§ 258.5. Computation of claim.
(a) The Department’s claim with respect to a decedent shall consist of the total of all MA payments made with respect to the decedent for nursing facility services, home and community based services and related hospital and prescription drug services rendered on or after August 15, 1994.
(b) Premium payments and cost-sharing for decedents who were qualified Medicare beneficiaries shall be included in the statement of claim for the period of time the decedent received nursing facility services, home and community based services or related hospital and prescription drug services rendered on or after August 15, 1994. A qualified Medicare beneficiary is an individual whose Medicare copayments, premiums or deductibles only are paid by the MA program.
(c) With respect to a claim for the costs of MA services delivered through a Managed Care Organization (MCO) contract, the Department’s claim will be based on the amount the Department paid to the MCO on behalf of the decedent.
(d) The Department will not reduce its claim on account of attorneys’ fees or other costs incurred by the estate to obtain or liquidate assets. These costs may be treated as expenses of administration of the estate.
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