## Facts

- Clarence Wirtz received Medicaid benefits for nursing home care from July 1996 until his death on August 24, 1997; the parties stipulated benefits paid totaled $53,635.83.
- Clarence was married to Verna Wirtz during the entire period of benefit receipt and was over age 55.
- Clarence’s estate was not probated.
- Verna died on September 21, 1998, and Vernon Caroline was appointed personal representative of her estate.
- The North Dakota Department of Human Services (DHS) filed a creditor’s claim against Verna’s estate seeking reimbursement for Medicaid payments made on Clarence’s behalf (benefits plus interest).
- The personal representative denied the claim; DHS petitioned for allowance.
- DHS asserted Verna’s entire estate was subject to recovery because Clarence allegedly had a marital or equitable interest in all of Verna’s property at the time of his death.
- The estate asserted recovery was limited to property that passed from Clarence at death via nonprobate arrangements (e.g., joint tenancy, survivorship, life estate, trust) and stipulated no such transfers occurred.

## Issues

1. Whether Medicaid estate-recovery statutes permit recovery from a surviving spouse’s entire estate based solely on the deceased recipient’s alleged marital or equitable interest in the spouse’s separately titled property.
2. Whether recovery is limited only to assets transferred from the recipient at death through enumerated nonprobate mechanisms, or instead extends to any property in which the recipient had legal title or a legal interest at death.

## Decision

- The North Dakota Supreme Court affirmed the denial of DHS’s claim against Verna’s estate.
- The court rejected DHS’s theory that a generalized marital or equitable interest makes the surviving spouse’s entire estate recoverable.
- The court rejected the estate’s position that recovery is confined to assets passing at death only through the enumerated transfer devices.
- The court held recovery is limited to property in which the Medicaid recipient had legal title or a legally cognizable interest at the time of death (including interests reflected through nonprobate arrangements), and the record showed Clarence had none in assets included in Verna’s estate.

## Legal Principles

- Medicaid recovery for correctly paid assistance to recipients age 55+ must be sought from the recipient’s “estate” as defined by federal and state law.
- Where state law adopts the federal optional “expanded estate” definition, recoverable assets include property in which the recipient had legal title or a legal interest at death, including (illustratively) interests passing through joint tenancy, survivorship, life estate, living trust, or similar arrangements.
- A recipient’s general marital relationship or generalized equitable expectations in a spouse’s separately titled property, without an identifiable legal interest at death, does not render the spouse’s entire estate subject to Medicaid recovery.
- The enumerated nonprobate transfer mechanisms are examples; the controlling inquiry is whether the recipient held legal title or a legal interest at death, measured under applicable law and proven in the record.

## Conclusion

The court limited Medicaid estate recovery from a surviving spouse’s estate to assets in which the deceased Medicaid recipient held legal title or a legally recognized interest at death, and denied recovery because no such interest was shown in property included in the surviving spouse’s estate.


In re Estate of Wirtz, 607 N.W.2d 882 (N.D. 2000)