points to Blackmon v. Weaver, 366 S.C. 245 (Ct. App. 2005) and Johnson v. Waldrop, 256 S.C. 372 (1971), which uphold life estates with a power of sale created by will, not by deed; these cases were not read. H. 4264, the South Carolina Enhanced Life Estate Deed Act, was introduced March 27, 2025 and remains in House Judiciary.", "hardship_waiver_home": "Waiver is mandatory on proof of undue hardship (Sec. 43-7-460(C)). Under the state plan (SPA 25-0008, eff. Aug. 1, 2025) an immediate family member (parent, sibling, adult child, grandchild) who lived in the home, has it as legal residence and would have no other place to live can get a waiver: a sibling with an equity interest who lived there 1 year before nursing home or community long-term care began, or a parent, sibling, child or grandchild who lived there 2 years before.", "recovery_exemptions_note": "Statute reaches nursing facility, HCBS and related hospital and drug services for recipients 55 or older, plus institutionalized recipients of any age, for assistance paid after June 30, 1994 (Sec. 43-7-460(A), (D)). If federal law ever lets states exempt HCBS, recovery for those 55 and older shrinks to nursing facility services (Sec. 43-7-460(G)). SPA 25-0008 added grandchildren to the hardship family members.", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://www.scstatehouse.gov/code/t43c007.php; https://www.scstatehouse.gov/code/t62c001.php; https://www.scstatehouse.gov/code/t62c002.php; https://www.scstatehouse.gov/code/t62c006.php; https://www.scstatehouse.gov/code/t62c007.php; https://www.scstatehouse.gov/code/t27c007.php; https://www.scstatehouse.gov/sess126_2025-2026/bills/49.htm; https://www.scstatehouse.gov/sess126_2025-2026/bills/4264.htm; https://www.scstatehouse.gov/billsearch.php?billnumbers=4264&session=126&summary=B&PRINT=1; https://www.scstatehouse.gov/sess125_2023-2024/bills/5189.htm; https://www.medicaid.gov/medicaid-spa/2025-09-26/185211; https://www.medicaid.gov/medicaid/spa/downloads/SC-25-0008.pdf; https://letstalkdirtsc.com/2023/08/23/do-lady-bird-deeds-work-in-south-carolina/", "confidence": "high", "flags": "SCDHHS pages (scdhhs.gov estate recovery page, brochure, eligibility manual) returned 403 to all fetch methods; search snippets say SCDHHS recovers only when the estate exceeds $25,000 and claims exceed $500, but this was not read and is left out of the notes. Only Attachment 4.17-A page 3 (SPA 25-0008) was read; pages 1 and 2 (estate definition, liens, cost effectiveness) were not. Sec. 62-1-201(11) defines estate broadly as 'the property of the decedent, trust, or other person whose affairs are subject to this Code'; read with Sec. 43-7-460 as the probate estate. Revocable trust exposure turns on Sec. 62-7-505(a)(3); no DHHS policy on trust claims was read. No enacted TOD deed or enhanced life estate deed law found through the 2026 session (S. 49 and H. 4264 in committee; 2025 to 2026 is the final year of the 126th session). Code site shows no amendment to Sec. 43-7-460 since 2011." }, { "code": "SD", "name": "South Dakota", "recovery_scope": "expanded", "recovery_scope_note": "SDCL Sec. 28-6-23 makes Medicaid paid for institutional care, and for nursing facility, HCBS, ICF, hospital and prescription drug services at age 55+, a debt due the Department of Social Services and directs DSS to define the scope of recovery by rule. ARSD 67:48:02:01(2) defines estate as the probate estate under SDCL 29A-1-201 plus any other property in which the individual had legal title or interest at death, including assets conveyed through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement. SD uses TEFRA-type liens on real property of institutionalized recipients (SDCL Sec. 28-6-24; ARSD 67:48:02:04). DSS may also claim against the surviving spouse's estate (SDCL Sec. 28-6-23), limited on petition to the spouse's estate value at the recipient's death (SDCL Sec. 28-6-23.1).", "recovery_statute": "SDCL Sec. 28-6-23; ARSD 67:48:02:01(2) (estate definition), 67:48:02:05", "recovery_statute_url": "https://sdlegislature.gov/Statutes/28-6-23", "state_plan_4_17_a_url": "https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/SD/09-21-09-SD-09-001-179.pdf", "life_estate": "reachable", "life_estate_note": "The rule's estate definition expressly includes assets conveyed to a survivor, heir or assign through a life estate.", "life_estate_cite": "ARSD 67:48:02:01(2)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No South Dakota statute, case or DSS rule on enhanced life estate deeds was found. If used, the expanded definition (life estate or other arrangement in which the recipient had an interest at death) would likely reach it.", "lady_bird_deed_cite": "ARSD 67:48:02:01(2)", "tod_deed": "reachable", "tod_deed_note": "The TOD deed beneficiary is liable for the transferor's debts to the extent other property is insufficient, up to the property's value, subject to homestead exemptions; the act gives DSS a special deadline for medical assistance recovery actions (shorter of 2 years after death or 6 months after notice). The estate rule's 'other arrangement' language also applies.", "tod_deed_cite": "SDCL Sec. 29A-6-420 to 29A-6-424 (esp. 29A-6-421); ARSD 67:48:02:01(2)", "joint_tenancy": "reachable", "joint_tenancy_note": "The rule's estate definition expressly includes assets conveyed through joint tenancy, tenancy in common and survivorship.", "joint_tenancy_cite": "ARSD 67:48:02:01(2)", "revocable_trust": "reachable", "revocable_trust_note": "The rule's estate definition expressly includes assets conveyed through a living trust.", "revocable_trust_cite": "ARSD 67:48:02:01(2)", "tod_deed_recognized": "yes", "tod_deed_statute": "SDCL Sec. 29A-6-401 to 29A-6-432 (South Dakota Real Property Transfer on Death Act)", "tod_deed_effective": "2014-07-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "None found. Searched SDCL, ARSD 67:46 and 67:48, and DSS estate recovery pages; ARSD 67:46:05:08 values ordinary life estates only. Popular lists do not include SD.", "hardship_waiver_home": "Undue hardship means severe financial distress or significant compromise to a person's health care or shelter needs; DSS may compromise or waive a claim up to $15,000 (as of July 1, 2009, indexed). No home lien while a spouse, child under 21 or blind or disabled, sibling with equity interest (1 year residence) or caregiver adult child (2 years) lawfully resides in the home. State Plan Att. 4.17-A (SPA 09-001) paras. 1, 4, 5; ARSD 67:48:02:04.", "recovery_exemptions_note": "Recovery at 55+ limited to nursing facility, HCBS, ICF/IID, hospital and prescription drug services (SDCL 28-6-23). Long-term care partnership disregard reduces recovery (ARSD 67:48:02:05). Recovery under 67:48:02:06 ignores the lien and estate limits if the recipient had undisclosed assets that would have made him or her ineligible. Claims under $100 waived as not cost effective (Att. 4.17-A para. 6). Real estate deemed available to a community spouse is exempt from the lien (SDCL 28-6-26).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://sdlegislature.gov/api/Statutes/28-6-23.html; https://sdlegislature.gov/api/Statutes/28-6-23.1.html; https://sdlegislature.gov/api/Statutes/28-6-24.html; https://sdlegislature.gov/api/Statutes/28-6-26.html; https://sdlegislature.gov/api/Rules/Rule/67:48:02:01.html; https://sdlegislature.gov/api/Rules/Rule/67:48:02:04.html; https://sdlegislature.gov/api/Rules/Rule/67:48:02:05.html; https://sdlegislature.gov/api/Rules/Rule/67:48:02:06.html; https://dss.sd.gov/keyresources/benefitfraud/estate.aspx; https://dss.sd.gov/formsandpubs/docs/FRAUD/EstateRecoveryBrochure.pdf; https://dss.sd.gov/docs/medicaid/medicaidstateplan/4_GeneralProgramAdministration/4.17/4.17liensandadjustmentsofrecoveries.pdf; https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/SD/09-21-09-SD-09-001-179.pdf; https://sdlegislature.gov/api/Statutes/29A-6-401.html; https://sdlegislature.gov/api/Statutes/29A-6-403.html; https://sdlegislature.gov/api/Statutes/29A-6-420.html; https://sdlegislature.gov/api/Statutes/29A-6-421.html; https://sdlegislature.gov/api/Statutes/29A-6-422.html; https://sdlegislature.gov/api/Statutes/29A-6-423.html; https://mylrc.sdlegislature.gov/api/Documents/32285.html?Year=2014", "confidence": "high", "flags": "Expanded definition is in the administrative rule (ARSD 67:48:02:01(2), amended 40 SDR 229, eff. June 30, 2014), not in