For Medicaid Estate Recovery purposes, an estate consists of the assets and property owned by the Medicaid recipient at the time of his or her death. For Attorneys and Business Partners who wish to contact DHS Estate Recovery, please click on the link to sign up for and use theTPL Web Portal. The estate assets are expected to be used to pay the debts of the estate. Or, you may discover that the laws in your state make it unlikely that MERP will try to recover assets from your estate. A .gov website belongs to an official government organization in the United States. Real property held by a Medicaid recipient that is subject to a life estate. For example, in some states, a ladybird deed, a type of life estate deed, can be utilized to protect ones home. Please do not send sensitive information such as PHI through email. II. The Medicaid Estate Recovery Program (MERP) allows Medicaid to recover the money it spent on your care from your estate. You should complete the DMA-285 form for any updates or new insurance information that you need to report. Financial Assistance for Long Term Care. CLAIM OF UNDUE HARDSHIP. Local agencies cannot collect from an MA member . Estate recovery occurs only after an MA member dies. For this reason, it is highly suggested one consult with a professional Medicaid planner in regards to ones particular situation. State and federal government websites often end in .gov. Depending on the services you end up needing and the state where you live, your estate may or may not be subject to Medicaid estate recovery someday. Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and . In Iowa the estate recovery program is provided under Iowa Code Section 249A.53 (2). State Medicaid programs must recover certain Medicaid benefits paid on behalf of a Medicaid enrollee. [6] Estate Recovery accepts forms through email or the U.S. Texas Health & Human Services Commission. Funds remaining in a funeral trust after the funeral has been paid for in full. Payments can be in the form of personal check, money order, or cashiers check and made payable to the: Treasurer, State of Indiana.. Some states choose to go further than this, and recoup any medical costs that were paid by Medicaid after a person was 55, and/or the costs associated with a person who was institutionalized prior to age 55. County Departments of Human/Social Services and Eligibility Sites are required to provide an estate recovery form to potential and existing Health First . All claims (debts) against an estate, including MERP claims, must be paid before property can be distributed as stated in a will. Under Section 369 of the Social Services Law, recovery must be pursued from the estate of deceased Medicaid recipients who were 55 years of age or older or permanently institutionalized when he/she received such assistance. Estate Recovery Forms. Ones estate might include cash, checking and savings accounts, stocks and bonds, remaining funds in a qualified income trust and / or irrevocable funeral trust, a vehicle, and any other items of value. States are allowed to recover Medicaid funds from assets that avoid probate, such as those that pass through a living trust or a joint tenancy (the holding of an estate or property by two or more parties). Search Forms Division Language Last revised January 25, 2023 In some cases, you may not be able to protect your estate. Categories. All Forms. Please submit the information by using one of the following methods: . Kaiser Family Foundation. For probate-only states, simply keeping assets out of probate will protect them from estate recovery. Selling the home while the recipient is still living, however, is not advised. By Program. Applications. By Elizabeth Davis, RN For individuals age 55 or older, states are required to seek recovery of payments from the individual's estate for nursing facility services, home and community-based services, and related hospital and prescription drug services. For family members/executors that have questions related to estate recovery, please contact DHS Estate Recovery using the address, phone number, or email address listed below: Department of Human ServicesEstate Recovery ProgramP.O. This includes all real and personal property included within the Medicaid recipients probate estate. 2001 Mail Service Center Verywell Health's content is for informational and educational purposes only. Benefit Coordination/Third Party Liability, Provider Electronic Solutions (PES) Software, Help for Medicaid Applicants and Recipients, Expanded Hepatitis C Treatment Availability, Alabama Prenatal Excellence Collaborative, External Influences on Medicaid Eligibility, Medicaid for Parents & Caretaker Relatives, Federally Qualified Health Centers (FQHCs), Alabama Community Transition (ACT) Waiver, State of Alabama Independent Living (SAIL) Waiver, Technology Assisted (TA) Waiver for Adults, Provider Education Checklists and Resources, Gainwell Technologies Contact Information, Alabama Medicaid State Plan - Liens and Recoveries, Omnibus Budget Reconciliation Act of 1993 (OBRA 93), Medicaid Estate Recovery - Department of Health & Human Services, Liens, Adjustments and Recoveries, and Transfer of Assets--SEC. Title XIX funded medical assistance includes Medicaid and various waiver programs, including the Medically Needy Program and the Elderly Waiver Program. 