6-002.08C Cooperation in Obtaining Third Party Payments

479 NAC 6-002.08C

As a condition of eligibility for medical assistance, the former ward or his/her representative must cooperate in obtaining third party payments unless s/he has good cause for noncooperation (see 479 NAC 6-002.08E). Cooperation includes any or all of the following:

1. Providing complete information regarding the extent of third party coverage which s/he has or may have. This includes coverage provided by an individual or by an agency;

2. Providing any additional information or signing claim forms which may be necessary for identification and collection of potential third party payments;

3. Appearing as a witness in a court or another proceeding, if necessary;

4. Notifying the Department of any action s/he is initiating to recover money from a liable third party for medical care or services. This includes the identity of the third party as well as the entire amount of any settlement, court award, or judgment;

5. Reimbursing the Department or paying to the provider any payments received directly from a third party for any services payable by NMAP; and

6. Taking any other reasonable steps to secure medical support payments.