the statute; SDCL 28-6-23 delegates scope to rule. State Plan Att. 4.17-A (SPA 09-001, 2009) still carries an older estate definition (SDCL 10-40-1 style, property passing to heirs, grantees, donees) without the explicit non-probate list; DSS web page cites the same older definition. TOD act (SL 2014, ch 133, HB 1077) is titled Uniform Real Property Transfer on Death Act but its creditor sections (29A-6-420 to 424) are non-uniform and name DSS medical assistance recovery. Act applies to TOD deeds executed, acknowledged and recorded after July 1, 2014 (Sec. 35). Rule text on sdlegislature.gov is UTF-16 and saved copies show spaced characters. No 2024 to 2026 amendments to 28-6-23 found (history ends SL 2013, ch 125)." }, { "code": "TN", "name": "Tennessee", "recovery_scope": "probate_only", "recovery_scope_note": "T.C.A. Sec. 71-5-116(c) allows recovery from the recipient's estate for assistance received at 55+, and requires a TennCare release before any probate estate of a TennCare enrollee is closed. The statute does not define estate; State Plan Att. 4.17-A defines it as property owned immediately before death 'as limited or expanded by T.C.A. Titles 30, 31, and 32', i.e. the probate estate plus what probate law lets the personal representative reach. The claim is a third-priority probate claim (T.C.A. 30-2-317). One non-probate exception: revocable trust property is reachable when the probate estate is insufficient (Sec. 35-15-505; In re Estate of Stidham, 2012). No pre-death lien except by court judgment for incorrectly paid benefits (Sec. 71-5-116(b)); the State Plan says Tennessee does not apply TEFRA liens. No statute found authorizing recovery from the surviving spouse's estate.", "recovery_statute": "T.C.A. Sec. 71-5-116", "recovery_statute_url": "https://unicourt.github.io/cic-code-tn/transforms/tn/octn/r73/gov.tn.tca.title.71.html", "state_plan_4_17_a_url": "https://downloads.cms.gov/cmsgov/archived-downloads/MedicaidGenInfo/downloads/TN-10-006-Att.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder passes outside probate; Tennessee recovers only through a claim in the probate estate.", "life_estate_cite": "T.C.A. Sec. 71-5-116(c); State Plan Att. 4.17-A item 3 (TN 10-006)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "No Tennessee statute, reported case or TennCare rule on enhanced life estate deeds was found. If valid, the remainder would pass outside probate and outside the probate-only claim.", "lady_bird_deed_cite": "T.C.A. Sec. 71-5-116(c); State Plan Att. 4.17-A item 3", "tod_deed": "n/a", "tod_deed_note": "Tennessee has no transfer-on-death deed statute for real property. URPTODA bills SB 984 (2025) and HB 1793 / SB 2029 (2026) died in the 114th General Assembly.", "tod_deed_cite": "TN SB 984 and HB 1793 (114th G.A.), not enacted", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Property passing by survivorship is not part of the probate estate, and no Tennessee statute found makes the surviving joint owner liable for the Medicaid claim.", "joint_tenancy_cite": "T.C.A. Sec. 71-5-116(c); State Plan Att. 4.17-A item 3", "revocable_trust": "reachable", "revocable_trust_note": "Property of a trust revocable at death is subject to the settlor's creditors, with probate claim priorities, when the probate estate is inadequate; the Court of Appeals let TennCare reach real property in a revocable trust on this basis.", "revocable_trust_cite": "T.C.A. Sec. 35-15-505 (paragraph on trusts revocable at the settlor's death); In re Estate of Stidham, 438 S.W.3d 535 (Tenn. Ct. App. 2012)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "None found. Searched Tennessee Code, TennCare estate recovery page and State Plan, and case law annotations to Sec. 71-5-116; only practitioner web pages (conflicting) address it.", "hardship_waiver_home": "Undue hardship: (1) estate property is the survivors' sole income-producing asset, such as a family farm or business (no value limit), which waives recovery; (2) sibling who lived in the home 1 year before admission, gave care that kept the recipient home, and still lives there; (3) child who did the same for 2 years. The sibling and child hardships defer recovery only while that person lives in the home. State Plan Att. 4.17-A item 4; TennCare Estate Recovery web page.", "recovery_exemptions_note": "Statute defers recovery while a child under 18 (not 21) survives, and extends the disabled-child protection to a child who became blind or disabled after majority when TennCare or the court finds undue hardship (Sec. 71-5-116(c)(1)). Estate cannot close without a TennCare release (Sec. 71-5-116(c)(2)). Waivers and compromises go through T.C.A. 20-13-103 approval or the probate court (Att. 4.17-A item 5).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://unicourt.github.io/cic-code-tn/transforms/tn/octn/r73/gov.tn.tca.title.71.html; https://unicourt.github.io/cic-code-tn/transforms/tn/octn/r73/gov.tn.tca.title.35.html; https://downloads.cms.gov/cmsgov/archived-downloads/MedicaidGenInfo/downloads/TN-10-006-Att.pdf; https://www.tn.gov/tenncare/legal/estate-recovery.html; https://codes.findlaw.com/tn/title-71-welfare/tn-code-sect-71-5-116/; https://www.billtrack50.com/billdetail/1943472; https://www.billtrack50.com/billdetail/1819745", "confidence": "medium", "flags": "Statute text read from the public Tennessee Code Annotated release mirror (unicourt cic-code-tn, release 73), not the official LexisNexis site; Justia and wapp.capitol.tn.gov blocked. Mirror history for 71-5-116 ends with Acts 2006, ch. 639; no later amendment found but mirror may lag. Statute uses child under 18, while the federal floor in 42 U.S.C. 1396p(b)(2) is under 21; TennCare practice on this point not verified. Probate-only in form, but revocable trusts are reachable. TOD deed bills (SB 984, HB 1793) died; HB 1793 sponsor withdrawn Feb 25, 2026. Lady bird deed status unresolved." }, { "code": "TX", "name": "Texas", "recovery_scope": "probate_only", "recovery_scope_note": "Gov't Code Sec. 546.0403 (former Sec. 531.077, recodified by HB 4611, eff. April 1, 2025) directs HHSC to implement 42 U.S.C. 1396p(b)(1). 1 TAC Sec. 373.105 defines estate by reference to the probate estate definition, now Estates Code Sec. 22.012, and the MERP claim is a Class 7 probate claim (1 TAC 373.201, 373.203; Estates Code 355.102). HHSC's MERP FAQ says the estate is property subject to probate and excludes assets passing outside probate. MERP places no liens before or after death (MERP FAQ). No recovery from the surviving spouse's estate found. Recovery applies only to recipients who first applied for covered long-term care on or after March 1, 2005 (1 TAC 373.103).", "recovery_statute": "Tex. Gov't Code Sec. 546.0403 (former Sec. 531.077); 1 TAC ch. 373", "recovery_statute_url": "https://capitol.texas.gov/tlodocs/88R/billtext/html/HB04611F.htm", "state_plan_4_17_a_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/d-7800-medicaid-estate-recovery-program", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder is not part of the probate estate, which is the only estate MERP claims against.", "life_estate_cite": "1 TAC Sec. 373.105 (Estate); Estates Code Sec. 22.012", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "The home passes to the remainder beneficiaries at death outside probate, so the probate-only MERP claim does not reach it. HHSC eligibility policy treats an enhanced life estate deed approved by the regional attorney as no transfer penalty.", "lady_bird_deed_cite": "1 TAC Sec. 373.105; MEPD Handbook I-3100", "tod_deed": "not_reachable", "tod_deed_note": "Although TOD deed property is liable for general creditor claims when the estate is insufficient (Sec. 114.106(a)), the statute says TOD property is not probate estate property for any purpose, expressly including Medicaid estate recovery under Gov't Code 546.0403.", "tod_deed_cite": "Tex. Estates Code Sec. 114.106(b)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "Survivorship property passes outside probate; HHSC's MERP FAQ lists joint accounts with right of survivorship as outside the recoverable estate.", "joint_tenancy_cite": "1 TAC Sec. 373.105; HHSC MERP FAQ", "revocable_trust": "not_reachable", "revocable_trust_note": "Trust property is not part of the probate estate that MERP claims against. No Texas statute equivalent to UTC Sec. 505 making a revocable trust liable for estate claims was found.", "revocable_trust_cite": "1 TAC Sec. 373.105; Estates Code Sec. 22.012", "tod_deed_recognized": "yes", "tod_deed_statute": "Tex. Estates Code ch. 114 (Texas Real Property Transfer on Death Act), Sec. 114.001 et seq.", "tod_deed_effective": "2015-09-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "agency_rule", "lady_bird_authority": "HHSC MEPD Handbook I-3100 (Rev. 20-4, eff. Dec. 1, 2020): transfer of the home to children, siblings, etc. is not penalized if the deed is an enhanced life estate or TOD deed approved by the regional attorney. No Texas statute creates the deed; no Texas appellate case was read today.", "hardship_waiver_home": "Homestead undue hardship: first $150,000 of appraisal district value (raised from $100,000 effective Aug. 27, 2026) exempt when siblings or direct descendants inheriting have gross family income below 300% of the federal poverty threshold; prorated when only some heirs qualify. Other grounds: family business, farm or ranch operated on the property 12+ months that provides 50%+ of heirs' livelihood; heirs would become eligible for public assistance; crime against the recipient; other compelling reasons. Deductions for home maintenance costs and paid care that delayed institutionalization. 