Medicaid Estate Recovery Collections. COLLECTIONS BY STATE


Amounts collected by individual states are show in Table 1 and Table 2 below. Collections resulting from estate recovery activities vary widely from state to state, and changes in the amounts collected by individual states over time are highly irregular.

2004 High and Low State Collection Rates

  • The three states that recouped the largest share of their nursing home spending are Arizona (10.4%),* Oregon (5.8%), and Idaho (4.5%).
  • Five additional states recouped >2.0% of nursing home spending: Iowa (2.9%), Minnesota (2.8%), Wyoming (2.7%), Maine (2.5%), and Massachusetts (2.0%).
  • Three states reported minimal recoveries (rounding out to 0%): Louisiana, New Mexico, and Utah.
  • Four states did not report any estate recoveries: Alaska, Georgia, Michigan, and Texas.

* Arizona's estate recovery collections, as a percentage of nursing home spending, are not comparable to any other state because comprehensive prepaid managed care contracts dominate that state's Medicaid program. Nursing home care provided under these contracts is not identified separately for reporting purposes.

Most of the higher recovery states have more mature programs and long experience with estate recovery.

Changes in Collection Rates Between 2002 and 2004*

  • National collections rose by over $40 million (12.4%).
  • State-specific changes in collections were roughly similar to the average change nationally in only four states: California, Massachusetts, New York and South Dakota. Though their rates of increase were close to the national average (12-13%), the increases in funds they collected comprised nearly one-third (30.1%) of the total increase in national collections. Similarly, their share of total collections in 2004 was just under one-third (30.0%).
  • All other state collections between 2002 and 2004 departed significantly from the national average.
  • Thirty-five states increased their collections between 2002 and 2004. The five states with the highest percent increases were Kentucky (184.7%), Louisiana (100.0%), New Mexico (100.0%), Wyoming (90.8%), and Tennessee (85.1%).
  • Twelve states collected less in 2004 than in 2002. The five with the largest percent decreases were: Utah (-97.7%), Pennsylvania (-74.7%), West Virginia (-64.6%), Nevada (-64.3%) and Mississippi (-57.4%).
  • Factors explaining volatile rates of change within a given state over time are speculative and include: programs in early and unsettled states of implementation; gains or declines in a small number of relatively large estates (which can have disproportionate effects on rates of change, especially in smaller states); and errors or inconsistencies in reporting.

* See Table 1, Table 2, and Table 3.

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