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A Better Partnership
April 19, 2015

COA determines that Michigan’s Medicaid estate recovery program does not require notice of recovery upon Medicaid enrollment

In In re Keyes, No. 320420, the Court of Appeals held that the Michigan Department of Community Health (MDCH) does not have to provide a Medicaid enrollee with notice of estate recovery unless that person actually applies for Medicaid eligibility. Therefore, the Court of Appeals reversed the trial court’s order granting summary disposition to the estate because the MDCH gave sufficient notice of recovery in this case.
 
In April 2010, Esther Keyes moved into a nursing home and concurrently enrolled in Medicaid. At that time, the MDCH did not notify Keyes that her estate may be subject to Medicaid recovery. Two years later, Robert Keyes applied for Medicaid eligibility on Esther’s behalf and acknowledged in the form that Esther’s estate may be subject to Medicaid recovery upon her death. Esther died in January 2013 and the MDCH subsequently sought recovery of costs for services paid by Medicaid. The estate disallowed the expense and this suit followed. The trial court ruled that the MDCH could not recover costs from Esther’s estate because it did not give Esther notice of recovery when she enrolled for Medicaid in 2010, thus violating the Michigan Social Welfare Act and the estate’s due process rights.
 
The estate argued that Michigan’s Social Welfare Act, MCL 400.112g et seq, requires the MDCH to provide notice to individuals for potential recovery when they enroll in Medicaid for long-term care. Because Esther enrolled in the program in 2010, the estate contended that the MDCH was required to give Esther notice of recovery at that time, but neglected to do so. The MDCH asserted that the statute’s notice provision does not require notice of recovery when an individual enrolls in the program, but rather when an individual actually seeks Medicaid eligibility, which occurred in 2012 in this case.
 
The Court of Appeals held that the MDCH sufficiently notified Keyes that her estate could be subject to estate recovery. The court reasoned that the Social Welfare Act allows the MDCH to engage in estate recovery so long as the MDCH notifies the individual of such recovery when he or she has sought Medicaid benefits rather than when an individual enrolls in benefits. The court explained that the section in the Social Welfare Act regarding notice says nothing about notice upon enrollment and instead focuses on when a person actually “seeks” eligibility. Because Robert Keyes sought Medicaid eligibility on Esther’s behalf in 2012, the MDCH provided the estate with proper notice. The court also concluded that the estate’s due process rights were not violated because the estate was personally apprised of the MDCH’s actions and it had an opportunity to contest the recovery in circuit court. Therefore, the Court of Appeals reversed the trial court’s holding and remanded the case back for proceedings consistent with its opinion. 

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