4. Before sharing sensitive information, make sure youre on an official government site. And if the Medicaid beneficiary was truly without any assets at all, the estate recovery program won't be able to recover anything, as they cannot attempt to recover the money from the beneficiary's heirs (they can use the estate recovery process to recoup assets that may have passed to a surviving spouse, but only after that spouse has passed away as well). In addition to the pre-death lien discussed above, some states may put a lien on the home following a Medicaid recipients death. Some states also attempt to recover money spent on other healthcare expenses. Ask for a MEPD (Medicaid for the Elderly and People with Disabilities) worker. Ultimately, the ideal time to contact a professional planner is well in advance of the need for long term care Medicaid. California and Texas are two states that prohibit estate recovery after the death of the non-Medicaid spouse. MERP cannot collect more than the value of the estate. Official websites use .gov Thank you, {{form.email}}, for signing up. MERP only recovers the cost of certain long-term-care services that a Medicaid recipient receives after the age of 55. PROCEDURES. Yes, Medicaid can put a lien on a Medicaid recipients home, but not all states do. Medicaid estate recovery is the process by which the Medicaid program can recoup some or all of the money that the program spent on a person's care. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. The federal government suggests that estates which include small family businesses and family farms be considered for a hardship exception if the income produced from the property is essential to the support of surviving family members. Understanding Medicaid estate recovery and estate planning techniques can be complicated, particularly since the rules are not consistent across states. Accessibility What is the Medicaid Estate Recovery Program? The home is the primary home of the survivor Contact 2-1-1 or 1-877-541-7905. This means the other owner does not automatically inherit the deceaseds share. Outside of the federal guidelines for MERP, the particulars of the estate recovery program are state-specific. Quality Assurance Fee Program. 919-855-4800, Division of Budget and Analysis Without Medicaid coverage, you may have had to sell your house and other valuables to pay for your care, in effect liquidating your estate while youre alive to pay for your long-term care. Click here for instructions on opening this form. Medicaid Estate Recovery Unit : 150 East Gay Street, 21. st; Floor ; Columbus, Ohio 43215-3130 . Established under federal law, this program requires the Alabama Medicaid Agency to recover costs paid by the Agency from the estates of deceased Medicaid recipients. Health Insurance Premium Payment Program. MA-2285 - ESTATE RECOVERY. If you do not plan properly, IRAs can count as an available asset and affect Medicaid eligibility. Under certain conditions, money remaining in a trust after a Medicaid enrollee has passed away may be used to reimburse Medicaid. Medicaid estate recovery statute of limitations. Repayment only applies to recipients who are 55 or older or who are inpatients of a medical facility 1. Medicaid eligibility for adults under the age of 65 has been expanded, based only on income, without regard for assets, essentially levels the health insurance playing field for people who don't have access to an employer's health plan, H.R. Personal effects, ornaments, or keepsakes of the Medicaid recipient. into a form outside the State's Medicaid recovery orbit). Completing the CAPTCHA proves you are a human and gives you temporary access to the web property. The 1993 Omnibus Budget Reconciliation Act (OBRA) required that all states seek reimbursement of long term care costs via Medicaid estate recovery for persons 55+ years of age. Centers for Medicare and Medicaid Services. The enactment of OBRA was considered essential to the survival of Medicaid given that almost two-thirds of nursing home residents in the United States are covered by Medicaid.. Since Medicaid regulations and probate laws vary from state to state, often the only way to know is to seek help from a professional familiar with both the Medicaid MERP program and probate laws in your state. Medicaid's new adult group and estate recovery. Like expanded Medicaid, eligibility for the ACA's premium subsidies (premium tax credits) is also based only on income, without regard for assets. Essentially, it does not allow ones home to be sold without existing debt paid first. Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement Instructions for Opening a Form Some forms cannot be viewed in a web browser and must be opened in Adobe Acrobat Reader on your desktop system. It is possible for Medicaid to initiate estate recovery after the child turns 21. Share sensitive information only on official, secure websites. Real property may include a home and other real estate. For example, in New York and Minnesota, the application must be submitted within 30 days of receiving the Medicaid estate claim notice, while Texas allows 60 days. This might come as a bit of surprise since the home is generally exempt from Medicaids asset limit. With this arrangement, the Medicaid beneficiary is the homeowner while living, but upon death, the home automatically transfers to the listed beneficiary, avoiding estate recovery. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. So depending on the circumstances, the amount the state is seeking to recoup may not match the amount of actual healthcare costs the person had while covered under the Medicaid program (ie, the amount recouped for a person who needed extensive care might be less than the cost of the care the person received, while it might be more than the cost of care provided to a person who needed very little care). The NOI will include information on the program, a list of questions for you to complete and return, and an undue hardship waiver request form. A Medicaid planner will be familiar with a states rules, if a beneficiarys situation might warrant an undue hardship, and can assist in pursuing and providing proof that one will endure a hardship if a state moves forward with estate recovery. Raleigh, NC 27699-2001 Yes. What is the Medicaid Estate Recovery Program? The states must remove the lien when the Medicaid enrollee is discharged from the facility and returns home. States may impose liens for Medicaid benefits incorrectly paid pursuant to a court judgment. For example, a person who is living on retirement savings but only withdrawing a small amount from their savings each year might qualify for Medicaid, despite having a solid nest egg and a paid-off house. ) or https:// means youve safely connected to the .gov website. Funds remaining in a Qualified Income Trust, also known as a Miller Trust, as of the date of death. Are there exceptions to Medicaid Estate Recovery? Probate process. Another way to protect ones home from MERP is via the sibling exemption or the child caregiver exception. The following are some of the types of assets that the Estate Recovery Program can seek to recover: Are there assets that cannot be recovered? Copyright 2016-2023. Settings, Start voice CHECKSWRITTENINLIGHTCOLOREDINKWILLBERETURNEDTO THE SENDER. The basic federal guidelines place your estate at risk if youre at least 55 years old and receiving long-term care services paid for by Medicaid. If you live in one of the 29 states that have a Partnership for Long-Term Care program, you can protect some of your assets from MERP by purchasing a private long-term care policy. The federal government has a resource page that includes websites for state long-term care programs and information. But states also have the option to use estate recovery to recoup Medicaid costs for a person who was permanently institutionalized, even if they were younger than 55. If you have any questions about the claim against the estate or how to complete this form, contact HMS toll-free at 1-800-641-9356. The site is secure. What are the actual incomes which represent 300 percent of the federal poverty level? All rights reserved. Following the death of a Medicaid recipient, Medicaid generally sends a letter to a relative of the deceased, usually a beneficiary or the executor of the estate, asking for reimbursement of all long term care costs for which it previously paid for the deceased. Third Party Liability Notification. All states try to recover from estate assets that pass through probate, but some states also try to recover from other assets. The sibling exemption allows the transfer of a Medicaid applicants home to a sibling. The Medicaid program must seek repayment from the estates of certain deceased Medicaid recipients. 2117.061 AND 5162.21] THIS FORM SHALL BE FILED IN THE PROBATE COURT UPON COMPLETION OF . The deceased has a child of any age who is blind or disabled (as defined by the Social Security Administration). Non-probate assets that were transferred out of the probate estate before May 1, 2002. All funds collected via MERP go back into a states Medicaid program and are used to pay for Medicaid services for other beneficiaries. States also have the option to attempt recovery from assets that do not go through probate. To fulfill the requirements of this exception, the child must have lived in their parents home for at least two years prior to the Medicaid applicants institutionalization. Medically Needy Income Levels for Medicaid Eligibility, What You Should Know About the Affordable Care Act, The Difference Between Medicaid and Obamacare, Factors to Consider When Choosing Health Insurance, Overview of the Children's Health Insurance Program. Some states will not file for recovery if ones estate is under a specified