When a MA LTC recipient (as defined in 495.1) dies, DPW will attempt to recover the costs of previously provided MA LTC services from the decedent’s estate. If an individual received MA LTC services during the five years preceding death, his/her estate representative (e.g. the administrator or executor) is responsible for notifying DPW of the individual’s death and for requesting a statement of claim. DPW will then issue the statement of claim to the estate representative; this statement will serve as notice that the estate is obligated to reimburse DPW for the amount of MA LTC services that had been paid on behalf of the decedent. 55 Pa. Code § 258.4 55 Pa. Code § 258.8
NOTE: The five-year time period is for notification purposes only, and does not limit the Department's claim.
An estate representative may request a statement of claim via mail, fax, telephone or internet:
Mail: Department of Public Welfare
Division of Third Party Liability
Estate Recovery Program
Post Office Box 8486
Harrisburg, PA 17105-8486
Fax: 1-717-772-6553
Telephone: 1-800-528-3708
Internet: http://www.dpw.state.pa.us/foradults/estaterecoveryprogram/index.htm
A request for a statement of claim must include the following:
A statement that the personal representative is requesting a statement of claim against the decedent’s estate.
The decedent's name.
The decedent's last address.
The decedent's date of birth
The decedent's date of death.
The decedent's Social Security Number.
The personal representative's name, address and telephone number.
Written documentation of the gross value of the decedent's estate.
DPW will then submit a statement of claim to the personal representative within 45 days in accordance with Federal regulations.
The request from the personal representative must include all of the information described above. If the request is considered incomplete, DPW will so notify the representative, and will suspend the 45-day response period until a fully compliant notice is received.
If DPW fails to submit a statement of claim to the personal representative within the 45-day response period, DPW’s claim is forfeited.
55 Pa. Code § 258.4 62 P.S. § 1412
DPW’s claim is entitled to priority as specified under 20 Pa. C.S. § 3392, which stipulates classification of debts and order of payment.
DPW’s claim against deposit accounts and patient care accounts is subordinate to reasonable funeral expenses and to claims of those creditors having priority over DPW, as specified in 20 Pa. C.S. § 3392.
DPW’s claim against assets subject to 20 Pa. C.S. § 3101 will be considered superior to that of family members.
DPW’s claim is subordinate to the family exemption as provided by 20Pa. C.S. § 3121. 55 Pa. Code § 258.4 55 Pa. Code § 258.6
Issued May 1, 2012