Estate Recovery

Resolve and recover, respectfully

At Optum™, our Estate Recovery services are customized to meet each state’s specific estate recovery statues. Optum provides subject matter expertise and comprehensive analysis of a variety of data sources to assist states in recovering of expenses.

Recovering expenditures from the states of deceased Medicaid recipients is often seen as politically insensitive and intrusive. However, states are obligated by federal statute and regulation to pursue estate recoveries for Medicaid care provided to people over the age of 55. Optum Estate Recovery services can respectfully help states recover amounts correctly paid for certain people with Medicaid including:

  • Nursing home or other long-term institutional services
  • Home and community-based services
  • Hospital and prescription drug services

Optum provides Estate Recovery services through a combination of approaches, including:

  • A team of attorneys specializing in estate matters
  • Analysis to identify likely estates through such data as claim detail, vital statistics, Medicaid eligibility, and more
  • Notification to estates and probate courts
  • Monitoring by an Optum Recovery Analyst throughout the process
  • Identification of property transfers that may be in violation of the 60 month look-back period for institutional eligibility under Medicaid

Optum™ provides deep public sector expertise and a full range of program integrity solutions to support government efforts in identifying and avoiding payment upfront, as well as retrospectively recovering inaccurate, inappropriate, or fraudulent Medicaid payments.