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Terms Used In Vermont Statutes Title 33 Sec. 1907

  • Agency: means the Agency of Human Services. See
  • Insurer: means any insurance company, prepaid health care delivery plan, self-funded employee benefit plan, pension fund, hospital or medical service corporation, managed care organization, pharmacy benefit manager, prescription drug plan, retirement system, or similar entity that is under an obligation to make payments for medical services as a result of an injury, illness, or disease suffered by an individual. See
  • Person: shall include any natural person, corporation, municipality, the State of Vermont or any department, agency, or subdivision of the State, and any partnership, unincorporated association, or other legal entity. See
  • State: when applied to the different parts of the United States may apply to the District of Columbia and any territory and the Commonwealth of Puerto Rico. See
  • Third party: means a person having an obligation to pay all or any portion of the medical expense incurred by a recipient at the time the medical service was provided. See

§ 1907. Subrogation

To the extent that payment for covered expenses has been made under the Medicaid program or through any State agency administering health benefits or a health benefit plan for which Medicaid is a source of funding for health care items or services furnished to an individual, in any case where 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. An insurer shall accept the Agency‘s right to recovery and the assignment to the Agency of any right of a person to payment from the third party for medical services for which the Agency has made payment under this chapter. (Added 1993, No. 231 (Adj. Sess.), § 5; amended 2007, No. 65, § 110b; 2013, No. 131 (Adj. Sess.), § 43, eff. May 20, 2014.)