Kentucky Statutes 205.624 – Assignment to cabinet by recipient of rights to third-party payments — Right of recovery by cabinet
Current as of: 2024 | Check for updates
|
Other versions
(1) An applicant or recipient shall be deemed to have made to the cabinet an assignment of his rights to third-party payments to the extent of medical assistance paid on behalf of the recipient under Title XIX of the Social Security Act. The applicant or recipient shall be informed in writing by the cabinet of such assignment.
(2) The cabinet shall have the right of recovery which a recipient may have for the cost of hospitalization, pharmaceutical services, physician services, nursing services, and other medical services not to exceed the amount of funds expended by the cabinet for such care and treatment of the recipient under the provisions of Title XIX of the Social Security Act.
(a) If a payment for medical assistance is made, the cabinet, to enforce its right, may:
1. Intervene or join in an action or proceeding brought by the injured, diseased, or disabled person, the person’s guardian, personal representative, estate, dependents, or survivors against a third party who may be liable for the injury, disease, or disability, or against contractors, public or private, who may be liable to pay or provide medical care and services rendered to an injured, diseased, or disabled recipient, in state or federal court; or
2. Institute and prosecute legal proceedings against a third party who may be liable for the injury, disease, or disability, or against contractors, public or private, who may be liable to pay or provide medical care and services rendered to an injured, diseased, or disabled recipient, in state or federal court, either alone or in conjunction with the injured, diseased, or disabled person, the person’s guardian, personal representative, estate, dependents, or survivors; or
3. Institute the proceedings in its own name or in the name of the injured, diseased, or disabled person, the person’s guardian, personal representative, estate, dependents, or survivors.
(b) The injured, diseased, or disabled person may proceed in his own name, collecting costs without the necessity of joining the cabinet or the Commonwealth as a named party, provided the injured, diseased, or disabled person shall notify the cabinet of the action or proceeding entered into upon commencement of the action or proceeding. The injured, diseased, or disabled person must notify the cabinet of any settlement or judgment of his or her claim.
(c) In the case of an applicant for or recipient of medical assistance whose eligibility is based on deprivation of parental care or support due to absence of a parent from the home, the cabinet may:
1. Initiate a civil action or other legal proceedings to secure repayment of medical assistance expenditures for which the absent parent is liable;
and
2. Provide for the payment of reasonable administrative costs incurred by such other state or county agency requested by the cabinet to assist in the enforcement of securing repayment from the absent parent.
(3) Each insurer issuing policies or contracts under Subtitle 17, 18, 32, or 38 of KRS Chapter 304 shall cooperate fully with the Cabinet for Health and Family Services or an authorized designee of the cabinet in order for the cabinet to comply with the provisions of subsection (1) of this section.
Effective: June 20, 2005
History: Amended 2005 Ky. Acts ch. 99, sec. 247, effective June 20, 2005. — Amended
1998 Ky. Acts ch. 426, sec. 205, effective July 15, 1998. — Amended 1994 Ky. Acts ch. 96, sec. 18, effective July 15, 1994; and ch. 316, sec. 18, effective July 15, 1994.
— Created 1980 Ky. Acts ch. 252, sec. 4, effective July 15, 1980.
(2) The cabinet shall have the right of recovery which a recipient may have for the cost of hospitalization, pharmaceutical services, physician services, nursing services, and other medical services not to exceed the amount of funds expended by the cabinet for such care and treatment of the recipient under the provisions of Title XIX of the Social Security Act.
Terms Used In Kentucky Statutes 205.624
- Action: includes all proceedings in any court of this state. See Kentucky Statutes 446.010
- Cabinet: means the Cabinet for Health and Family Services. See Kentucky Statutes 205.010
- Federal: refers to the United States. See Kentucky Statutes 446.010
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Physician: means a person authorized to practice medicine or osteopathy under the laws of the Commonwealth. See Kentucky Statutes 205.510
- Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
- State: when applied to a part of the United States, includes territories, outlying possessions, and the District of Columbia. See Kentucky Statutes 446.010
- Treatment: when used in a criminal justice context, means targeted interventions
that focus on criminal risk factors in order to reduce the likelihood of criminal behavior. See Kentucky Statutes 446.010
(a) If a payment for medical assistance is made, the cabinet, to enforce its right, may:
1. Intervene or join in an action or proceeding brought by the injured, diseased, or disabled person, the person’s guardian, personal representative, estate, dependents, or survivors against a third party who may be liable for the injury, disease, or disability, or against contractors, public or private, who may be liable to pay or provide medical care and services rendered to an injured, diseased, or disabled recipient, in state or federal court; or
2. Institute and prosecute legal proceedings against a third party who may be liable for the injury, disease, or disability, or against contractors, public or private, who may be liable to pay or provide medical care and services rendered to an injured, diseased, or disabled recipient, in state or federal court, either alone or in conjunction with the injured, diseased, or disabled person, the person’s guardian, personal representative, estate, dependents, or survivors; or
3. Institute the proceedings in its own name or in the name of the injured, diseased, or disabled person, the person’s guardian, personal representative, estate, dependents, or survivors.
(b) The injured, diseased, or disabled person may proceed in his own name, collecting costs without the necessity of joining the cabinet or the Commonwealth as a named party, provided the injured, diseased, or disabled person shall notify the cabinet of the action or proceeding entered into upon commencement of the action or proceeding. The injured, diseased, or disabled person must notify the cabinet of any settlement or judgment of his or her claim.
(c) In the case of an applicant for or recipient of medical assistance whose eligibility is based on deprivation of parental care or support due to absence of a parent from the home, the cabinet may:
1. Initiate a civil action or other legal proceedings to secure repayment of medical assistance expenditures for which the absent parent is liable;
and
2. Provide for the payment of reasonable administrative costs incurred by such other state or county agency requested by the cabinet to assist in the enforcement of securing repayment from the absent parent.
(3) Each insurer issuing policies or contracts under Subtitle 17, 18, 32, or 38 of KRS Chapter 304 shall cooperate fully with the Cabinet for Health and Family Services or an authorized designee of the cabinet in order for the cabinet to comply with the provisions of subsection (1) of this section.
Effective: June 20, 2005
History: Amended 2005 Ky. Acts ch. 99, sec. 247, effective June 20, 2005. — Amended
1998 Ky. Acts ch. 426, sec. 205, effective July 15, 1998. — Amended 1994 Ky. Acts ch. 96, sec. 18, effective July 15, 1994; and ch. 316, sec. 18, effective July 15, 1994.
— Created 1980 Ky. Acts ch. 252, sec. 4, effective July 15, 1980.