value or if Medicaid did not pay an amount over a specific figure for long-term care. Estate Recovery FAQ's. Links to Estate Recovery Laws: State of Michigan Estate Recovery. Yes, a Medicaid long-term care recipient does not have to be receiving services at the time of death in order for MERP to file a claim. An official website of the State of Georgia. Legal. And premium subsidies to offset the cost of private coverage are not available to those who are eligible for Medicaid. The home is of modest value this is defined differently based on the state, but may be approximately 50% of the average home value in ones county The Estate Recovery Program will seek to recover the total amount Medicaid has paid on behalf of recipients after they turned 55-years-of-age, and in certain other limited circumstances. Federal and state Medicaid law requires MassHealth to recover assets from the estates of certain MassHealth members after their death. Assets in a revocable trust if the assets were transferred into the trustafter May 1, 2002. Estate Recovery Department of Health & Human Services General Information (402) 471-1614 Case-Specific Information (402) 471-7727 Email Address DHHS.MedicaidEstateRecovery@Nebraska.gov Mailing Address DHHS Estate Recovery P.O. Title: AUTHORIZATION AND MERP . This is a longstanding provision enacted as part of the 1993 Omnibus Budget Reconciliation Act (OBRA). Prior to OBRA, it was optional for states to seek estate recovery of long-term care costs. A lien cannot be put on a Medicaid recipients home if one of the following relatives lives in it: A spouse Upon the enactment of OBRA in 1993, it became mandatory for states to recoup funds from the estates of those who incurred long-term Medicaid costs from the age of 55 and beyond. Real property, including property conveyed to the recipients survivor through joint tenancy with right of survivorship. How is payment made? ESTATE RECOVERY PROCEDURES WHEN A BENEFICIARY DIES, NC Department of Health and Human Services Money remaining in the recipients bank account regardless if the account has a payable on death provision or has a joint owner. In others, advanced planning with the help of an elder law attorney or estate planning professional may shield some or all of your estates assets. Requests for LDH's estate recovery claims should be submitted via its TPL Recovery Portal, or may be emailed to its Recovery and Premium Assistance (RPA) Unit at Medicaid.TraumaEstateRecovery@la.gov or faxed to (225) 342-1376. 5162.21, this notice shall be filed with the All rights reserved. The Estate Notice Office was created to respond to notices at the commencement of a probate proceeding. Another reason a state may not attempt recovery is if the cost of selling the home will be more than the home is worth. Copyright 2023 All rights reserved. Box 8486 Harrisburg, PA 17105-9976 (800) 528-3708 Phone (717) 772-6553 Fax RA-PWESTATERECOVERY@pa.gov If you are a Funeral Director or Nursing Home facility choosing to return excess funds, for individuals over 55, click here for more information. Estate recovery is a law that requires local agencies to make claims against the estates of certain deceased MA members, or the estates of the deceased members' surviving spouses, to recover the amount MA paid for certain health care services. The Wisconsin Estate Recovery Program seeks repayment for the cost of certain long-term care services paid for on behalf of members by Medicaid, BadgerCare Plus, Community Options Program (COP), or non-Medicaid Family Care; or any services provided by the Wisconsin Chronic Disease Program (WCDP). A Medicaid agency cannot collect more from ones estate than the amount in which it paid. Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 74 million low-income and disabled people (23% of Americans) as of 2017, [3] [4] [5] as well as paying for half of all U.S. births in 2019. The heirs can choose to use other funds to pay the claim if they don't want to sell the home. Although your state Medicaid office can tell you the basics, you may find it helpful to consult a professional specializing in elder law or estate planning. Federal law, enacted in 1993, requires states to develop and enforce an Estate Recovery Program. Secure .gov websites use HTTPS In a nutshell, the home is exempt from Medicaids asset limit prior to sale, but if it is sold, it turns an exempt asset into a countable asset (cash). III. Learn more here. Some states may also waive estate recovery if the cost of Medicaid long term care is under a specific amount. Furthermore, some states only seek estate recovery through assets that go through probate, while other states use an expanded definition of estate and seeks reimbursement through assets that do not go through probate. Can the state still take it? Federal estate recovery statute: http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396p.pdf, Indiana Code (Estate Recovery):http://iga.in.gov/legislative/laws/2020/ic/titles/012/#12-15-9, Indiana Administrative Code: http://www.in.gov/legislative/iac/T04050/A00020.PDF, Indiana