TITLE 27
Insurance
CHAPTER 27-18.4
Health Insurance Coordination with Federal Medicaid Program
SECTION 27-18.4-2
§ 27-18.4-2 Coordination of benefits with
Medical Assistance Acquired rights to payments.
(a) An insurer is prohibited from considering the availability or eligibility
for medical assistance in this or any other state when considering eligibility
for coverage or making payments under its plan for eligible enrollees,
subscribers, policyholders or certificate holders.
(b) To the extent that payment for covered expenses has been
made under the state Medicaid program for health care items or services
furnished to an individual in any case where a third party, including an
insurer, has a legal liability to make payments, the department of human
services is considered to have acquired the rights of the individual to payment
by any other party, including an insurer, for those health care items or
services. These rights are further defined and are enforceable in accordance
with §§ 40-6-9 and 40-6-9.1.
History of Section.
(P.L. 1994, ch. 237, § 2; P.L. 2002, ch. 65, art. 35, § 2.)
