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State lawmakers push to limit MassHealth's ability to recoup funds after members die06:00
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One of the proposed state laws left in limbo at the end of formal legislative sessions on Beacon Hill this week is an amendment to limit MassHealth's estate recovery program.

MassHealth is the state's Medicaid program. It provides health coverage mainly to people with low incomes.

Many people don't know that after certain MassHealth members die, the agency moves to recoup money it paid out for their health care. It does that by filing claims against members' estates that end up in probate court.

Federal Medicaid law requires that states try to recover costs related to long-term care members received after they turned 55. But the federal government allows states to go further than that. MassHealth attempts to recover all costs enrollees incurred after they turned 55 — for everything from routine doctor visits to specialty care, hospital stays and medical equipment.

"We are one of the most aggressive states in our [estate] recovery, traditionally," said state Sen. Jo Comerford, of Northampton. "That changed a bit during the pandemic, but we still are among the states that recover the most on top of what the federal government asks us to recover."

MassHealth implemented some changes to the practice last year — the first in two decades. Among the changes are that the agency no longer tries to recover costs from estates worth less than $25,000. It now sends a notice about estate recovery to members when they turn 55, and it broadened eligibility for waivers.

Comerford sponsored legislation this year to restrict how MassHealth recovers money from the estates of patients who die. The proposed law would require that Massachusetts only do the estate recovery required by federal statute. The measure got bogged down in the legislative process. So, late in the session, Comerford and colleagues attached an estate recovery reform amendment to the comprehensive economic development and tax relief bill lawmakers were considering. The Senate passed that amendment, but the broader bill never got out of conference committee.

Comerford told WBUR's Steve Brown on All Things Considered that she hopes the larger bill and amendment get passed this year; that can only happen if the Legislature holds a special session.

She explained that she got into the estate recovery issue because she heard from a constituent whose sister, a MassHealth member, had died abruptly and left behind a disabled son.

"She had saved her whole life to buy a very small home," Comerford said. "And wouldn't you know it — shortly after her death, [the family] received a note that they were going to have to provoke the sale of the home where this young man was living. ... It became unthinkable to me that this was actually happening in Massachusetts, but in fact, it was."

Hear the full conversation above.

This segment aired on August 5, 2022.

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Lynn Jolicoeur Twitter Producer/Reporter
Lynn Jolicoeur is the field producer for WBUR's All Things Considered. She also reports for the station's various local news broadcasts.

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Steve Brown Twitter Senior Reporter/Anchor
Steve Brown is a veteran broadcast journalist who serves as WBUR's senior State House reporter.

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