N.J. Admin. Code § 10:79-3.7 - Third-party liability

Current through Register Vol. 54, No. 7, April 4, 2022

(a) Program applicants and beneficiaries are required to identify to the eligibility determination agency any third-party individual, entity, or program that is or may be liable to pay all or part of the medical cost of injury, disease, or disability of an applicant or beneficiary.
(b) Any authorized agent or applicant who applies for NJ FamilyCare-Children's Program who is eligible pursuant to 10:79-3.4(a)1, by virtue of the application for benefits, is deemed to have assigned to the Commissioner of the Department for Human Services any rights to support for the applicant for the purpose of medical care as determined by a court or administrative order and any rights to payment for care from any third party. Authorized agents, program applicants and beneficiaries are required to cooperate in the identification of and the obtainment of any such rights.
(c) The eligibility determination agency shall advise authorized agents, program applicants and beneficiaries of the terms of the assignment and the consequences thereto.
(d) The eligibility determination agency shall require the authorized agent to pursue any coverage for health care services available through a group health plan for which the child is eligible that is noncontributory or otherwise results in no premium contribution cost to the household unit.

Notes

N.J. Admin. Code § 10:79-3.7
Amended by 49 N.J.R. 203(a), effective 1/17/2017

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