53-6-171. Department lien upon real property of certain medicaid recipients -- conditions.
53-6-171. Department lien upon real property of certain medicaid recipients -- conditions. (1) Following notice and opportunity for hearing as provided in 53-6-172, the department shall impose a lien upon the real property, including the home, of an institutionalized recipient of recoverable medical assistance to secure the assets of the recipient for recovery of medical assistance paid on behalf of the recipient prior to, on, or after the imposition of the lien if:
(a) the recipient has been admitted to a nursing facility, an intermediate care facility for the developmentally disabled, or an institution for mental disease;
(b) the property upon which a lien is being imposed is the recipient's home and the home is not lawfully resided in by:
(i) the recipient's spouse;
(ii) the recipient's child who is under 21 years of age, blind, or permanently and totally disabled; or
(iii) the recipient's sibling who was residing in the recipient's home for a period of at least 18 months immediately prior to the recipient's institutionalization; and
(c) the recipient has been determined by the department, pursuant to subsection (2), to be permanently institutionalized.
(2) A recipient is permanently institutionalized for purposes of subsection (1)(c) if the department determines that the recipient cannot reasonably be expected to be discharged from the facility and to return home. There is a rebuttable presumption that the recipient cannot reasonably be expected to be discharged from the facility and return home if the recipient or a representative of the recipient declares that there is no intent to return home or if the recipient has been institutionalized for 6 months or longer without a discharge plan. The recipient's institutionalization for a period of 6 months or longer without a discharge plan does not give rise to the presumption if the facility was required by law to adopt a discharge plan but failed to do so. A recipient or a recipient's representative who alleges that there is a reasonable expectation of discharge from the facility and a return home has the burden of demonstrating the reasonable expectation. The reasonable expectation must be established based upon medical evidence and medical opinion. A declaration by the recipient or a recipient's representative that the recipient intends to be discharged from the facility and to return home is not alone sufficient to establish that there is a reasonable expectation of discharge from the facility and a return home.
(3) For purposes of this section, real property of a recipient includes any interest in real property that may be subject to a judgment lien.
History: En. Sec. 8, Ch. 492, L. 1995; amd. Sec. 3, Ch. 403, L. 2003.