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COMAR 10.09.24.15

1505

State of Maryland Medical Assistance Manual Revised July 2012 necessary for the LDSS to complete a Form 1169 for the sole purpose of reporting a death. This information is now provided to the Division of Recoveries by means of a monthly computer list from the Division of Vital Statistics.

Note: No recovery for recipients of QMB, SLMB only effective 03/03.

1500.6 Voluntary Reimbursement

The Program will accept any reimbursement when voluntarily offered by a current or former recipient or someone acting on the recipient‟s behalf for correct and incorrect payments made on a person‟s behalf.

Voluntary reimbursements are often made in order to properly reduce excess resources. If a recipient is found to have excess resources, timely notice of the case closing must be given. During the timely notice period, the person may reduce resources by voluntarily reimbursing the program and eligibility may continue uninterrupted. Case closing may not be delayed beyond the timely notice period to allow for reimbursement.

In addition to excess resource situations, voluntary reimbursement may be made to the Program for services covered during a period of ineligibility. This situation may occur as a result of either client or agency error.

Voluntary reimbursements may not be regarded as an eligibility requirement. A recipient‟s intent to make voluntary reimbursement does not change the requirement that the LDSS take appropriate action, e.g. closing, notification of ineligibility, referral to OIG, or Division of Recoveries, etc. In the case of excess resources, verification that the reimbursement has been made must be received in order to prevent the case closing or to reopen the case at reapplication.

1500.7 Health Insurance

(CM) need to aware of the possibility of health insurance through a place of employment, a union or trade association, a separated spouse or an absent parent. The coverage may be carried by a non-assistance unit member.

Health insurance information is collected by the LDSS and reported on CARES. By signature on the application, an applicant agrees to assign to the Program all health insurance or other third party payments to the extent that the Program will pay for his/her medical services. Eligibility may not be denied to an eligible person who cannot legally assign his own rights when the person who can legally assign his rights refuses to make any assignment of benefits to the Program. The Insurance Recovery section of MACA is responsible for maintaining health insurance coverage information on MA recipients and assuring payments by insurance before program payments are made.