(1) Except as provided in Subsections (2) and (3), the department may impose a TEFRA lien on the real property of an individual for the amount of medical assistance provided for, or to, the individual while the individual is an inpatient in a care facility, if:

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Terms Used In Utah Code 26B-3-1015

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Care facility: means :
         (2)(a) a nursing facility;
         (2)(b) an intermediate care facility for an individual with an intellectual disability; or
         (2)(c) any other medical institution. See Utah Code 26B-3-1001
  • Inpatient: means an individual who is a patient and a resident of a care facility. See Utah Code 26B-3-1001
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Medical assistance: means :
         (8)(a) all funds expended for the benefit of a recipient under this chapter or Titles XVIII and XIX, federal Social Security Act; and
         (8)(b) any other services provided for the benefit of a recipient by a prepaid health care delivery system under contract with the department. See Utah Code 26B-3-1001
  • Property: includes both real and personal property. See Utah Code 68-3-12.5
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • real property: includes :
         (31)(a) land;
         (31)(b) a tenement;
         (31)(c) a hereditament;
         (31)(d) a water right;
         (31)(e) a possessory right; and
         (31)(f) a claim. See Utah Code 68-3-12.5
  • State plan: means the state Medicaid program as enacted in accordance with Title XIX, federal Social Security Act. See Utah Code 26B-3-1001
  • TEFRA lien: means a lien, authorized under the Tax Equity and Fiscal Responsibility Act of 1982, against the real property of an individual prior to the individual's death, as described in Utah Code 26B-3-1001
     (1)(a) the individual is an inpatient in a care facility;
     (1)(b) the individual is required, as a condition of receiving services under the state plan, to spend for costs of medical care all but a minimal amount of the individual’s income required for personal needs; and
     (1)(c) the department determines that the individual cannot reasonably be expected to:

          (1)(c)(i) be discharged from the care facility; and
          (1)(c)(ii) return to the individual’s home.
(2) The department may not impose a lien on the home of an individual described in Subsection (1), if any of the following individuals are lawfully residing in the home:

     (2)(a) the spouse of the individual;
     (2)(b) a child of the individual, if the child is:

          (2)(b)(i) under 21 years old; or
          (2)(b)(ii) blind or permanently and totally disabled, as defined in Title 42 U.S.C. Sec. 1382c(a)(3)(F); or
     (2)(c) a sibling of the individual, if the sibling:

          (2)(c)(i) has an equity interest in the home; and
          (2)(c)(ii) resided in the home for at least one year immediately preceding the day on which the individual was admitted to the care facility.
(3) The department may not impose a TEFRA lien on the real property of an individual, unless:

     (3)(a) the individual has been an inpatient in a care facility for the 180-day period immediately preceding the day on which the lien is imposed;
     (3)(b) the department serves:

          (3)(b)(i) a preliminary notice of intent to impose a TEFRA lien relating to the real property, in accordance with Section 26B-3-1017; and
          (3)(b)(ii) a final notice of intent to impose a TEFRA lien relating to the real property, in accordance with Section 26B-3-1018; and
     (3)(c)

          (3)(c)(i) the individual does not file a timely request for review of the department’s decision under Title 63G, Chapter 4, Administrative Procedures Act; or
          (3)(c)(ii) the department’s decision is upheld upon final review or appeal under Title 63G, Chapter 4, Administrative Procedures Act.