31A-22-604. Reimbursement by insurers of Medicaid benefits.
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Effective 5/3/2023
31A-22-604. Reimbursement by insurers of Medicaid benefits.
(1)As used in this section, "Medicaid" means the program under Title XIX of the federal Social 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, or health maintenance organization as defined in Section 31A-8-101 , is prohibited from considering the availability or eligibility for medical assistance in this or any other state under Medicaid, when considering 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 state Medicaid program for health care items or services furnished to an individual in any case when a third party has a legal liability to make payments, the state is considered to have acquired the rights of the individual to payment by any other party for those health care items or services.
(4)Title 26B, Chapter 3, Part 10, Medical Benefits Recovery , applies to reimbursement of insurers of Medicaid benefits.
Amended by Chapter 327 , 2023 General Session