SECTION 373.307. Notice of Intent to File A Claim upon the Death of a Medicaid Recipient

(a) The Medicaid Estate Recovery Program (MERP) will, within 30 days of the notification of the death of a Medicaid recipient, provide a Notice of Intent to File a Claim, to the following:

(1) Estate representative;

(2) Recipient's guardian of the person, if any; guardian of the estate, if any; or guardian of the person and estate, if any, provided that the name and address of the guardian or guardians are known by MERP;

(3) Recipient's agent under a durable power of attorney if the name and address of the agent are known by MERP;

(4) Recipient's agent under a medical power of attorney if the name and address of the agent are known by MERP; or

(5) If none of the above are known, family members who have acted on behalf of the recipient provided that the name and address of those family members who have acted on behalf of the recipient are known by MERP.

(b) Contents of Notice of Intent to File a Claim. Written notice of MERP's intent to file an estate recovery claim against the estate of a deceased Medicaid recipient for covered services will be provided to individuals identified in subsection (a) of this section. The notice will include the following:

(1) A program overview;

(2) A questionnaire that seeks to determine whether the deceased recipient had:

(A) A surviving spouse;

(B) A surviving child under age 21;

(C) A surviving child of any age who is blind or disabled, as defined by 42 U.S.C. §1382c; or

(D) An unmarried adult child residing continuously in the decedent's homestead for at least one year prior to the time of the Medicaid recipient's death.

(c) An undue hardship waiver request form. Undue hardship request forms and supporting documentation must be submitted to MERP within 60 days of the date of the Notice of Intent to File a Claim. No action will be taken on an undue hardship request that is submitted without supporting documentation. The request form and documentation should be sent to MERP, Hardship Waiver Request, P.O. Box 13247, Austin, Texas 78711.

(d) The Notice of Intent to File a Claim will state the date that MERP received notification of the death of a Medicaid recipient and the source of the death notification of the Medicaid recipient.

Source Note: The provisions of this §373.307 adopted to be effective March 1, 2005, 30 TexReg 830