Section 19-14 - A-01. Definitions.

§ 19-14A-01. Definitions.
 

(a)  In general.- In this subtitle the following words have the meanings indicated. 

(b)  Final report.- "Final report" means the third party liability audit report issued to a nursing home stating the total amount due to the Department as a result of the completed audit. 

(c)  Nursing home.- "Nursing home" has the meaning stated in § 19-1401(e) of this title. 

(d)  Third party.-  

(1) "Third party" means any individual, entity, or program that is or may be liable to pay all or part of the medical cost of any medical assistance furnished to a recipient under the Medical Assistance Program. 

(2) "Third party" includes private health insurance, employment-related health insurance, medical support from absent parents, automobile insurance, court judgments or settlements from a liability insurer, State workers' compensation, first party probate-estate recoveries, or any federal programs. 

(e)  Third party liability audit.- "Third party liability audit" means a financial review of Medical Assistance payments to a provider to ascertain the legal liability of third parties to pay for care and services available under the Medical Assistance Program. 

(f)  Third party liability review.- "Third party liability review" means a financial review of the credit balances of a nursing home to ascertain the legal liability of third parties to pay for care and services available under the Medical Assistance Program. 
 

[2003, ch. 394.]