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Recipients' Estates: A Source of Revenue for Medicaid?

Jose J. Escarce, MD, AM; and Risa Lavizzo-Mourey, MD, MBA
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The opinions expressed are the authors' and do not necessarily reflect the views of the Robert Wood Johnson Foundation or the National Institute of Aging.

Requests for Reprints: Jose J. Escarce, MD, Ralston-Penn Center, 3615 Chestnut Street, Suite 314, Philadelphia, PA 19104-2676.

Ralston-Penn Center
Leonard Davis Institute of Health Economics
University of Pennsylvania
Philadelphia, PA 19104

Ann Intern Med. 1990;112(10):725-726. doi:10.7326/0003-4819-112-10-725
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Medicaid is a major source of financing for nursing-home care. In 1986, nursing-home care for elderly and disabled persons cost $38 billion. Patients and their families paid approximately 50% and Medicaid paid 41%. Coverage of nursing-home care accounts for almost two fifths of total Medicaid expenditures (1).

For many years, persons needing nursing-home care could give away their assets and obtain Medicaid coverage without concern about repayment (2). In 1982, through provisions in the Tax Equity and Fiscal Responsibility Act (TEFRA), Congress authorized states to restrict the Medicaid eligibility of persons transferring assets to others at less than fair market




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