1 TAC Sec. 373.209, 373.213.", "recovery_exemptions_note": "No claim while an unmarried adult child has lived continuously in the homestead for 12 months before death (1 TAC 373.207(a)(4)). American Indian and Alaska Native property and government reparation payments exempt (373.207(b), (d)). No claim if recoverable estate is $15,000 or less or recoverable costs $5,000 or less (raised from $10,000 and $3,000, eff. Aug. 27, 2026) or sale costs would equal the property value (373.215). Recovery only for recipients who first applied for covered LTC on or after March 1, 2005 (373.103).", "karp_2005_scope": "not_in_survey", "last_verified": "2026-09-23", "sources": "https://capitol.texas.gov/tlodocs/88R/billtext/html/HB04611F.htm; https://www.law.cornell.edu/regulations/texas/1-Tex-Admin-Code-SS-373-101; https://www.law.cornell.edu/regulations/texas/1-Tex-Admin-Code-SS-373-103; https://www.law.cornell.edu/regulations/texas/1-Tex-Admin-Code-SS-373-105; https://www.sos.state.tx.us/texreg/archive/March202026/Proposed%20Rules/1.ADMINISTRATION.html; https://www.sos.state.tx.us/texreg/pdf/backview/0821/0821adop.pdf; https://tcss.legis.texas.gov/resources/ES/htm/ES.114.htm; https://capitol.texas.gov/tlodocs/84R/analysis/html/SB00462F.htm; https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-3100-transfer-home; https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/d-7800-medicaid-estate-recovery-program; https://www.hhs.texas.gov/regulations/legal-information/your-guide-medicaid-estate-recovery-program/medicaid-estate-recovery-program-faqs", "confidence": "high", "flags": "Gov't Code 531.077 was recodified as Sec. 546.0403 by HB 4611 (88th Leg., R.S., 2023), eff. April 1, 2025; Estates Code 114.106(b) now cross-references 546.0403. 1 TAC ch. 373 amended effective Aug. 27, 2026 (adopted without changes to the March 20, 2026 proposal, 51 TexReg 1777; adoption in Aug. 21, 2026 TexReg): homestead hardship cap $100,000 to $150,000, cost-effective floors $10,000/$3,000 to $15,000/$5,000, claim filing window 70 to 120 days; related SPA approved July 31, 2026, eff. July 2, 2026 (not retrieved). Cornell LII copies of 373.103 and 373.105 predate these amendments; current text taken from the Texas Register proposal as adopted. statutes.capitol.texas.gov is JS-only; Gov't Code text read from the enrolled HB 4611. Attachment 4.17-A not found; field holds the MEPD handbook MERP section. TOD act is Texas-named and non-uniform in its creditor section; uniform_act=yes rests on its URPTODA-style structure and Sec. 114.005 uniformity clause, not confirmed on the ULC enactment list. Revocable trust: Texas has no UTC 505 counterpart located; post-death common-law creditor reach not researched." }, { "code": "UT", "name": "Utah", "recovery_scope": "expanded", "recovery_scope_note": "After death the department may recover from the 'recovery estate' and from any trust in which the recipient is grantor and beneficiary (Utah Code Sec. 26B-3-1013(1)). 'Recovery estate' includes the probate estate (Sec. 75-1-201), the decedent's augmented estate (Sec. 75-2-203), and property in which the decedent had a legal interest at death, including assets passing by joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement (Sec. 26B-3-1001(12)). The claim is a lien on the recovery estate or trust with the priority of last-illness medical expenses, of indefinite duration; a trust clause denying recovery is void (Sec. 26B-3-1013(2), (5), (7)). TEFRA liens on the real property of permanently institutionalized recipients are authorized, with a 180-day presumption (Sec. 26B-3-1015, 1016). Recovery is deferred while the spouse lives; agency materials say recovery occurs after the deaths of both the member and the surviving spouse.", "recovery_statute": "Utah Code Sec. 26B-3-1001(12), 26B-3-1013 (formerly Title 26, Ch. 19; definition formerly Sec. 26-19-102(12))", "recovery_statute_url": "https://le.utah.gov/xcode/Title26B/Chapter3/26B-3-S1013.html", "state_plan_4_17_a_url": "https://medicaid-documents.dhhs.utah.gov/stateplan/spa/A_4-17-A.pdf", "life_estate": "reachable", "life_estate_note": "The recovery estate expressly includes assets conveyed to a survivor or heir through a life estate, to the extent of the decedent's legal interest at death. The augmented estate prong also counts property the decedent transferred during marriage while keeping a life estate. How ORS values an ordinary life estate that ends at death was not found.", "life_estate_cite": "Utah Code Sec. 26B-3-1001(12)(b), (c); Sec. 75-2-205(2)(a); State Plan Att. 4.17-A item 3", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Utah authority for the deed was found, but if used it is a life estate arrangement with full retained control, within 'life estate ... or other arrangement'. A retained power to convey likely also counts in the augmented estate as property over which the decedent held a presently exercisable general power immediately before death.", "lady_bird_deed_cite": "Utah Code Sec. 26B-3-1001(12)(b), (c); Sec. 75-2-205(1)(a)", "tod_deed": "reachable", "tod_deed_note": "The owner holds full title until death, so the property is within the recovery estate (legal interest at death, and augmented estate). Separately, the TOD act lets the estate reach the property for allowed claims if the probate estate is insufficient, within 12 months of death.", "tod_deed_cite": "Utah Code Sec. 26B-3-1001(12)(b), (c); Sec. 75-6-415", "joint_tenancy": "reachable", "joint_tenancy_note": "The recovery estate expressly includes assets passing to a survivor by joint tenancy or survivorship, to the extent of the decedent's interest.", "joint_tenancy_cite": "Utah Code Sec. 26B-3-1001(12)(c)", "revocable_trust": "reachable", "revocable_trust_note": "The statute authorizes recovery from any trust in which the recipient is grantor and beneficiary, makes the claim a lien on the trust, and voids trust clauses that deny recovery. Living trust assets are also in the recovery estate definition.", "revocable_trust_cite": "Utah Code Sec. 26B-3-1013(1), (2), (4), (5); Sec. 26B-3-1001(12)(c)", "tod_deed_recognized": "yes", "tod_deed_statute": "Utah Code Sec. 75-6-401 to 75-6-419 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2018-05-08", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Utah statute, reported case or Medicaid rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Web search found only secondary pages, which say Utah does not recognize it.", "hardship_waiver_home": "Undue hardship (State Plan Att. 4.17-A item 4): survivor is a minor or blind or disabled child, or limited income where the property is the sole income-producing asset and support for survivors (e.g., a family farm or business); applies only to the share passing to those persons. Recovery is deferred while anyone with an equity interest in the home lives there as a primary residence, while a caregiver son or daughter who lived there 2 years before admission remains, and (for TEFRA liens) while a sibling who lived there 1 year before admission remains (item 5). Request in writing within 30 days of notice. Recovery is waived if less than $500 would remain after priority claims (item 8).", "recovery_exemptions_note": "Deferral while an equity-holding resident lives in the home is a state addition (State Plan Att. 4.17-A item 5(b)). Medicare cost sharing (QMB, SLMB, QI-1) excluded; certain American Indian and Alaska Native property exempt (DHHS pamphlet 05-994). A home exempt for eligibility is not exempt from recovery (ORS page).