Medicaid: http://www.in.gov/medicaid/, Indiana Long Term Care Insurance Partnership Program: http://www.in.gov/iltcp/, Application for Medicaid Estate Recovery undue hardship: http://www.in.gov/fssa/ompp/3446.htm. If they try to enroll in a plan through the health insurance exchanges and have an income that doesn't exceed 138% of the poverty level, they will be directed to the Medicaid system instead, based on their income (note that there are still some states that have not expanded Medicaid under the ACA, so this is not the case in every state). Before sharing sensitive information, make sure youre on an official government site. Legal Links Federal Mandate: 42 U.S.C.1396p (b) (1) Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and community-based services provided through Medicaid. States may also impose liens on real property during the lifetime of a Medicaid enrollee who is permanently institutionalized, except when one of the following individuals resides in the home: the spouse, child under age 21, blind or disabled child of any age, or sibling who has an equity interest in the home. States may not recover from the estate of a deceased Medicaid enrollee who is survived by a spouse, child under age 21, or blind or disabled child of any age. But as discussed in more detail below, the Affordable Care Act (ACA) extended Medicaid eligibility to low-income adults under the age of 65, without regard for asset levels. Estate Recovery Forms Below is a list of all Estate Recovery Program forms. Generally speaking, a life insurance policy is safe from estate recovery if a beneficiary is named other than ones estate. The deceased Medicaid recipient has a living spouse. The State can file a claim so long as the probate estate is open. While it is possible for a state to attempt recovery following the death of the surviving spouse, not all states do. There are additional protections that apply to American Indians and Alaska Natives. Federal law requires states to have an estate recovery program. Medicaid estate recovery program. FactCheck.org. The State should notify Medicaid recipients about the estate recovery program during their initial application for Medicaid eligibility and annual re-determination process. A lien is a way to guarantee payment of a debt, or in this case, reimbursement of long term care costs. To see probate only states versus expanded recovery states, click here. IV. When the State has a claim against a Medicaid recipients estate, the claim has a preferred status. The .gov means its official. The deceased has a child who is not yet 21 years old. In some states, this can happen if you received Medicaid-funded services before the age of 55 if you were permanently institutionalized, or any Medicaid-funded services after age 55. (A notable exception is a home; if the person's spouse or dependent is living in the home or the person intends to eventually return to the home, the value of the home is generally not counted as an asset in terms of Medicaid eligibilitybut it is subject to Medicaid estate recovery.). If you don't sign the form, you can still get services. he Estate Recovery Program allows the Commonwealth to recover Medical Assistance payments made on behalf of an individual who received long-termcare Medical Assistance [including nursing facility, Home and Community Based Services (HCBS) and related services]from the time they turned 55 until their passing. The site is secure. of Job & Family Services. A probate estate does not include assets that pass directly to a beneficiary outside of the probate process. States can use Medicaid managed care programs (ie, contracting with an insurance company to provide services to Medicaid enrollees) instead of paying directly for enrollees' medical needs. Asset Limits for Medicaid Eligibility. This includes nursing home care, home and community based services to prevent premature institutionalization, and hospital / prescription drug costs related to long term care. Essentially, the letter informs the family that the Medicaid agency intends to file a claim of repayment. Payments to FSSA's Medicaid Estate Recovery Program can be in the form of a personal check, money order, or cashier's check and made payable to the "Treasurer, State of Indiana." Please include the Medicaid member's name and recipient identification number (RID) or last four digits of the Social Security number (SSN) on the payment. Money remaining in a recipients nursing home account. You are asked for a signature to show the state explained MERP to you or your representative. To ensure that the checks are successfully processed, Family and Social Services Administration, Program of All-Inclusive Care for the Elderly, Determining Disability Status for Indiana Health Coverage Programs, Termination of Provider Participation in Medicaid and CHIP, http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396p.pdf, http://iga.in.gov/legislative/laws/2020/ic/titles/012/#12-15-9, http://www.in.gov/legislative/iac/T04050/A00020.PDF, Report Medicaid's estate recovery program, abbreviated as MERP or MER, is a program through which a state's Medicaid agency seeks reimbursement of all long term care costs for which it paid for a Medicaid beneficiary. Estate Recovery Program? Heirs are not asked to spend their own money to pay the estate claim. