This policy brief was prepared under contract #HHS-100-03-0022 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and Thomson/MEDSTAT. For additional information about the study, you may visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the ASPE Project Officer, Hunter McKay, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. His e-mail address is: Hunter.McKay@hhs.gov.
State Medicaid programs are administered within broad federal guidelines and are financed jointly by states and the Federal Government. Since the 1993 enactment of the Omnibus Budget Reconciliation Act (OBRA 93), federal law has required states to recover Medicaid spending on behalf of beneficiaries from their estates after death.1 This issue brief summarizes the estate recovery mandate, discusses variations in mechanisms employed by states to implement the mandate, and presents a state-by-state analysis of collections from 2002 through 2004.