Final approval for a legislative fix to help Minnesotans with estate claims against them because they were on Medical Assistance has gone into overtime.
"I'm not hitting the panic button just yet," said state Sen. Tony Lourey, DFL-Kerrick, a primary architect of legislation passed in the final minutes of this year's session to end the state's authority to enter claims against the estates of Minnesotans aged 55-64 who receive Medical Assistance.
But the federal agency with ultimate authority is delaying action until getting more information from the state.
The legislation, which also retroactively removed claims dating back to Jan. 1, 2014, was passed by both houses and signed by Gov. Mark Dayton as part of the state's spending bill. But it still required approval by the Centers for Medicare and Medicaid Services, the federal agency that administers those health insurance programs.
CMS had 90 days to approve, disapprove or ask for additional information from the state Department of Human Services, said Samantha Bisogno, spokeswoman for U.S. Rep. Rick Nolan, D-Crosby, in an email.
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The request for additional information came on Nov. 14, according to a statement from DHS.
"We are developing a response now and expect to respond in the next few days," DHS stated. "(We) have no prediction about the ultimate outcome."
Once DHS responds, the clock will be reset and CMS will have another 90 days to reach a verdict. That means a decision could come under a new presidential administration that will include a new CMS administrator. But Lourey said he's confident CMS will act sooner.
"I still believe we're on solid footing with what we passed," Lourey said. "And in the end CMS is going to approve it within this administration."
The DHS statement said, "We have made it clear that time is of the essence."
CMS is questioning the retroactive portion of the legislation, Bisogno wrote.
For a group of small farmers and property owners, mostly in Pine County, who raised the issue early this year, that's a key portion. They argued that they were placed in Medical Assistance by MNsure in 2014 and '15 without any knowledge that the money they received could be recovered via liens placed on their properties after their death.
"The whole issue was the undisclosed liens in the first place," said Rick Rayburn, who discovered in late 2015 that $30,000 in estate claims had accumulated against him and his wife, Rose, on their small, wooded farm near Willow River. "It's the liens that were accrued without our knowledge."
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Scott Killerud, another Pine County farmer whose wife, Ellen, was subject to a claim of about $11,000 on their property, wrote in an email that federal approval "may be the torpedo that strikes the entire effort."
"CMS needs to understand that neither the online MNsure portal or traditional paper applications EVER disclosed the (Medical Assistance) estate claim ... at signup," Killerud wrote.
Despite the wait for federal action, the Minnesota Department of Human Service's website includes a reference as if the estate claim fix were a done deal. It states the state and county agencies will collect only Medical Assistance paid for long-term services, such as nursing home care, effective back to Jan. 1, 2014, from those ages 55 to 64.
Lourey said he doesn't think the feds will reject the retroactive clause in the legislation. The language of the bill is complicated, so there may need to be some language changes, he said.
"I don't have any indication that there's any portion of this at risk," Lourey said. "I'm not aware of it being anything other than clarification."
Although Lourey has no direct role in the process, he's monitoring it closely, he said.
Likewise, members of Nolan's staff are working closely with CMS "to facilitate a timely resolution to this issue," Bisogno wrote.
The Chicago office of CMS didn't respond to the News Tribune's queries about the situation.
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The process has been "nerve-wracking," Lourey acknowledged.
"Some are frustrated," he said. "I am frustrated. I was expecting an answer one way or the other."
