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Medicaid Recoveries

Client Recoveries

 

In certain instances, an individual may have obtained Medicaid benefits that they were not entitled to receive. In such cases the overpayment of benefits may be recovered from the individual.

 

For more information please contact the human services office in the county where the client resides.

 

Estate Recovery

 

The Colorado Medical Assistance Estate Recovery Program is a federally mandated program that requires the State of Colorado to recover Medicaid expenditures correctly paid on behalf of certain Medicaid clients. After the death of a person who has received medical assistance, the law requires that certain individual's assets be used to repay the Colorado Department of Health Care Policy and Financing (Department) for these benefits. Colorado’s estate recovery statute can be found at Section 25.5-4-302, C.R.S. The Department’s estate recovery rules are found at 10 CCR 2505-10, Section 8.063.

For more information on the Estate Recovery Program please review the Department's handout.

 

Post Pay Recoveries

 

Post-Pay projects recover the cost of benefits paid on behalf of a Medicaid client by the Department where another party is legally responsible for payment. Post-pay recovery projects encompass several separate and distinct recovery programs, which include but are not limited to, the following: Medicare recoveries, commercial insurance recoveries, and provider retractions. The Department contracts with Health Management Systems (HMS) to perform post-pay recoveries.

 

Additional information regarding client recoveries, estate recoveries, and post-pay recoveries may be obtained by contacting ashley.dirienzo@state.co.us.    

 

Trust Recoveries 

 

Certain trusts are required to establish and/or maintain Medicaid eligibility. Upon the death of a Medicaid client, the Department is required to collect certain trust funds in order to offset Medicaid benefits paid on behalf of the client.

 

For more information regarding trusts, please contact medicaid.trusts@state.co.us.