A BILL TO BE ENTITLED AN ACT TO MODIFY THE MEDICAID SUBROGATION STATUTE IN RESPONSE TO THE UNITED STATES SUPREME COURT DECISION IN WOS V. E.M.A.
Amends GS 108A-57(a) deleting the county as an entity that will be subrogated. Also requires a personal injury or wrongful death claim brought by a medical assistance beneficiary against a third party to include a claim for all medical assistance payments for health care items or services furnished to the beneficiary as the result of the injury referred to in the statute as the Medicaid claim.
Amends GS 108A-57, adding subsection (b) establishing presumptions for Medicaid claims that exceed or do not exceed one-third of the medical assistance beneficiary's gross recovery.
Amends GS 108A-57, adding subsection (c) outlining the procedure for a medical assistance beneficiary to dispute the presumptions established in subsection (b).
Amends GS 108A-57(d), changing the amount of assistance distributed to the Department to the portion presumptively determined under subsection (b) or the portion judicially determined under subsection (c) of this section.
Amends GS 108A-57(e) specifying that the United States and the state of North Carolina are entitled to share in each net recovery by the Department of Health and Human Services (DHHS).
Amends GS 108A-57, adding subsection (h) granting authority to enforce this section to DHHS and allowing DHHS to adopt administrative rules for this purpose.
© 2021 School of Government The University of North Carolina at Chapel Hill
This work is copyrighted and subject to "fair use" as permitted by federal copyright law. No portion of this publication may be reproduced or transmitted in any form or by any means without the express written permission of the publisher. Distribution by third parties is prohibited. Prohibited distribution includes, but is not limited to, posting, e-mailing, faxing, archiving in a public database, installing on intranets or servers, and redistributing via a computer network or in printed form. Unauthorized use or reproduction may result in legal action against the unauthorized user.