Florida Medicaid Trust & Annuity Recovery Program
Pursuant to Section 1917 of the Social Security Act, the Agency for Health Care Administration (Agency) is entitled to reimbursement of the Medicaid benefits made to, or on behalf of, a Medicaid recipient from the trust balance on the date of death or upon early termination of an Irrevocable Trust. An Irrevocable Trust allows for a disabled person to maintain his or her eligibility for public assistance benefits, despite having assets that would otherwise make the person ineligible for those benefits.
Nursing Home Refunds
If the trust paid the nursing home for the month, and the patient was not in the nursing home for the entire month, the nursing home may have been overpaid. The nursing home should issue a refund. Contact the nursing home to determine if a refund is due.
The refund check must be deposited to the trust account and include the balance paid to Medicaid. If the trust account has already been closed, the refund check should be endorsed to “The Agency for Health Care Administration” and forwarded with a cover letter identifying the beneficiary. The check and letter should be mailed to the address below.
Qualified Income Trust
The Qualified Income Trust (QIT) is a legal instrument drafted in accordance with federal law. The Agency is entitled to recover the total lifetime assistance paid on behalf of the Medicaid beneficiary from the balance of the trust at death. The trustee is responsible for ensuring reimbursement to the Agency. If the trustee requires a calculation of this claim, kindly contact us at the address below.
To reimburse Medicaid the balance of the trust, send a check made payable to “Agency for Health Care Administration” in the amount of the balance of the trust fund, including any nursing home refunds, along with a copy of the month of death bank statement to the address below.
No other checks should be written from the Trust account after the grantor’s death until notification of has been received that the Medicaid debt is fulfilled and the claim has been satisfied.
Please include the following with the check:
• Copy of month of death bank statement encompassing the date of death of the recipient
• Copy of the death certificate
• Trustee’s mailing address
• Either a check for the nursing home refund of patient responsibility or a document stating no refund is owed. Due to the length of time the facility may need to process the refund, this may be sent under separate cover when the refund is received.
Florida Medicaid TPL Recovery Program
PO Box 12188
Tallahassee, FL 32317
Other Trust Types
For other trust types that require Medicaid payback, such as Special Needs Trusts and Pooled Special Needs Trusts, please send a letter with the trust agreement/joinder and death certificate to the address above to determine the amount of reimbursement owed to the Agency.
If you required information regarding recoveries from guardianship accounts, irrevocable funeral/burial accounts, and annuity policies, please call or email us with any questions relating to these assets.
Conduent Payment Integrity Solutions (Conduent) is the Florida Agency for Health Care Administration (AHCA) approved subcontractor of Health Management Systems (HMS) contracted to administer the Florida Trust and Annuity Recovery Program.
Relevant Statutes and Codes
42 USC 1396p(d)(4)(A)
42 USC 1396p(d)(4)(B)
42 USC 1396p(d)(4)(C)
42 USC 1396p(e)(1)
Omnibus Budget Reconciliation Act of 1993 (or OBRA-93)
POMS SI 01120.200 H (1-2)