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-S1001_2023050320230503.html; https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-S1013_2025050720250507.html; https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-S1013_2023050320230503.html; https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-S1014_2023050320230503.html; https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-S1015_2023050320230503.html; https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-S1016_2023050320230503.html; https://le.utah.gov/xcode/Title26B/Chapter3/C26B-3-P10_2023050320230503.html; https://le.utah.gov/xcode/Title75/Chapter6/75-6-S401.html; https://le.utah.gov/xcode/Title75/Chapter6/75-6-S409.html; https://le.utah.gov/xcode/Title75/Chapter6/75-6-S415.html; https://web.archive.org/web/20250613001529id_/https://medicaid-documents.dhhs.utah.gov/stateplan/spa/A_4-17-A.pdf; https://web.archive.org/web/20250628001759id_/https://medicaid-documents.dhhs.utah.gov/Documents/pdfs/05-994%20Estate%20Recovery.pdf; https://web.archive.org/web/20240821023450id_/https://bepmanuals.health.utah.gov/Medicaidpolicy/800/835_Estate_Recovery.htm; https://ors.utah.gov/medicaid-recovery/estate-recovery/; https://le.utah.gov/xcode/Title75/Chapter2/75-2-S205.html", "confidence": "high", "flags": "Title 26 was recodified as Title 26B by Ch. 306, 2023 General Session (effective 2023-05-03); the State Plan (TN 19-0009, effective 2019-07-01) still cites the old Sec. 26-19-102(12) with identical text. Sec. 26B-3-1013 was amended by Ch. 310, 2025 General Session (effective 2025-05-07), which only changed the trust claim cross-references from Sec. 75-7-509, 510 to the new Title 75B, Sec. 75B-2-509, 510 (compared with the 2023 version). The augmented estate prong is unusual and reaches property the decedent transferred to others that counts in the elective-share augmented estate. The TOD act gives the estate 12 months to enforce (Nevada's version of the same act uses 18). Search results mention a 2024 amendment to the TOD deed forms (Sec. 75-6-416, 417); not verified. The DHHS eligibility manual page (Sec. 835, eff. 2019-07-01) and the pamphlet were read via Wayback. TOD deed effective date detail: 2018-05-08, Ch. 26, 2018 General Session." }, { "code": "VT", "name": "Vermont", "recovery_scope": "probate_only", "recovery_scope_note": "DVHA rule 7108.3.3 defines the estate as all real and personal property and other assets listed on an inventory filed in the probate court, and DVHA recovers by filing a creditor's claim in probate (7108.3). Attachment 4.17-A (TN 99-8, eff. 07/01/1999) uses the same probate definition and says liens are not placed on property (no TEFRA liens). Recovery covers only long-term care: nursing facility, HCBS waiver, and related hospital and drug services for people 55 and older, plus personal needs account balances (7108.3). The claim is filed only after the surviving spouse's death, but no rule text read says DVHA recovers from the spouse's own estate. The statute, 33 V.S.A. Sec. 1906a, contains only the homestead exemption; there is no statutory definition of estate.", "recovery_statute": "33 V.S.A. Sec. 1906a; DVHA Medicaid Covered Services Rules 7108.3 to 7108.3.4", "recovery_statute_url": "https://legislature.vermont.gov/statutes/fullchapter/33/019", "state_plan_4_17_a_url": "https://humanservices.vermont.gov/sites/ahsnew/files/documents/MedicaidPolicy/MedicaidStatePlan/attachment-4.17-a.pdf", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and the remainder is not on the probate inventory, and Vermont recovers only from the probate estate.", "life_estate_cite": "DVHA Rule 7108.3.3; Attachment 4.17-A", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "At the grantor's death, title vests in the grantee outside probate, so it is not on the probate inventory that DVHA claims against. The Act says a recorded deed does not affect 'the grantor's creditors', but no text read makes the grantee liable for probate claims after death.", "lady_bird_deed_cite": "27 V.S.A. Sec. 654(a)(1), (c); DVHA Rule 7108.3.3", "tod_deed": "n/a", "tod_deed_note": "Vermont has no transfer-on-death deed statute. Title 27 has no such chapter, and the enhanced life estate deed fills that role.", "tod_deed_cite": "27 V.S.A. (chapter list checked 2026-09-23)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes by right of survivorship outside probate, so the house is not on the probate inventory. Vermont did not adopt the expanded estate definition.", "joint_tenancy_cite": "DVHA Rule 7108.3.3; Attachment 4.17-A", "revocable_trust": "reachable", "revocable_trust_note": "Trust property is outside probate, but after death property of a trust revocable at death is subject to the settlor's creditors' claims to the extent the probate estate is inadequate. The DVHA rule itself assumes recovery from homes in revocable trusts: it exempts only those whose owners got long-term care before Dec. 1, 1997, and only until 1998.", "revocable_trust_cite": "14A V.S.A. Sec. 505(a)(3); DVHA Rule 7108.3.1(A)", "tod_deed_recognized": "no", "tod_deed_statute": "", "tod_deed_effective": "", "tod_deed_uniform_act": "n/a", "lady_bird_deed_recognized": "yes", "lady_bird_authority_type": "statute", "lady_bird_authority": "Enhanced Life Estate Deed Act, 27 V.S.A. Sec. 651 to 660 (2019, No. 145 (Adj. Sess.), Sec. 1, eff. July 13, 2020): grantor reserves a life estate and the right to convey without the grantee's joinder, consent or notice (Sec. 653(2), 654(b)); statutory form in Sec. 660; Sec. 659 preserves 'Lady Bird' deeds recorded before July 13, 2020. Medicaid rule HBEE Sec. 29.08 (life estates) says a transfer of the home with a retained life estate and power to sell or mortgage is not a transfer for penalty purposes.", "hardship_waiver_home": "Statute: no recovery against a homestead passing to lineal heirs or siblings who have income below 300 percent of the federal poverty level or who contributed significantly so the decedent could delay or avoid nursing home placement (33 V.S.A. Sec. 1906a). Rule: the home is exempt if a sibling lived there 1 year, or a child lived there 2 years and gave care, before long-term care began; or if a sibling or lineal heir inherits and meets the income or caregiving test, with the first $250,000 of fair market value exempt (Rule 7108.3.2). Income-producing assets that are a family's sole income are also protected (7108.3.1(B)).", "recovery_exemptions_note": "Only long-term care costs are recovered (Rule 7108.3). No recovery if the probate inventory is only personal property worth $2,000 or less (7108.3.1(C); Attachment 4.17-A). No recovery of assets already penalized as transfers (7108.3.1(C)). Exemption requests are due within 4 months after notice to creditors (7108.3.1). Vermont Long-Term Care Partnership policyholders get extended coverage without regard to estate recovery (33 V.S.A. Sec. 1908a).