Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter VII › Section 144-101-VII-5 - Estate Recovery › Subsection 144-101-VII-5.07 - GENERAL REQUIREMENTS FOR ALL WAIVERS

Current through 2024-29, July 17, 2024
A claim under 5.03(B) may be waived if enforcement of the
						claim would cause an undue hardship for the person, providing that the person
						holds a beneficial interest in the Member's estate, as defined in this Section,
						and properly requests a hardship waiver. An applicant may request an undue
						hardship waiver because the applicant is reliant upon the assets of the estate
						or an undue hardship waiver based upon care given to the Member. The specific
						requirements for each type of waiver are set forth below. To qualify for a
						waiver, a person who is not a son or daughter of the deceased member must also
						be an adult, aged eighteen (18) or over. If a determination is made that an
						undue hardship exists, the Department may waive all or a portion of its
						claim.
Only one (1) waiver, undue hardship, or undue hardship
						based on care given will be granted per estate.
A.
Application process:
A person
					 applying to the Department for consideration of an undue hardship waiver ("the
					 applicant") must comply with the following:
1. An applicant must file an application on a
					 form prescribed by the Department; and
2. The request for an undue hardship waiver
					 must be made within six (6) months from the Member's death or within sixty (60)
					 days from the notice of the Department's claim, whichever is later;
					 and
3. The applicant must be either
					 the son or daughter of the Member or an adult aged eighteen (18) or older;
					 and
4. The Department may require
					 the applicant to submit any information and documentation regarding the
					 applicant's and all household Member's finances, tax returns, property,
					 employment, liabilities, expenses, and any other matters relevant and necessary
					 to determine whether an undue hardship would result from recovery. If the
					 information requested by the Department is not provided within sixty (60) days
					 of the written request of the Department, or if the request is materially
					 incomplete the request for an undue hardship waiver may be denied; and
5. The applicant must prove that
					 they have a beneficial interest in the estate:
a. through a legal right to the property of
					 the estate through a will;
b.
					 through the law of intestate succession; or c. must establish to the
					 Department's satisfaction by providing written documentation that the
					 applicant:
i. cohabitated with the Member for
					 the five consecutive years prior to the Member's most recent eligibility for
					 MaineCare benefits;
ii. provided
					 significant support for the household and to maintain property in the estate
					 during that time; and
iii. along
					 with the Member held themselves out to the public as married or in a civil
					 union; and
6. Should the applicant's beneficial interest
					 in the estate be less than 100%, the Department must reduce the undue hardship
					 waiver, if granted, to meet the applicant's beneficial interest; and
7. If the applicant is securing agreement
					 from other heirs to increase their legal interest in the estate, the applicant
					 must do so through irrevocable assignment by the other heirs; and
8. For all applicants claiming a beneficial
					 interest in the estate, if the asset of concern to the applicant is the
					 decedent's home, the applicant must prove that the home was the applicant's
					 primary residence for two or more years immediately prior to the death of the
					 MaineCare recipient, that the applicant's contribution to the upkeep of the
					 house was significant, and that it was the understanding and belief of both the
					 MaineCare recipient and the applicant that this was the home of both the
					 applicant and the MaineCare recipient; and
9. Only one waiver application per estate may
					 be submitted to the Department. The applicant may only request one type of
					 waiver per application; and
10.
					 The Department shall determine whether an undue hardship exists within ninety
					 (90) days from the date of the receipt of all information requested.
					 Appropriate notice of the decision will be sent to the person making the
					 request. All decisions regarding the undue hardship waiver will be provided in
					 writing and provide an explanation if the application is denied. The written
					 decision must also provide information about how to appeal the denial to the
					 Department's Administrative Hearings Unit.