Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-3 - MEDICAL ASSISTANCE › Subject 111-3-8 - ESTATE RECOVERY › Rule 111-3-8-.02 - Definitions

Current through Rules and Regulations filed through June 27, 2024
(1) "Authorized
				representative" means a guardian or a person designated by the Member to act on
				his or her behalf during the Member's life.
(2) "Creditor" means an entity (person or
				institution) to whom an obligation is owed because a Member received something
				of value in exchange.
(3) "Debt"
				means a sum of money owed from one person to another, including the right of
				the creditor to receive and enforce payment.
(4) "Department" means the Georgia Department
				of Community Health, Division of Medical Assistance.
(5) "Discharge from the medical institution
				and return home" means a qualifying discharge, which involves the Member's
				dismissal from the nursing institution and/or facility for at least thirty (30)
				days wherein the Member's personal effects and bed are released at the same
				time of his or her discharge.
(6)
				"Equity interest in the home" means value of the property in which the Member
				holds legal interest beyond the amount owed on it in mortgages and
				liens.
(7) "Estate" means all real
				and personal property under the probate code, including real and personal
				property passing by reason of joint tenancy, right of survivorship, life
				estate, survivorship, trust, annuity, Individual Retirement Accounts, homestead
				or any other arrangement. Estate also includes excess funds from a burial trust
				or contract, promissory notes, cash, and personal property. Estates with a
				gross value of $25,000 or less are exempt from estate recovery.
(8) "Hearing" means a formal proceeding
				before an Administrative Law Judge or Probate Judge in which an aggrieved party
				affected by an action or an intended action of the Department shall be allowed
				to present testimony, documentary evidence, and argument as to why such action
				should or should not be taken.
(9)
				"Heirs" means heirs-at-law who are entitled under the statutes of intestate
				succession to property of a decedent and beneficiaries who are entitled to
				inherit the estate if there is a lawful will.
(10) "Lawfully residing" means permissive use
				by the owner/power of attorney at the law.
(11) "Lien" means a claim, encumbrance or
				charge against the Medicaid Member's real or personal property on account of
				medical assistance paid to the Member correctly under the State Plan. A Lien
				may be placed on the real property of a Member who is an inpatient of a nursing
				facility, intermediate care facility for individuals with intellectual
				disabilities, or other institution or a Lien may be placed on both real and
				personal property of a Member after the Member's death.
(12) "Long-term care" means a service
				provided in a long-term care facility or in the home, pursuant to federally
				approved home and community based services, as an alternative to
				institutionalization.
(13) "Medical
				assistance" means payment by the State's program under Title XIX of the Social
				Security Act or Medicaid program administered by the Department.
(14) "Member" means a person who has been
				certified as Medicaid eligible, pursuant to the terms of the State Plan, to
				have medical assistance paid on his or her behalf.
(15) "Member's home" means a true, fixed and
				permanent domicile and principal establishment to which the Member has the
				intention of returning to whenever absent.
(16) "Permanently institutionalized" means
				residing in a nursing facility or intermediate care facility for individuals
				with intellectual disabilities and developmentally disabled for six (6)
				consecutive months or more.
(17)
				"Personal representative" means an executor, administrator, guardian,
				conservator, committee, trustee, fiduciary, or other person having a status
				which by operation of law or written instrument confers upon such person a duty
				of distributing property to Heirs.
(18) "On a continuous basis" means that the
				qualifying relative lived with the Member in the Member's home at his or her
				principal place of residence during an uninterrupted timeframe. An absence of
				residence greater than six months is presumed to disrupt the continuity of
				residence.
(19) "Residing in the
				home for at least one or two years" means one is domiciled in the principal
				place of residence.
(20) "State
				Plan" means all documentation submitted by the Commissioner, on behalf of the
				Department, to and for approval by the Secretary of Health and Human Services
				pursuant to Title XIX of the federal Social Security Act of 1935, as
				amended.
O.C.G.A. §
											49-4-147.1.