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://legislature.vermont.gov/statutes/fullchapter/33/019; https://humanservices.vermont.gov/sites/ahsnew/files/documents/Covered-Services-Rules-040124.pdf; https://humanservices.vermont.gov/sites/ahsnew/files/documents/MedicaidPolicy/MedicaidStatePlan/attachment-4.17-a.pdf; https://legislature.vermont.gov/statutes/fullchapter/27/006; https://legislature.vermont.gov/statutes/title/27; https://legislature.vermont.gov/statutes/title/14; https://legislature.vermont.gov/statutes/section/14A/005/00505; https://humanservices.vermont.gov/sites/ahsnew/files/documents/Combined-HBEE-Rules-for-Web-12.17.2025.pdf; https://humanservices.vermont.gov/sites/ahsnew/files/documents/HBEE-Part-4-Special-Rules-for-Medicaid-LTC.pdf", "confidence": "high", "flags": "Estate definition is in DVHA rule and the State Plan, not statute; both read on official state sites. Covered Services Rules copy is dated 04/01/24, estate recovery rule dated 02/01/2003; a newer version was not checked. Statute and rule differ on the homestead value cap: Sec. 1906a mentions $125,000 (state pays federal share up to that value), while Rule 7108.3.2 exempts up to $250,000. ELED Act Sec. 654(a)(1) says the deed does not affect the grantor's creditors; whether that lets a probate creditor, including DVHA, reach the house after death is untested. H.120 (2025 to 2026, long-term care trust fund) drew testimony on estate recovery, life estates and trusts; bill status not checked, and no enacted change to recovery was found in the statute or rules read. The DVHA EstateRecoveryRules.pdf is an image-only PDF and could not be read. Popular lists correctly name Vermont as a lady bird state; note it is by statute since 2020, not only practice." }, { "code": "VA", "name": "Virginia", "recovery_scope": "expanded", "recovery_scope_note": "The statutes (Va. Code Sec. 32.1-326.1 and 32.1-327) authorize a claim against the recipient's estate but do not define estate. The regulation 12VAC30-20-141 A (eff. July 23, 2009, amended Jan. 2, 2013) and State Plan 4.17C define estate as all property held at death plus any other real and personal property in which the individual had any legal title or interest (to the extent of such interest) at death, which is the 42 U.S.C. 1396p(b)(4)(B) expanded definition. Recovery applies to recipients age 55 or older and is deferred until the surviving spouse dies. No TEFRA lien or surviving spouse estate recovery provision found in the sections read.", "recovery_statute": "Va. Code Sec. 32.1-326.1; Va. Code Sec. 32.1-327; 12VAC30-20-141", "recovery_statute_url": "https://law.lis.virginia.gov/admincode/title12/agency30/chapter20/section141/", "state_plan_4_17_a_url": "https://www.dmas.virginia.gov/media/3365/417c-estate-recoveries.pdf", "life_estate": "unclear", "life_estate_note": "The regulation reaches any legal title or interest only to the extent of that interest at death; a retained life estate ends at death, and no Virginia text found says how it is valued for recovery.", "life_estate_cite": "12VAC30-20-141 A (definition of Estate)", "lady_bird_deed": "unclear", "lady_bird_deed_note": "Same issue as a plain life estate: the life tenant's interest ends at death and no rule addresses a retained power of disposal. Undue hardship is denied where the heir's hardship came from estate planning to avoid recovery.", "lady_bird_deed_cite": "12VAC30-20-141 A and D 5", "tod_deed": "reachable", "tod_deed_note": "The owner holds full title until death, so the house falls within the regulatory estate definition; separately, the TOD act makes the property liable for the transferor's creditor claims to the extent the probate estate is inadequate, enforceable within one year of death.", "tod_deed_cite": "12VAC30-20-141 A; Va. Code Sec. 64.2-634", "joint_tenancy": "reachable", "joint_tenancy_note": "The regulatory estate definition includes property in which the recipient had legal title or interest at death, to the extent of that interest, which covers the decedent's share of survivorship property on its face. No statute read makes survivorship real estate liable for estate claims.", "joint_tenancy_cite": "12VAC30-20-141 A; Va. Code Sec. 55.1-134, 55.1-135", "revocable_trust": "reachable", "revocable_trust_note": "Covered by the regulatory estate definition, and the Uniform Trust Code makes property of a trust revocable at death subject to the settlor's creditor claims to the extent the probate estate is inadequate.", "revocable_trust_cite": "12VAC30-20-141 A; Va. Code Sec. 64.2-747(A)(3)", "tod_deed_recognized": "yes", "tod_deed_statute": "Va. Code Sec. 64.2-621 to 64.2-638 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2013-07-01", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "Va. Code 55.1-106 is a general statute on a life estate given to another with a power to dispose; it does not address a grantor who keeps the power; not counted, same as West Virginia's 36-1-16. The section provides that where property is disposed of by deed for life with a remainder over and the instrument confers a power on the life tenant to dispose absolutely of the property, the remainder does not fail except to the extent the power is exercised. It does not use the term lady bird or enhanced life estate. No Virginia reported case or DMAS rule recognizing a deed in which the grantor reserves the power was found.", "hardship_waiver_home": "Undue hardship waiver with special consideration where the estate is a homestead of modest value (worth 50 percent or less of the average or median home price in the county or city) or the sole income-producing asset of survivors such as a family farm or business; recovery is waived when heirs are themselves Medicaid eligible; heirs who want to keep the home may arrange alternative repayment. 12VAC30-20-141 A, D.", "recovery_exemptions_note": "Recovery only for benefits paid at age 55 or older. Waived when heirs are Medicaid eligible or recovery is not cost effective. Exempts certain American Indian and Alaska Native property, government reparation payments, and assets disregarded under a long-term care partnership policy; Medicare cost-sharing for certain dual eligibles is protected. The DMAS fact sheet says no recovery while a surviving spouse who has not been a Medicaid member is alive.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://law.lis.virginia.gov/vacode/title32.1/chapter10/section32.1-326.1/; https://law.lis.virginia.gov/vacode/title32.1/chapter10/section32.1-327/; https://law.lis.virginia.gov/admincode/title12/agency30/chapter20/section141/; https://www.dmas.virginia.gov/media/3365/417c-estate-recoveries.pdf; https://www.dmas.virginia.gov/media/5997/revised-estate-recovery-fact-sheet-08-24-2022.pdf; https://law.lis.virginia.gov/vacodefull/title64.2/chapter6/article5/; https://law.lis.virginia.gov/vacode/title64.2/chapter7/section64.2-747/; https://law.lis.virginia.gov/vacode/title55.1/chapter1/section55.1-134/; https://law.lis.virginia.gov/vacode/title55.1/chapter1/section55.1-135/; https://law.lis.virginia.gov/vacode/title55.1/chapter1/section55.1-106/; https://law.lis.virginia.gov/vacodeupdates/title32.1/; https://www.vplc.org/news/support-medicaid-estate-recovery-cleanup/", "confidence": "high", "flags": "Expanded definition comes from regulation, not statute. The Virginia Poverty Law Center (secondary) says current DMAS practice is inconsistent with the statute and that HB 855 (2026 Regular Session, Del. Cousins) would define estate in statute and align it with probate law; the bill's final status could not be confirmed (LIS bill page is JavaScript only), but the official Code page for Sec. 32.1-326.1 still shows only 1993 history and the 2026 Title 32.1 update list shows no change to Sec. 32.1-326.1 or 32.1-327 as of 2026-09-23. Re-check if HB 855 was enacted or continued. Popular lists calling Virginia probate-only conflict with the regulation text. Lady bird recognition reclassified 2026-09-23 from yes (statute) to unclear: Va. Code 55.1-106 is a general life estate power-of-disposal statute that does not address a grantor-retained power, treated the same as W. Va. Code 36-1-16; Medicaid treatment not addressed." }, { "code": "WA", "name": "Washington", "recovery_scope": "expanded", "recovery_scope_note": "For a recipient 55 or older, the authority must seek recovery from the estate and from nonprobate assets as defined by RCW 11.02.005 (RCW 41.05A.090). The rule defines estate as property passing by will or intestacy plus, for deaths on or after Sept. 14, 2006, nonprobate assets and any life estate interest held immediately before death (WAC 182-527-2730). Nonprobate asset includes joint tenancy with survivorship, TOD deeds, deeds postponing possession until death, trusts that become irrevocable at death, and community property agreements (RCW 11.02.005). Pre-death TEFRA liens are authorized on the property of a permanently institutionalized recipient (RCW 41.05A.090); DSHS will not file one if a spouse, domestic partner, child under 21 or sibling lives in the home (DSHS 14-454). Recovery is deferred until the surviving spouse dies, then taken against property in which the recipient had an interest at death (HCA estate recovery page). Recovery for Medicaid is limited to long-term services and supports and related hospital and drug costs (WAC 182-527-2742).", "recovery_statute": "Rev. Code Wash. Sec. 41.05A.090 (HCA); Sec. 43.20B.080 (DSHS); WAC 182-527-2730 to 182-527-2750", "recovery_statute_url": "https://app.leg.wa.gov/RCW/default.aspx?cite=41.05A.090", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The