§ 27-18.4-2 - Coordination of benefits with Medical Assistance – Acquired rights to payments.
SECTION 27-18.4-2
§ 27-18.4-2 Coordination of benefits withMedical Assistance – Acquired rights to payments. – (a) An insurer is prohibited from considering the availability or eligibilityfor medical assistance in this or any other state when considering eligibilityfor 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 beenmade under the state Medicaid program for health care items or servicesfurnished to an individual in any case where a third party, including aninsurer, has a legal liability to make payments, the department of humanservices is considered to have acquired the rights of the individual to paymentby any other party, including an insurer, for those health care items orservices. These rights are further defined and are enforceable in accordancewith §§ 40-6-9 and 40-6-9.1.