Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-20 - THIRD PARTY
Section 560-X-20-.07 - Recipient Responsibility
Current through Register Vol. 43, No. 02, November 27, 2024
(1) The Alabama Medicaid Agency by statute is subrogated to the rights of a Medicaid recipient against any third party arising out of injury, disease, or sickness. Medicaid recipients are required to assist and cooperate fully with Alabama Medicaid Agency in its efforts to secure such rights including the requirement to:
(2) The State of Alabama by statue is assigned any and all rights to benefits payable and/or payments made by any person, firm or corporation which result from medical care received by the recipient, together with the rights of any other individuals eligible for Medicaid for whom the recipient can make assignment. This assignment shall be effective to the extent of the amount of medical assistance actually paid by the Agency and shall, effective 11/9/84, exclude Medicare. The recipient is required to assist and cooperate fully with Alabama Medicaid Agency in its effort to secure such rights.
(3) Failure of the applicant or recipient to cooperate with the Medicaid Program to secure its rights to subrogation and assignment may result in denial or termination of Medicaid eligibility. Recipients terminated under this Rule will be notified in writing of the agency action and afforded the opportunity for a Fair Hearing under the provisions of Chapter 3 of these Rules.
Author: Wanda Wright, Administrator, Third Party Liability
Statutory Authority: Code of Ala. 1975, §§ 22-6-6, 22-6-6 -.1, 42 CFR §§432 and 433; Section 1902(a)(25), Social Security Act.