MO SB1683

Limits Medicaid estate recovery to only the probate estate, excluding assets transferred through nonprobate mechanisms such as transfer-on-death deeds or beneficiary designations under Chapter 461

Restricts estate recovery for recipients age 55+ to only nursing facility services, home and community-based services, and related hospital/prescription drug costs mandated by federal law, rather than all medical assistance

Establishes undue hardship exemptions from estate recovery, including when heirs would become eligible for public assistance, when property value is below 50% of county average home price or $200,000, when property is an heir's primary residence, or when heirs have income below 300% of federal poverty level

Requires estate recovery to be cost-effective, with potential recovery at least twice the administrative/legal costs, and prohibits collection when estate net value is at or below $50,000 (adjusted annually for inflation)

Mandates the Department of Social Services to maintain website information about hardship exemptions and publish annual reports on estate recovery cases and exemptions granted, including demographic data