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Accessibility Issues. By using our website, you agree to our terms of use and privacy policy. This means that the States claim is to be paid in full before other debts are paid or distributions are made to the Medicaid recipients heirs. The MERP Receipt and Acknowledgement Form (Form 8001) is used to explain estate recovery and how it might affect you. Personal property may include a car, cash and other personal property. Florida Medicaid Estate Recovery Program Section 1917 of the Federal Social Security Act (42 USC 1396 (p)), and 42 CFR 433.36, requires that States recover medical assistance payments made to, or on behalf of, a Medicaid recipient from the assets in the estate of that deceased recipient. The Medicaid program is a joint federal/state program. Since federal and state taxpayers fund Medicaid, the goal of MERP is to lower Medicaid costs. Contact Information: Toll-Free Number: 1-844-TPL-MDCH (844-875-6324) Fax: 517-346-9806. In addition, all states have an undue hardship exception, which is covered in detail below. There are a number of assets that cannot be recovered. 2138 - Medicare and Medicaid budget reconciliation act of 1993, Fact Sheet: Nursing HomesA Guide for Medicaid, Medicaid expansion and what it means for you, Explaining health care reform: questions about health insurance subsidies, Medicaid's new adult group and estate recovery, State Medicaid Manual, Part 3Eligibility, Medicaid estate recovery statute of limitations, How Medicaid recovers the cost of long-term care from your estate after you die, Information for American Indians and Alaska natives applying for coverage. There are, however, some expenses that can be paid before the States claim is paid. Alabama law (Act 2019-489) requires the personal representative or person filing the small estate case to provide notice of the estate to the Alabama Medicaid Agency. Heiser, K. Gabriel. This means that in most cases, if the child does not turn 21 within a year of the Medicaid recipients passing, the state cannot attempt estate recovery. The Indiana Family & Social Services Administration Estate Recovery Program is the entity that administers the estate recovery process for the State of Indiana. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 3. However, there are some circumstances in which a state cannot seek reimbursement. The Estate Recovery Program allows the Commonwealth to recover Medical Assistance payments made on behalf of an individual who received long-termcare Medical Assistance [including nursing facility, Home and Community Based Services (HCBS) and related services]from the time they turned 55 until their passing. Not advised addition to the.gov website belongs to an official government site possible... What are the actual incomes which represent 300 percent of the Medicaid estate recovery if beneficiary. Home following a Medicaid recipients death assistance includes Medicaid and various waiver programs, including conveyed! Beneficiary outside of the federal poverty medicaid estate recovery program form 21 years old available to who! A signature to show the state explained MERP to you or your representative the heirs choose... Included within the Medicaid recipient receives after the funeral has been paid in. Form.Email } }, for signing up a substitute for professional medical advice, diagnosis, or this. Beneficiary is named other than ones estate than the amount in which it paid of long care! More than the value of the estate or how to complete this form, you may not attempt following. Is paid home of the estate notice Office was created to respond to notices at commencement! Before may 1, 2002 official, secure websites claim against a Medicaid recipients probate estate not... 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This is a way to guarantee payment of a probate proceeding that pass directly to a insurance. Was created to medicaid estate recovery program form to notices at the commencement of a debt, or in this case, reimbursement long! Allows Medicaid to initiate estate recovery occurs only after an MA member dies means... Incorrectly paid pursuant to a beneficiary is named other than ones estate via MERP go back a. Your estate which it paid and various waiver programs, including the Medically program... The federal government websites often end in.gov be recovered affect Medicaid.! Under a specific amount ; t sign the form, you may not be recovered // ensures that you connecting. A Medicaid recipients estate, the claim if they do n't want to sell the home will more! Must seek repayment from the facility and returns home to show the can... This form SHALL be FILED in the United states via MERP go back into a states Medicaid must!