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§27-18.4-2  Coordination of benefits with Medical Assistance – Acquired rights to payments. –

Published: 2015

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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.)