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Medi-Cal Recovery Reform – At Last!


When Governor Brown signed the budget bills on June 27th 2016, he signed into law the most significant and progressive changes in Medi-Cal recovery since 1993, when Governor Pete Wilson signed his budget bill that created California’s current draconian Medi-Cal Recovery program.

Current California law requires the state to place a claim on the estates of those who received Medi-Cal benefits when they were 55 years of age or older to recoup benefits paid, regardless of the type of medical services received. Most other states, in an effort to encourage health care enrollment, have eliminated recovery for this population.

While federal Medicaid laws do require that states maintain a Medicaid estate recovery program, federal law does not require California to place claims on the estates of surviving spouses, nor does it require California to collect for optional benefits for those 55 and over.

Medi-Cal’s aggressive recovery program has put an inordinate burden on the families of California’s low-income Medi-Cal beneficiaries. Some heirs and survivors of Medi-Cal recipients have been forced to sell the family home to pay the estate claim. Others, hoping to stay in their homes, were forced to sign a “voluntary lien” which accrues 7% annual interest.

The budget bills signed by Governor Brown incorporated the provisions of SB 33 (Hernandez) and ensures:

  • No recovery on the estates of surviving spouses.
  • Recovery will be limited to only what is required by federal law, i.e., for those 55+ years of age, nursing home facility and long term care services or any age if the person was “permanently institutionalized."
  • Waivers of estate claims for homesteads of modest value.
  • The “Estate” from which the state can recover will be limited to the probate estate - thus, living trusts, joint tenancies, etc. will not be subject to recovery.
  • Interest on liens will be limited.
  • Those who could be subject to recovery can receive an itemized billing once a year for a $5 fee.

The new provisions are effective for those who die on or after January 1, 2017
CANHR co-sponsored SB 33 with Western Center on Law and Poverty.

Western Center, Senator Hernandez, the author, and his staff, Scott Bain, are to be congratulated for their resolve to help low income communities and prevent the destabilization of these communities.

And thanks to all of you who advocated and sent letters of support. It's been a long time coming, but we did it.

Page Last Modified: August 24, 2015