estate includes a life estate interest held immediately before death, and the lien may be enforced against it, valued as the decedent's interest just before death using life estate factors. The lien cannot be enforced against property rights that vested before July 1, 2005.", "life_estate_cite": "Rev. Code Wash. Sec. 41.05A.090; WAC 182-527-2730; WAC 182-527-2746(3)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Washington authority on enhanced life estate deeds was found. On the text, the retained life estate is reachable as a life estate interest held before death, and the remainder is a nonprobate asset as a deed where possession is postponed until death.", "lady_bird_deed_cite": "Rev. Code Wash. Sec. 41.05A.090; Sec. 11.02.005; WAC 182-527-2730", "tod_deed": "reachable", "tod_deed_note": "A TOD deed is a listed nonprobate asset and recovery runs against nonprobate assets. The TOD act also makes the beneficiary liable for allowed claims against the probate estate under RCW 11.18.200.", "tod_deed_cite": "Rev. Code Wash. Sec. 41.05A.090; Sec. 11.02.005; Sec. 64.80.120; Sec. 11.18.200", "joint_tenancy": "reachable", "joint_tenancy_note": "Joint tenancy with right of survivorship is a listed nonprobate asset. The lien reaches the decedent's fractional share, valued as if held as tenants in common at death; not enforceable against rights vested before July 1, 2005.", "joint_tenancy_cite": "Rev. Code Wash. Sec. 41.05A.090; Sec. 11.02.005; WAC 182-527-2746(4)", "revocable_trust": "reachable", "revocable_trust_note": "A trust of which the person is grantor and that becomes irrevocable only at death is a listed nonprobate asset, and a self-settled trust is liable for the decedent's claims.", "revocable_trust_cite": "Rev. Code Wash. Sec. 41.05A.090; Sec. 11.02.005; Sec. 11.18.200", "tod_deed_recognized": "yes", "tod_deed_statute": "Rev. Code Wash. ch. 64.80 (Washington uniform real property transfer on death act)", "tod_deed_effective": "2014-06-12", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Washington statute, reported case or HCA/DSHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Web search returned only secondary pages, some saying Washington does not provide for it.", "hardship_waiver_home": "Recovery is delayed, not waived, for undue hardship: only when the property is an heir's sole income-producing asset, recovery would deprive an heir of shelter they cannot replace, or the client leaves a state-registered domestic partner. The heir must live on the property, not sell or encumber it, and pay taxes and insurance. No hardship if the client or heir created the circumstances to avoid recovery (WAC 182-527-2750). The statute requires recognizing hardship for a surviving domestic partner where a spouse would be protected (RCW 41.05A.090).", "recovery_exemptions_note": "Medicare Savings Program cost sharing is exempt for services from Jan. 1, 2010; Medicaid transformation LTSS (MAC, TSOA, supportive housing, supported employment) exempt from July 1, 2017 (WAC 182-527-2742). State-only funded services are recoverable at any age, with listed exceptions. Qualified long-term care partnership assets, American Indian and Alaska Native property, and segregated reparation payments are exempt (WAC 182-527-2746). A home transferred before death to a spouse or a minor, blind or disabled child is not part of the estate (HCA estate recovery page).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://wa-law.org/rcw/41_public_employment_civil_service_and_pensions/41.05A_overpayments_of_assistance_and_coordination_of_benefits.html; https://wa-law.org/rcw/11_probate_and_trust_law/11.002_general_provisions.html; https://wa-law.org/rcw/11_probate_and_trust_law/11.018_liability_of_beneficiary_of_nonprobate_asset.html; https://wa-law.org/rcw/64_real_property_and_conveyances/64.80_uniform_real_property_transfer_on_death_act.html; https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-527-2730-definitions; https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-527-2742-estate-recovery-service-related-limitations; https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/wac-182-527-2746-estate-recovery-asset-related-limitations; https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/estate-recovery; https://www.dshs.wa.gov/sites/default/files/forms/pdf/14-454.pdf; https://fastdemocracy.com/bill-search/wa/2023-2024/bills/WAB00019305/", "confidence": "medium", "flags": "app.leg.wa.gov and lawfilesext.leg.wa.gov were unreachable (timeouts, connection refused), so RCW text was read on the wa-law.org mirror; its history note for 41.05A.090 shows only 2011 1st sp.s. c 15 sec. 96, so later amendments may be missing from the note. The mirror drops subsection numbers, so 41.05A.090 is cited without subsections. WAC text read on HCA reprints of the official rules (2730 effective Aug. 26, 2025; 2742 effective Dec. 3, 2025). RCW 43.20B.080 (DSHS parallel) not read. Recent bills: SB 5318 (2023 to 2024, 'limiting estate recovery', would have ended pre-death liens and related recovery) passed the Senate Mar. 6, 2023 but was sent to the Senate Rules X file Jan. 8, 2024 and did not become law. No 2025 or 2026 estate recovery amendment found. TOD effective date is from the act's applicability clause (RCW 64.80, deeds by transferors dying on or after June 12, 2014). TOD deed effective date detail: 2014-06-12, Laws 2014, ch. 58." }, { "code": "WV", "name": "West Virginia", "recovery_scope": "probate_only", "recovery_scope_note": "W. Va. Code Sec. 9-5-11c(a) lets the department file a claim or lien against the recipient's 'estate' but does not define the term; the claim is classed with debts due the state in probate. The BMS manual defines estate as real and personal property belonging to the decedent at death, including property in Sec. 11-11-2(b)(4) (an estate tax definition). It says recovery covers property passing under probate law by will or intestacy, and no recovery is made on estates of $5,000 or less 'at the time the estate is admitted to probate' (BMS Manual 900.5, 900.7, Glossary). The state's recovery contractor files claims in probate court. TEFRA liens are allowed on property of permanently institutionalized recipients after notice and hearing, with no lien on a home occupied by a spouse, minor or disabled child, or equity-holding sibling (Sec. 9-5-11c(c), (d)). No recovery from a surviving spouse's estate was found.", "recovery_statute": "W. Va. Code Sec. 9-5-11c; BMS Provider Manual Ch. 900", "recovery_statute_url": "https://code.wvlegislature.gov/9-5-11c/", "state_plan_4_17_a_url": "", "life_estate": "not_reachable", "life_estate_note": "A retained life estate ends at death and does not pass by will or intestacy, so it is outside the probate estate the program reaches. An Ohio appeals court noted that a trial court dismissed a claim on a West Virginia life estate under 'West Virginia's narrower concept of estate recovery', before reversing on the ground that Ohio law governed.", "life_estate_cite": "W. Va. Code Sec. 9-5-11c(a); BMS Manual 900.5; Phillips v. McCarthy, 2016-Ohio-2994, para. 15 (describing Miracle, 2015-Ohio-1516)", "lady_bird_deed": "not_reachable", "lady_bird_deed_note": "If valid, the house passes to the remainder beneficiaries at death outside probate, and recovery is limited to the probate estate. A TEFRA lien recorded during life (permanently institutionalized recipients only) is a separate risk.", "lady_bird_deed_cite": "W. Va. Code Sec. 9-5-11c(a), (c); BMS Manual 900.5", "tod_deed": "not_reachable", "tod_deed_note": "West Virginia enacted the uniform act but left out its creditor-liability section (uniform Sec. 15). No section of Art. 12 makes the beneficiary liable for estate claims, and the property passes outside probate. The beneficiary does take subject to liens existing at death, which would include a recorded TEFRA lien.", "tod_deed_cite": "W. Va. Code Sec. 36-12-13(b); Art. 36-12 (Secs. 1 to 17, no creditor section); Sec. 9-5-11c(a)", "joint_tenancy": "not_reachable", "joint_tenancy_note": "The survivor takes by operation of law outside probate. The recovery brochure says that for jointly owned property the state recovers only the recipient's share of sale proceeds, which applies to a lien sale or a tenancy in common share.", "joint_tenancy_cite": "W. Va. Code Sec. 9-5-11c(a); BMS Manual 