SUBJECT:
TAX EQUITY AND FISCAL RESPONSIBILITY ACT Of 1982 (TEFRA) LIENS
DISCUSSION:
Senate Bill 539 (2005) revised Mo. Law 208.215. Subsection 13, under 208.215, now requires the Department of Social Services to file a lien on any real property (including the home) owned by a Medicaid recipient who is approved for vendor benefits on or after September 1, 2005 and who is permanently institutionalized and cannot reasonably be expected to be discharged and return home. These liens are referred to as TEFRA liens. The Division of Medical Services (DMS) is the agency responsible for placing the liens on property. For property to be considered, the recipient must have:
- sole legal interest, or
- a legal interest based upon co-ownership of the property which is the result of a transfer of property for less than the fair market value within thirty months prior to the recipient's entering the nursing facility.
Upon approval, recipients of Vendor Nursing Care who own real property and who do not meet any of the below exceptions, will receive a Notice of Intent to File Medicaid TEFRA Lien (sample attached) from DMS. Any lien filed against an individual will be removed upon the individual's discharge from the medical institution and return home.
No lien may be imposed on such individual's home if one or more of the following persons is lawfully residing in such home:
| (1) | the individual's spouse; |
| (2) | the individual's child who is under twenty-one years of age or is blind or permanently and totally disabled; or |
| (3) | a sibling of the individual who has an equity interest in the home and who was residing in the home for a period of at least one year immediately before the date of the individual's admission to the medical institution. |
Effective immediately, staff must provide a copy of the Notice of Possible Legal Claim Against Home 
(attached below) to applicants for Vendor Nursing Care. Also, a copy of the notice must be included with the IM-62's when the case is approved. DMS will mail a copy of the notice to recipients approved between September 1, 2005 and the date of this memorandum.
NECESSARY ACTION:
- Share this memorandum with appropriate staff as soon as possible.
- Effective immediately, provide a copy of the attached notice to applicants for Vendor Nursing Care and to the IM-62 when the case is approved.
ATTACHMENTS
Notice of Intent to File Medicaid TEFRA Lien
Notice of Possible Legal Claim Against Home