Utah Admin. Code R527-936-4 - Utah Third-Party Liability Program

(1) The Utah Third-Party Liability Program establishes:

(a) that private medical resources have been exhausted before a claim is paid by Medicaid; or

(b) the agency shall seek reimbursement when the agency discovers a liable third-party after the payment of a claim.

(2) Where appropriate, ORS provides third-party liability fund recovery required by the state plan for Medicaid by:

(a) verifying private health care coverage for Medicaid recipients;

(b) billing private health care coverage to reimburse Medicaid funds;

(c) recovering Medicaid expenditures from tort settlements; and

(d) recovering Medicaid expenditures from the estates of Medicaid beneficiaries.

Notes

Utah Admin. Code R527-936-4

Amended by Utah State Bulletin Number 2022-05, effective 2/22/2022