31A-22-604 - Reimbursement by insurers of Medicaid benefits.
31A-22-604. Reimbursement by insurers of Medicaid benefits.
(1) As used in this section, "Medicaid" means the program under Title XIX of the federalSocial Security Act.
(2) Any accident and health insurer, including a group accident and health insurance plan,as defined in Section 607(1), Federal Employee Retirement Income Security Act of 1974, orhealth maintenance organization as defined in Section 31A-8-101, is prohibited from consideringthe availability or eligibility for medical assistance in this or any other state under Medicaid, whenconsidering eligibility for coverage or making payments under its plan for eligible enrollees,subscribers, policyholders, or certificate holders.
(3) To the extent that payment for covered expenses has been made under the stateMedicaid program for health care items or services furnished to an individual in any case when athird party has a legal liability to make payments, the state is considered to have acquired therights of the individual to payment by any other party for those health care items or services.
(4) Title 26, Chapter 19, Medical Benefits Recovery Act, applies to reimbursement ofinsurers of Medicaid benefits.
Amended by Chapter 116, 2001 General Session