SECTION 340:75-13-78. Third party liability, accident, or injury

  When medical services are provided to a recipient of Medicaid as the result of an accident or injury, the Child Welfare (CW) worker determines if there has been or may be monetary settlements that affect eligibility. The Oklahoma Health Care Authority (OHCA), Third Party Liability Unit checks all paid claims for potential accident or trauma related diagnosis codes and follows up on those with the recipient directly. If the recipient fails to cooperate or does not respond to requests from OHCA, OHCA may request the local office to submit Form ADM-50, Third Party Liability Resource. If a recipient continues to not respond to requests for information or fails to cooperate with the CW worker, the worker suspends further benefits until the recipient has supplied the necessary information to OHCA.

[Source: Amended at 10 Ok Reg 3987, eff 7-13-93 (emergency); Amended at 11 Ok Reg 1733, eff 5-12-94; Amended at 16 Ok Reg 102, eff 10-13-98 (preemptive); Amended at 19 Ok Reg 2265, eff 6-27-02; Amended at 24 Ok Reg 1323, eff 6-1-07]