900.5, 900.5.1", "revocable_trust": "reachable", "revocable_trust_note": "After the grantor's death, property of a trust that was revocable at death is subject to the grantor's creditors' claims when the probate estate is inadequate. The Medicaid claim is a debt due the state, which falls in a priority class under the trust code.", "revocable_trust_cite": "W. Va. Code Sec. 44D-5-505(a)(3), (a)(3)(E); Sec. 9-5-11c(a)", "tod_deed_recognized": "yes", "tod_deed_statute": "W. Va. Code Sec. 36-12-1 to 36-12-17 (Uniform Real Property Transfer on Death Act)", "tod_deed_effective": "2014-06-05", "tod_deed_uniform_act": "yes", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No statute, reported case or Medicaid rule expressly recognizing a deed in which the grantor reserves a life estate with power to sell without the remainder's consent was found. The closest authority is W. Va. Code Sec. 36-1-16: when an interest is given by sale, gift or will with a remainder over and a power to dispose absolutely, the remainder is defeated only to the extent the power is exercised. But that section speaks of an interest 'given' to a first taker, not reserved by a grantor, and by default it holds sale proceeds subject to the remainder. McDougal v. Musgrave, 46 W. Va. 509 (1899), upholds a reserved plain life estate (seen in search results only). The Income Maintenance Manual covers only plain life estates. CourtListener found no West Virginia or Fourth Circuit opinion using 'lady bird deed' or 'enhanced life estate'.", "hardship_waiver_home": "No lien or recovery where an adult child lived in the home 2 years before the parent became a member and gave care that kept the parent home; where an heir (1 year) or adult child (3 years) worked in the family business and the property is integral to it; or where an heir shows the family unit's survival or income would be jeopardized. Proof of a child's, grandchild's or sibling's monetary support reduces the claim dollar for dollar. Apply within 45 days of the lien or claim. No waiver if the hardship came from estate planning to avoid recovery (BMS Manual 900.6).", "recovery_exemptions_note": "No recovery on estates worth $5,000 or less when admitted to probate (BMS Manual 900.7). No lien, or recovery deferred, for people eligible under the ACA adult expansion group (Income Maintenance Manual 24.11.3). Long-term care partnership assets are protected at recovery, and a partnership member cannot get a hardship waiver (IMM 24.6; BMS Manual 900.7).", "karp_2005_scope": "probate_only", "last_verified": "2026-09-23", "sources": "https://code.wvlegislature.gov/9-5-11c/; https://code.wvlegislature.gov/11-11-2/; https://bms.wv.gov/sites/default/files/2025-07/BMS%20Chapter_900_Estate_RecoveryRevised12.6.24.pdf; http://www.wvrecovery.com/estate.asp; http://www.wvrecovery.com/docs/Estate_Recovery_BRO20021.pdf; https://code.wvlegislature.gov/36-12/; https://code.wvlegislature.gov/36-12-1/; https://code.wvlegislature.gov/36-12-13/; https://code.wvlegislature.gov/36-12-15/; http://wvlegislature.gov/bill_status/bills_history.cfm?year=2014&sessiontype=rs&btype=bill&input=3; http://wvlegislature.gov/bill_status/bills_history.cfm?year=2013&sessiontype=rs&btype=bill&input=159; https://code.wvlegislature.gov/44D-5-505/; https://code.wvlegislature.gov/36-1-16/; https://bfa.wv.gov/media/40005/download?inline; http://www.supremecourt.ohio.gov/rod/docs/pdf/12/2016/2016-Ohio-2994.pdf; https://www.bowlesrice.com/newsroom-articles-20.html; https://www.courtlistener.com/api/rest/v4/search/", "confidence": "medium", "flags": "Lady bird conflict with popular lists: WV is often named as one of 'five lady bird deed states' (FL, TX, MI, VT, WV), and one secondary page says WV 'enacted legislation in 2019'. No such statute, case or agency rule was found. The only WV deed legislation of that era found is the 2014 URPTODA (Bowles Rice described it as a 'new law' in May 2014), and H.B. 2336 (2019) is an unrelated waiver bill. Scope: Sec. 9-5-11c does not define estate. The probate-only reading rests on the BMS manual and contractor materials, and the manual's cross-reference to the estate tax definition in Sec. 11-11-2(b)(4) (whose 'transferor' includes a joint tenant) is ambiguous. Sec. 9-5-11c(f) says a claim or lien 'attaches and is perfected automatically as of the beginning date of medical assistance'; how this interacts with non-probate transfers is untested. The code site redirected scripts to fbi.gov, so statute text was read verbatim through Wayback snapshots of code.wvlegislature.gov (Oct. 2025). Sec. 9-5-11c was last amended by H.B. 4274 (2024), apparently the agency reorganization; its text was not read. H.B. 3499 (2023) amended 36-12-11 and 36-12-13 on revocation and survivorship designations. State Plan 4.17 not retrieved. TOD deed effective date detail: 2014-06-05, S.B. 3, Ch. 181, Acts 2014; approved 2014-03-26." }, { "code": "WI", "name": "Wisconsin", "recovery_scope": "expanded", "recovery_scope_note": "'Property of a decedent' is all property in which the recipient had legal title or interest immediately before death, 'including assets transferred to a survivor, heir, or assignee through joint tenancy, tenancy in common, survivorship, life estate, revocable trust, or any other arrangement, excluding an irrevocable trust' (Secs. 49.496(1)(cm), 49.849(1)(d)). Probate assets are reached by estate claim (Sec. 49.496(3)); nonprobate property by DHS affidavit requiring the holder to transmit it, and by a lien on any real property of the decedent, including a home (Sec. 49.849(3), (4)). By DHS policy, life estates, joint tenancy real property and revocable trusts are recovered only if created on or after Aug. 1, 2014. Claims are also filed in the nonrecipient surviving spouse's estate. Pre-death TEFRA liens on homes of permanent nursing home or hospital residents (Sec. 49.496(2)).", "recovery_statute": "Wis. Stat. Secs. 49.496 and 49.849; Wis. Admin. Code DHS 108.02(12)", "recovery_statute_url": "https://docs.legis.wisconsin.gov/statutes/statutes/49/vi/849", "state_plan_4_17_a_url": "https://www.dhs.wisconsin.gov/publications/p1/p13032.pdf", "life_estate": "reachable", "life_estate_note": "Life estates are named in the definition of property of a decedent. The recipient's interest is valued by age at death using the DHS life estate tables. DHS recovers only from life estates created on or after Aug. 1, 2014.", "life_estate_cite": "Wis. Stat. Sec. 49.849(1)(d), (4)(a), (5c)(c); DHS Handbook P-13032 (11/2024), p. 17", "lady_bird_deed": "reachable", "lady_bird_deed_note": "No Wisconsin authority for an enhanced life estate deed was found. If used, the grantor holds at least a life estate at death, and the definition also covers 'any other arrangement' short of an irrevocable trust.", "lady_bird_deed_cite": "Wis. Stat. Sec. 49.849(1)(d)", "tod_deed": "reachable", "tod_deed_note": "The TOD deed passes the house outside probate, but the owner held title immediately before death, so it is property of a decedent reachable by DHS affidavit and lien. The TOD statute does not limit creditors' rights under other laws, and DHS lists TOD property as nonprobate property it recovers.", "tod_deed_cite": "Wis. Stat. Secs. 49.849(1)(d), (3), (4); 705.10(2); 705.15(4); DHS Handbook P-13032, p. 17 and glossary", "joint_tenancy": "reachable", "joint_tenancy_note": "Joint tenancy is named in the definition; the recipient's share is valued as if held as tenants in common with non-spouse co-owners. DHS recovers from joint tenancy real property only if created on or after Aug. 1, 2014.", "joint_tenancy_cite": "Wis. Stat. Sec. 49.849(1)(d), (5c)(a); DHS Handbook P-13032, p. 17", "revocable_trust": "reachable", "revocable_trust_note": "Revocable trusts are named in the definition (irrevocable trusts are excluded). DHS recovers from revocable trusts established on or after Aug. 1, 2014.", "revocable_trust_cite": "Wis. Stat. Secs. 49.496(1)(cm), 49.849(1)(d); DHS Handbook P-13032, p. 17", "tod_deed_recognized": "yes", "tod_deed_statute": "Wis. Stat. Sec. 705.15", "tod_deed_effective": "2006-04-11", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Wisconsin statute, reported case or DHS rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. Web searches returned only secondary lists (which omit Wisconsin) and form sites.", "hardship_waiver_home": "Heirs, beneficiaries and co-owners of nonprobate property may seek