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:

Terms Used In Montana Code 53-6-171

  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-6-155
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Medicaid: means the Montana medical assistance program established under Title 53, chapter 6. See Montana Code 53-6-155
  • Property: means real and personal property. See Montana Code 1-1-205
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Real property: means lands, tenements, hereditaments, and possessory title to public lands. See Montana Code 1-1-205
  • Recipient: means a person:

    (a)who has been determined by a medicaid agency to be eligible for medicaid benefits, whether or not the person actually has received any benefits; or

    (b)who actually receives medicaid benefits, whether or not determined eligible. See Montana Code 53-6-155

  • Recoverable medical assistance: means a payment pursuant to this part, including but not limited to a payment made for items or services provided to and insurance premiums, deductibles, and coinsurance paid on behalf of a recipient who:

    (i)during the recipient's lifetime, was an inpatient in a nursing facility, intermediate care facility for the developmentally disabled, or institution for mental disease and, with respect to that institutionalization, the department determined under 53-6-171 that the person was not reasonably expected to be discharged and return home; or

    (ii)was at least 55 years of age or younger if allowed by 42 U. See Montana Code 53-6-165

  • Recovery: means legal action brought for the payment or repayment of recoverable medical assistance or amounts of money paid for other purposes. See Montana Code 53-6-165

(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.