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.