a hardship waiver (Sec. 49.849(3)(c)5., (7); Sec. 49.496(6m)). Criteria are narrow: the applicant would become or stay eligible for SSI, food stamps or Medicaid; the decedent's real property is used in the applicant's business, including a working farm, and recovery would cost the applicant their livelihood; or the applicant receives general relief, needy Indian relief or need-based veterans benefits (DHS 108.02(12)(b)2.). No modest-home exemption. A caregiver child (24 months) or sibling (12 months) living in the home defers recovery through a lien until they die or sell (Handbook P-13032, p. 14).", "recovery_exemptions_note": "Heirs keep up to the Sec. 861.33(2) amount of clothing, jewelry, furniture and other personal property (Sec. 49.849(2)(b); handbook says $5,000). Long-Term Care Partnership amounts excluded (Sec. 49.496(3)(a)). Claims against the nonrecipient surviving spouse's estate, with a rebuttable presumption that all of it was marital property subject to the claim (Sec. 49.849(2)(c)). Recovery limited to benefits paid on or after Aug. 15, 1991 for deaths after Sept. 30, 1991 (Sec. 49.496(6)). DHS says it does not recover pre-Aug. 1, 2014 life estates, joint tenancy real property, revocable trusts or named-beneficiary life insurance.", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://docs.legis.wisconsin.gov/statutes/statutes/49/iv/496; https://docs.legis.wisconsin.gov/statutes/statutes/49/vi/849; https://docs.legis.wisconsin.gov/statutes/statutes/49.pdf; https://docs.legis.wisconsin.gov/statutes/statutes/705.pdf; https://docs.legis.wisconsin.gov/2005/related/acts/206.pdf; https://docs.legis.wisconsin.gov/2025/related/acts/60.pdf; https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/108.pdf; https://www.dhs.wisconsin.gov/publications/p1/p13032.pdf", "confidence": "high", "flags": "docs.legis.wisconsin.gov refused connections from this environment; statute, act and rule texts were read from Wayback Machine copies of the official pages (statutes current through 2025 Wis. Act 170, published 2026-05-22). The Aug. 1, 2014 cutoff for life estates, joint tenancy and revocable trusts appears in the DHS handbook, not in the statute text read; its session law basis (likely 2013 Wis. Act 20) was not confirmed. Handbook says recovery from a surviving spouse's estate is from 50 percent of marital property, while Sec. 49.849(2)(c) presumes 100 percent. No 2024 to 2026 amendments to Secs. 49.496 or 49.849 found (histories end 2013 and 2019). TOD deed: 2025 Wis. Act 60 (enacted 2025-12-09, effective 2025-12-11) revised revocation rules in Sec. 705.15(3) only. Sec. 705.15(8) bars claims to recover TOD real property unless an action is filed within 120 days after death; how this interacts with the DHS affidavit and lien under Sec. 49.849 is unclear. Attachment 4.17-A not found; the state_plan column holds the DHS handbook. TOD deed effective date detail: 2006-04-11, 2005 Wis. Act 206, enacted 2006-03-27, published 2006-04-10; no effective date clause, so the day after publication under Sec. 991.11." }, { "code": "WY", "name": "Wyoming", "recovery_scope": "expanded", "recovery_scope_note": "Estate includes the probate estate plus any other real and personal property in which the individual had legal title or interest at death, to the extent of that interest, including assets conveyed to a survivor, heir or assign through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement (W.S. 42-4-206(g)(ii)). The rule defines legal title for real property as title of record in the county records, and lets the Department recover directly from a transferee of non-probate property (Wyo. Medicaid Rules ch. 35, Sec. 11(b)(i), (g)). Wyoming also recovers from the surviving spouse's estate, limited to assets that were marital or jointly owned property during the marriage (W.S. 42-4-206(a), (c)). Pre-death TEFRA liens (presumed after 90 days institutionalized without a discharge plan) and post-death liens on any estate property (W.S. 42-4-207(c), (j)).", "recovery_statute": "W.S. 42-4-206, 42-4-207; Wyo. Medicaid Rules ch. 35, Secs. 11 to 12", "recovery_statute_url": "https://wyoleg.gov/statutes/compress/title42.pdf", "state_plan_4_17_a_url": "", "life_estate": "reachable", "life_estate_note": "The statutory estate definition expressly includes assets conveyed to a survivor or heir through a life estate, to the extent of the recipient's interest at death.", "life_estate_cite": "W.S. 42-4-206(g)(ii)", "lady_bird_deed": "reachable", "lady_bird_deed_note": "If Wyoming recognizes the deed, the house passes through a life estate or 'other arrangement', both of which the estate definition covers. Recognition of the deed in Wyoming was not established.", "lady_bird_deed_cite": "W.S. 42-4-206(g)(ii); Wyo. Medicaid Rules ch. 35, Sec. 11(g)", "tod_deed": "reachable", "tod_deed_note": "The TOD deed act itself lets the Department of Health assert a lien on property passed by a TOD deed for the amount recoverable against the owner's estate. Title transfer requires recording a Department of Health certificate of clearance that all Medicaid claims are satisfied or do not exist.", "tod_deed_cite": "W.S. 2-18-103(g), (n)(ii); W.S. 42-4-207(k)", "joint_tenancy": "reachable", "joint_tenancy_note": "The estate definition expressly includes assets conveyed to a survivor through joint tenancy or survivorship, to the extent of the recipient's interest.", "joint_tenancy_cite": "W.S. 42-4-206(g)(ii)", "revocable_trust": "reachable", "revocable_trust_note": "The estate definition expressly includes assets conveyed through a living trust, and the Department may recover directly from the transferee.", "revocable_trust_cite": "W.S. 42-4-206(g)(ii); Wyo. Medicaid Rules ch. 35, Sec. 11(g)(ii)", "tod_deed_recognized": "yes", "tod_deed_statute": "W.S. 2-18-101 to 2-18-106 (Nontestamentary Transfer of Real Property on Death Act)", "tod_deed_effective": "2013-07-01", "tod_deed_uniform_act": "no", "lady_bird_deed_recognized": "unclear", "lady_bird_authority_type": "unclear", "lady_bird_authority": "No Wyoming statute, reported case or Medicaid rule recognizing a life estate deed with a retained power to sell without the remainder's consent was found. A web search returned only national secondary pages. W.S. 2-18-103(j) preserves other lawful methods of postponing enjoyment until death but does not describe this deed.", "hardship_waiver_home": "Undue hardship waiver must be requested by certified mail within 33 days of the lien or claim notice, and must show the home is part of a business, including a working farm or ranch, and that recovery would cost the heirs their means of making a living (Wyo. Medicaid Rules ch. 35, Sec. 12(b)). A pre-death lien is not imposed while a spouse, minor or disabled child, or equity-holding sibling lives in the home, and is not recovered while a qualifying sibling or caregiver child lives there (W.S. 42-4-207(d), (e)); the post-death lien may be imposed regardless (ch. 35, Sec. 11(b)).", "recovery_exemptions_note": "State additions: recovery reaches the surviving spouse's estate, limited to marital or jointly owned property (W.S. 42-4-206(c)). The claim is treated as an expense of last illness and no statute of limitations applies (W.S. 42-4-206(b)). Long-term care partnership benefits are considered (ch. 35, Sec. 11(c)). The Department may decline recovery that is not cost-effective (ch. 35, Sec. 11(j)).", "karp_2005_scope": "expanded", "last_verified": "2026-09-23", "sources": "https://wyoleg.gov/statutes/compress/title42.pdf; https://wyoleg.gov/statutes/compress/title02.pdf; https://wyoleg.gov/2013/Enroll/HB0201.pdf; https://wyoleg.gov/LsoService/api/BillInformation/2013/HB0201; https://www.law.cornell.edu/regulations/wyoming/048-35-Wyo-Code-R-SS-35-11; https://www.law.cornell.edu/regulations/wyoming/048-35-Wyo-Code-R-SS-35-12", "confidence": "high", "flags": "Rules (ch. 35) read on the LII copy, last amended eff. 2019-02-19. The 2013 act (Sec. 2) also added W.S. 42-4-207(k), which lets the Department file a lien under 2-18-103(g) on the grantor's death. No 2024 to 2026 amendment to 42-4-206, 42-4-207 or 2-18-103 found (search only; wyoleg.gov compiled titles read 2026-09-23). Wyoming's TOD act is its own act, not URPTODA. State Plan Attachment 4.17-A not searched. TOD deed effective date detail: 2013-07-01, 2013 Wyo. Sess. Laws ch. 100, HB 201, Enrolled Act No. 94; signed 2013-02-28." } ]