200.499 Recovery of costs from third-party payments -- Filing of claims.
610 words·~3 min read·
/ky/chapter-200/200-499A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)An applicant for or recipient of medical services provided by or paid for by the
Office for Children with Special Health Care Needs shall inform the office of any
rights that the applicant or recipient has to third-party payments for medical services
at the time of initial application for services or at any time thereafter when such
third-party payment should become available. The office shall automatically be
subrogated to any rights the recipient has to third-party payment for medical
services.
(2)The office shall recover the full cost of medical services provided to a recipient and
shall recover any payments made for medical services on his behalf directly from:
(a)Any third party liable to make a medical benefit payment to the provider of
the recipient's medical services or to the recipient under the terms and
provisions of any contract, health insurance policy, health insurance plan,
settlement, or award;
(b)The recipient, if he or she has received third-party payment for medical
services that have been provided to him; or
(c)The provider of the recipient's medical services if third-party payment for
medical services has been recovered by the provider.
(3)A recipient of medical services provided by the office or paid for by the office shall
be deemed to have made an assignment to the office of any right such recipient has
to any payment for such medical services from a third party.
(4)A recipient of medical services provided by the office or paid for by the office shall
be deemed to have provided the office the authority to release medical information
with respect to such medical services for the purpose of obtaining reimbursement
from a third party.
(5)The office may, in order to enforce its subrogation rights under this section,
institute, intervene in, or join any legal proceeding against any third party against
whom recovery rights arise. No action taken by the office shall operate to deny the
recipient recovery for that portion of his damage not subrogated to the office and no
action of the recipient shall prejudice the subrogation rights of the office.
(6)When the office provides, pays for, or becomes liable for the medical services, and
their costs, of a recipient, it shall have a lien for the full amount of the cost of such
medical services upon any and all causes of action which accrue to the recipient or
to his legal representatives, as a result of sickness, injury, disease, disability, or
death due to the liability of a third party which necessitated the medical service. The
office shall have one
(1)calendar year from the date when the last item of medical
services relative to a specific accident or spell of illness was provided or paid for in
which to file its verified lien statement. The statement shall be filed with the clerk
of the Circuit Court in the recipient's county residence. The verified lien statement
shall contain the name and address of the recipient of medical services; the date of
the injury or accident; the name and address of the vendor or vendors furnishing
medical services to the recipient; the date of the medical services; the amount
claimed to be due the office for the medical services provided or paid for; and, to
the best knowledge of the office, the names and addresses of all persons or
corporations claimed to be liable for damages arising from the injuries. The office's
failure to file a lien shall not affect the office's subrogation rights provided for in
subsection
(1)of this section.
(7)In recovering any payment in accordance with this action, the office is authorized to
make appropriate settlements.