California Department of Social Services - State Hearings Division
Notes from the Training Bureau - December 24, 1996

CDSS JUDGES DO NOT HAVE JURISDICTION TO ADJUDICATE MEDI-CAL ESTATE RECOVERY ISSUES

After a Medi-Cal recipient dies, the California Department of Health Services (CDHS) may file a claim against the estate of a decedent or a recipient of the decedent’s property to recover the lesser of the amount of health care premiums and services provided OR the value of the decedent’s interest in the property received.

If a representative of the decedent’s estate or recipient of the decedent’s property believes enforcement of the CDHS claim would cause undue hardship, he/she may apply for a hardship waiver. If dissatisfied with the outcome of such application, an individual may request an estate hearing before the CDHS. Refer to California Code of Regulations (CCR) §§50960 through 50964.

The CDHS has its own estate hearing process. CDHS hearings involving estate recovery are limited to the issue of alleged undue hardship.

If a California Department of Social Services (CDSS) judge is assigned a state hearing involving a Medi-Cal estate recovery issue, the judge must prepare a decision dismissing this issue because the AAD has no jurisdiction to adjudicate such issues.

CDSS judges may refer claimants raising Medi-Cal estate recovery issues to R.M. (Mack) Porterfield or Ted Labhard at (916) 322-0521 or:

Estate Recovery Unit

Third Party Liability Branch

Department of Health Services

591 N. 7th St. 2nd floor

P.O. Box 2471

Sacramento, CA 95813