2-010.01B2d Third Party Medical Payments
469 NAC 2-010.01B2d
Income received from a third party that pays the client directly is -
1. Disregarded if it is refunded to the provider or the Department as reimbursement for a specific service; or
2. Counted as unearned income if the client fails or refuses to refund these payments.
If the client receives a third party medical payment directly and the medical expense for which the third party medical payment is intended is payable by NMAP, the worker shall send a demand letter advising the client that s/he must reimburse the Department or the provider up to the amount of payment which has been or will be made for the specific service. The client is allowed ten days from the date of notification to reimburse the Department or pay the provider.
If an applicant receives a third party medical payment for services which are payable by NMAP, the worker shall not delay determination of eligibility for assistance and authorization for payment pending the applicant's reimbursement. At the time the application is approved, the worker shall notify the client of the number of days left in which to reimburse the payment.
If the client refunds within ten days, the worker shall take no further action. If the client fails or refuses to refund within ten days, the worker shall consider the entire third party payment as unearned income in the first month possible. Taking into account adequate and timely notice. Any balance remaining is considered a resource in the following month.