TITLE 27
Insurance
CHAPTER 27-57.1
Medical Assistance Intercept Act
SECTION 27-57.1-1
§ 27-57.1-1 Interception of insurance
payments.
(a) Every domestic insurer or insurance company authorized to issue policies of
liability insurance pursuant to this title, and also any workers' compensation
insurer, within thirty (30) days prior to the making of any payment equal to or
in excess of five hundred dollars ($500) to any claimant, for third party for
personal injury or workers' compensation benefits under a contract of
insurance, shall review information provided by the executive office of health
and human services pursuant to § 27-57.1-4, indicating whether the
claimant has received medical assistance in accordance with chapter 40-8.
(b) If the insurer determines from the information provided
by the executive office of health and human services pursuant to §
27-57.1-4 that the claimant or payee has not received medical assistance, the
insurer may make the payment to the claimant in accordance with the contract of
the insurance.
(c) If the insurer determines from the information provided
by the executive office of health and human services pursuant to §
27-57.1-4 that the claimant or payee has received medical assistance, the
insurer shall, except to the extent payments are subject to liens, written
notices, or interests described in § 27-57.1-3, withhold from payment the
amount to the extent of the distribution for medical assistance as a result of
the accident or loss, dating back to the date of the incident, pay that amount
to the executive office of health and human services and pay the balance to the
claimant or other persons entitled to it. The executive office of health and
human services shall provide written notice to the claimant and his or her
attorney, if any. The notice shall reflect the date, name, social security
number, case number, amount of the payment being withheld to reimburse the
state, reason for payment and opportunity to request a hearing as provided for
in subsection 27-57.1-1(e). Any insurer or insurance company, its directors,
agents, and employees and central reporting organizations and their respective
employees authorized by an insurer to act on its behalf that releases
information in accordance with the provisions of this chapter, or who withholds
an amount from payment based upon the latest information supplied by the
executive office of health and human services pursuant to § 27-57.1-4 and
disburses in accordance with § 27-57.1-3, shall be immune from any
liability to the claimant, payee lien holder, payee who provided written
notice, or security interest holder. Any withholding from payments in
accordance with this chapter and payment made to the executive office of health
and human services is further subject to the provisions of § 40-6-9,
regarding rights of assignment and subrogation by medical assistance
recipients. Said payments to the executive office of health and human services
shall be for reimbursement of distributed medical assistance incurred as a
result of the accident or loss, dating back to the date of the incident.
(d) Workers' compensation claimants who receive medical
assistance, provided in accordance with chapter 40-8, shall be subject to the
provisions of this chapter. However, the workers' compensation reimbursement
payments made to the executive office of health and human services in
accordance with this chapter shall be limited to that set forth in chapter
28-33 and § 40-6-10.
(e) Any claimant aggrieved by any action taken under this
section may within thirty (30) days of the mailing of the notice to the
claimant in subsection (c) of this section, request a hearing from the
executive office of health and human services. Any payments made by an insurer
pursuant to this chapter shall be made to the executive office of health and
human services, should there be no request for a hearing within thirty (30)
days of receipt of notice, or within ten (10) business days of a decision after
a hearing and in accordance with the decision of any hearing that takes place
as provided for in this subsection.
History of Section.
(P.L. 2012, ch. 241, art. 11, § 1.)