Massachusetts woman slapped with a $177,000 Medicaid bill after her dad died — plus a threat to take his house

Sandy LoGrande didn’t know when she signed her father, Salvatore, up for Medicaid as he battled cancer, that the state would later come knocking — until she got a $177,000 bill, one year after he died.

‘He never would have signed on’

Sandy LoGrande told the Associated Press she sought advice on her elderly father’s care from a local nonprofit years prior to his death in 2016. She said they suggested enrolling him in Medicaid.

LoGrande told the AP she remembered asking about her father’s house, “but was assured the state would only seek the house if it sent her father to a nursing home,” according to the AP.

LoGrande said she thought it must be a mistake when the state of Massachusetts sent her the $177,000 bill, and “threatened to sue for his home if she didn’t pay up quickly.”

“He never would have signed on with anything that would put his home in jeopardy,” LoGrande told the AP.

She said although a yearly renewal notice came from the state Medicaid office, only after she got the massive bill did she get a bill that related to his care, including a brief hospital stay, medications and hospice care.

After a two-year battle, the AP reports the state of Massachusetts reportedly settled with the LoGrandes in 2019 and released its claim on the house.

Medicaid Estate Recovery programs

Medicaid is a lifeline for low-income Americans. But since 1993, states have been required to seek repayment of some Medicaid costs through Medicaid Estate Recovery programs.

For anyone 55 and older who receives Medicaid benefits for “nursing facility services, home and community-based services, and related hospital and prescription drug services,” state Medicaid programs are required to seek repayment through that individual’s estate after they die, according to the Medicaid website.

State programs also “have the option to recover payments for all other Medicaid services provided to these individuals, except Medicare cost-sharing paid on behalf of Medicare Savings Program beneficiaries.”

A 2021 report from the Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that makes recommendations to Congress, recommended changes to laws around state Medicaid Estate Recovery programs.

The commission found “awareness and understanding of these [estate recovery] policies by potential Medicaid beneficiaries is low.”

It also found the “pursuit of modest estates contributes to generational poverty and wealth inequity, placing particular burdens on people of color.”

The report said a gap around awareness of these policies exists, and that individuals with more resources “may protect their assets from estate recovery while preserving Medicaid eligibility, allowing resources to be passed on to their heirs.”

“Stakeholders noted that individuals with little income and few assets besides a home, however, are less likely to be aware of estate recovery or have the resources to obtain an attorney,” it said.

The report recommended that “states should not be allowed to pursue recovery for: (1) any asset that is the sole income-producing asset of survivors; (2) homes of modest value; or (3) any estate valued under a certain threshold.”

‘A well-kept secret’

U.S. Representative Jan Schakowsky proposed a bill in 2024 that would end the mandatory requirement for states to have Medicaid Estate Recovery programs.