SB 1683 - This act repeals the current provisions regarding the Department of Social Services ("Department") or the MO HealthNet Division ("Division") enforcing liens on permanently institutionalized individuals for the recovery of certain Medicaid funds expended for long-term care under the federal Tax Equity and Fiscal Responsibility Act (TEFRA). Instead, this act provides that the Department or the Division shall collect the costs of medical assistance paid for permanently institutionalized individuals as provided in this act. This act provides that the current law relating to recovery of the amount of certain funds expended on behalf of a Medicaid recipient from the estate of such recipient only applies to those persons deceased on or after April 1, 1995, to August 27, 2026. For recovery from estates of persons deceased on or after August 28, 2026, this act provides that there may be no adjustments or recovery of assistance correctly paid, except for recovery from the estate of a recipient who was: (1) Regardless of age, a resident in a nursing facility or other medical institution when the recipient received such assistance, except recovery shall be limited to assistance provided on or after March 22, 1991; or (2) 55 years of age or older when the recipient received assistance for services provided on or after October 1, 1993, for which estate recovery is mandated under other federal law. Any recovery allowable may be made only after the death of the surviving spouse, if any, and only at a time when the recipient has no surviving child who is under 21 years of age or is blind or has a disability. Recovery against a recipient's estate may be made only when recovery: (1) Would not create an undue hardship as described in the act; (2) Is cost effective, which shall not include estates with a net value at or below $50,000 as adjusted annually by the Department of Social Services based on the federal cost of living adjustment of the Social Security Administration; and (3) Does not violate any of the limitations set forth in federal law. Lastly, this act provides that the Department shall make information about estate recovery and hardship exemptions easily accessible, including maintaining information about how to request a hardship exemption on its website. Additionally, on an annual basis, the Department shall publicly report on the number of estate recovery cases pursued and the number of undue hardship exemptions granted. KATIE O'BRIEN

SB 1683 modifies Missouri's estate recovery procedures for public benefit recipients, adjusting how states collect costs from deceased beneficiaries' estates.