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.
Senate committee substitute to the 2nd edition makes the following changes.
Amends GS 108A-57 to provide that if the beneficiary rebuts the presumption (concerning what specified amounts are presumed to represent compensation for the Medicaid claim), then the court must determine the portion of the recovery that represents compensation for the claim and order the beneficiary to pay that amount. Also provides that if the beneficiary does not rebut the presumption, then the court must order the beneficiary to pay the presumed amount. Allows the medical assistance beneficiary and the Department of Health and Human Services (Department) to reach an agreement on the portion of the recovery that represents compensation for the Medicaid claim. Requires the medical assistance beneficiary, or the beneficiary's attorney, to pay a certain amount to the Department, with the payment calculation varying depending on whether or not an application disputing the recovery presumptions has been filed, or if an agreement has been reached between the beneficiary and the Department. Makes it a Class 1 misdemeanor for a person who seeks or has been given assistance to willfully fail to disclose to the Department the identity of the person or organization against whom the recipient has a right of recovery.
Provides that the act is effective when it becomes law and it applies to (1) Medicaid claims arising on or after that date and (2) to Medicaid claims arising before that date for which the Department has not been paid in full. Provides that for claims that arose before the effective date of the act where the Department has not been paid in full, the beneficiary has 90 days from the act's effective date to apply to the court under GS 108A-57(a2).
Makes clarifying and technical changes.
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