Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0037 - Medicaid › Chapter 35 - MEDICAID BENEFIT RECOVERY › Section 35-4 - Definitions

Current through July 13, 2024
Except as otherwise specified in Chapter 1 or as defined in
				  this Section, the terminology used in this Chapter is the standard terminology
				  and has the standard meaning used in accounting, health care, Medicaid, and
				  Medicare.
(a) "Birth cost" - "Birth
				costs." As defined in W. S. §
									
										14-2-1002(a)(i).
(b) "Bona fide effort to sell." The act of
				putting property up for sale and entering a written agreement with the
				Department.
(c) "Estate recovery."
				The recovery from the estate of a deceased client or from the estate of the
				spouse of a deceased client for reimbursement of Medicaid payments made on
				behalf of a client.
(d) "Incentive
				allowance." An allowance payment to the heirs, legatees or other person(s) who,
				having a valid claim to ownership of the deceased client's assets, who
				cooperate fully with the Department in maintaining and disposing of the assets
				so as to satisfy to the full extent possible the State's reimbursement
				right.
(e) "Medicaid benefit
				recovery." The recovery for reimbursement of Medicaid funds paid on behalf of a
				client.
(f) "Net proceeds." The
				dollar value from the sale of any real or personal property determined by
				deducting from the gross proceeds any amounts, including at a minimum, any
				liens or encumbrances against the property, realtor's commission fee,
				maintenance and repairs to the home required by a property inspection or needed
				to sell the property, an appraisal or broker's price opinion, attorney's fees
				and costs, and closing costs.
(g)
				"Non-probate estate." That portion of a client's estate or the estate of the
				spouse of a client which is not administered pursuant to the Wyoming Probate
				Code.
(h) "Probate estate." That
				portion of a client's estate or the estate of the spouse of a client which is
				administered pursuant to the Wyoming Probate Code.
(i) "Reasonable expenses incurred preserving
				or disposing of the asset(s)." Reasonable expenses incurred either in
				maintaining or disposing of the assets of a client's estate distributed
				pursuant to the summary distribution provisions pursuant to the Wyoming Probate
				Code or distribution pursuant to an affidavit, including:
(i) Closing costs for the sale of real
				property which results in the partial or complete satisfaction of the
				Department's reimbursement right (closing costs include the reasonable
				attorney's fees of the seller, the cost of title insurance, and recording
				costs);
(ii) Costs of an
				Administration pursuant to W.S. §
										
											2-1-301(viii) and probate
				administration pursuant to W.S §
										
											2-7-802;
(iii) An incentive allowance as prescribed in
				Section 6 of this
				rule;
(iv) If Medicaid participates
				in a probate with a claim then it should not reduce its lien by the amount of
				the costs to sell the property;
(v)
				Property insurance premiums;
(vi)
				Real or personal property taxes;
(vii) Utility costs which are necessary to
				preserve the property, only allowed if the property is vacant or not payable by
				a renter or lessee pursuant to a rental or lease agreement;
(viii) Other costs incurred pursuant to a
				written property management agreement signed by the Department;
(ix) Expenses incurred in providing necessary
				maintenance or making necessary repairs, without which the salability of the
				property would be substantially impaired.
(A)
				Reasonable expenses do not include payment of credit card bills, telephone
				(cell phone) bills, or cable bills.