Medicaid program; liens, adjustments, and recoveries--HCFA. Final rule with comment period

We are revising Medicaid regulations to provide the conditions under which States may impose liens against the real property of certain individuals receiving Medicaid benefits in intermediate care and skilled nursing facilities. These individuals are those who the State determines, after notice to the individual and opportunity for a hearing, are unlikely to be discharged from the facility and return to their homes. These regulations also specify the conditions under which States may recover the amount of Medicaid payments made on behalf of individuals through foreclosure on liens on an individual's property, or adjustments or recoveries from their estate. These regulations implement Section 132 of Pub. L. 97-248, the Tax Equity and Fiscal Responsibility Act of 1982. The purpose of this provision is to permit States to recover the cost of Medicaid payments from an individual's property, and thereby reduce the public cost of supporting that individual in a long term care facility.