Skip to Main Content
<< Back | Return to Main COMAR Search Page

9 records match your request.

FileAbstract
10.09.83.00.htm 10.09.83.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 09 MEDICAL CARE PROGRAMS Chapter 83 Third Party Liability Authority: Health-General Article, §2-104(b) 15-103, 15-105, and 15-120―15-121.3, Annotated Code of Maryland
10.09.83.01.htm 10.09.83.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “Claim” means a demand for payment, whether or not the right is reduced to judgment, liquidated, unliquidated, fixed, contingent, matured, unmatured, disputed, undisputed, legal, equitable, secured or unsecured.2) "Department" means the Department of Health and Mental Hygiene, the single State agency designated to administer the Maryland Medical Assistance Pr
10.09.83.02.htm 10.09.83.02. 02 Program’s Right of Subrogation.. A. The Department may not pay medical claims that are payable by a third party.. B. The Department is assigned any and all rights to payments by any third party that result from medical care received by the recipient, together with the rights of any other individuals eligible for Program benefits for whom the recipient can make assignment. This assignment shall be effective to the extent of the amount of medical assistance actu
10.09.83.03.htm 10.09.83.03. 03 Recipient Responsibility.. A. A recipient shall cooperate with and assist the Department in identifying and providing information concerning third parties who may be liable to pay for care and services received by the recipient under the Program.B. A recipient is required to assist and cooperate fully with the Department in the Department’s efforts to secure the Department’s rights in Regulation .02 of this chapter, including but not limited to:1) Notifying the Program’
10.09.83.04.htm 10.09.83.04. 04 Notice to the Department.. A. An attorney representing a recipient in a cause of action that gives rise to the Department’s right of subrogation under Regulation .02 of this chapter shall notify the Program’s Division of Recoveries and Financial Services in writing before:1) Filing a claim;. 2) Commencing an action; or. 3) Negotiating a settlement.. B. The notice required under §A of this regulation shall include submission of the following information:1) The recipient's name,
10.09.83.05.htm 10.09.83.05. 05 Judgment, Award, or Settlement of a Medical Assistance Claim.. A. Except as provided in §B―E of this regulation, a third party shall have no further liability if it settles or compromises a dispute in good faith and without knowledge that the individual is a recipient of Program benefits.B. A recipient, or the recipient’s attorney, guardian, or personal representative, who receives money as a result of a judgment, award, or settlement of an action or claim in
10.09.83.06.htm 10.09.83.06. 06 Program Claim.. A. In a case where the Department is subrogated to the rights of the recipient, the Department has a claim to the proceeds of the recovery from the persons liable, whether the proceeds of the recovery are by way of judgment, settlement, or otherwise and shall, to the extent permitted by federal law, be satisfied in full.B. The claim is in the amount of all Program benefits paid minus any deductions required by law.. C. The claim is effective when:.
10.09.83.07.htm 10.09.83.07. 07 Conflict with Federal Requirements.. If any provision of this chapter related to subrogation, assignment, or lien conflicts with federal law concerning the Program or receipt of federal funds to finance the Program, the provision does not apply to the extent of the conflict.
10.09.83.9999.htm 10.09.83.9999. Administrative History Effective date: June 24, 2013 (40:12 Md. R. 1042).
<< Back | Return to Main COMAR Search Page