State Can Recover Benefits From Recipient's Estate Even If Recipient Was Improperly on Medicaid

A Massachusetts appeals court holds that the state was entitled to recover Medicaid benefits from the estate of a deceased recipient even if the recipient was improperly enrolled in Medicaid. Executive Office of Health and Human Services v. Fungaroli (Mass. Ct. App., No. 18-P-324, February 4, 2019).

Joseph Fungaroli received MassHealth (Medicaid) benefits before he died. After Mr. Fungaroli’s death, the state filed a claim against his estate to recover $163,073.87 in Medicaid benefits paid on his behalf. Mr. Fungaroli's estate disallowed the claim.

The state filed a complaint for recovery of the expenditures. State law allows the state to recover from an estate the amount of medical assistance "correctly paid" on a recipient's behalf. The estate argued that the medical assistance was not "correctly paid" because the state improperly put Mr. Fungaroli on Medicaid when he was not eligible. The trial court granted the state summary judgment, and the estate appealed.

The Massachusetts Court of Appeals affirms, holding that the state was entitled to recover Medicaid benefits from Mr. Fungaroli's estate. The court rules that the term "correctly paid" does not "create an additional exception to the criteria for recovery from the estates of beneficiaries age fifty-five and over." The court notes that even if Mr. Fungaroli was improperly enrolled in Medicaid, that would have no bearing on the state's right to recover the benefits paid.

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