Sec. 202. Strengthening Medicaid Third-Party Liability
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/bill/113/hjres/59/enr/section-202·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1902(a)(25) of the Social Security Act ( 42 U.S.C. 1396a(a)(25) ) is amended— in subparagraph (E)(i), by inserting before the semicolon at the end the following: , except that the State may, if the State determines doing so is cost-effective and will not adversely affect access to care, only make such payment if a third party so liable has not made payment within 90 days after the date the provider of such services has initially submitted a claim to such third party for payment for such services ; and in subparagraph (F)(i), by striking 30 days after such services are furnished and inserting 90 days after the date the provider of such services has initially submitted a claim to such third party for payment for such services, except that the State may make such payment within 30 days after such date if the State determines doing so is cost-effective and necessary to ensure access to care. .
Section 1902(a)(25) of the Social Security Act ( 42 U.S.C. 1396a(a)(25) ) is amended— in subparagraph (B), by striking to the extent of such legal liability ; and in subparagraph (H), by striking payment by any other party for such health care items or services and inserting any payments by such third party . Section 1912(a)(1)(A) of such Act ( 42 U.S.C. 1396k(a)(1)(A) ) is amended by striking payment for medical care from any third party and inserting any payment from a third party that has a legal liability to pay for care and services available under the plan .
Section 1917(a)(1)(A) of such Act ( 42 U.S.C. 1396p(a)(1)(A) ) is amended to read as follows: pursuant to— the judgment of a court on account of benefits incorrectly paid on behalf of such individual, or rights acquired by or assigned to the State in accordance with section 1902(a)(25)(H) or section 1912(a)(1)(A), or . The amendments made by this section shall take effect on October 1, 2014.
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