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COMAR 10.09.24.01-.16 1638 State of Maryland Medical Assistance Manual Revised July 2012

Q. Third-Party Liability.

(1) Applicants and recipients shall notify the Department or its designee within 10 working days when medical treatment has been provided as a result of a motor vehicle accident or other occurrence in which a third party might be liable for their medical expenses.

(2) Applicants and recipients shall cooperate with the Department or its designee in completing a form designated by the Department to report all pertinent information and in collecting available health insurance benefits and other third-party payments.

(3) In accident situations, applicants and recipients shall notify the Department or its designee of the time, date, and location of the accident, the name and address of the attorney, the names and addresses of all parties and witnesses to the accident, and the police report number if an investigation is made.

R. Retroactive Eligibility for Cash Assistance Applicants or Recipients. A Public Assistance applicant or recipient who desires Medical Assistance coverage for a past period shall apply for retroactive coverage. The date of application for retroactive coverage shall be established as follows:

(1) The Medical Assistance application date shall be the:

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Page 37

Official source

COMAR 10.09.24.01-.16 1638 State of Maryland Medical Assistance Manual Revised July 2012

Q. Third-Party Liability.

(1) Applicants and recipients shall notify the Department or its designee within 10 working days when medical treatment has been provided as a result of a motor vehicle accident or other occurrence in which a third party might be liable for their medical expenses.

(2) Applicants and recipients shall cooperate with the Department or its designee in completing a form designated by the Department to report all pertinent information and in collecting available health insurance benefits and other third-party payments.

(3) In accident situations, applicants and recipients shall notify the Department or its designee of the time, date, and location of the accident, the name and address of the attorney, the names and addresses of all parties and witnesses to the accident, and the police report number if an investigation is made.

R. Retroactive Eligibility for Cash Assistance Applicants or Recipients. A Public Assistance applicant or recipient who desires Medical Assistance coverage for a past period shall apply for retroactive coverage. The date of application for retroactive coverage shall be established as follows:

(1) The Medical Assistance application date shall be the:

(a)Same as that of the Public Assistance application date…#

(a) Same as that of the Public Assistance application date if the Medical Assistance application is filed within 3 months of the date of the Public Assistance application;

(b)Date the Medical Assistance application is filed if the…#

(b) Date the Medical Assistance application is filed if the filing date is more than 3 months after the date of the Public Assistance application.

(2) Retroactive eligibility shall be determined in accordance with the requirements of Regulations .09B and .10C of this chapter.

S. The Department or its designee shall explain the spend-down provision to an applicant determined ineligible because of excess income.

T. The Department or its designee shall maintain a case record including documentation of all required elements of eligibility.

U. The Department or its designee shall restrict disclosures of information concerning applicants and recipients to purposes directly connected with the administration of the Program, including:

(1) Establishing eligibility;

(2) Determining the extent of coverage under the Program; (3) Providing services for recipients; and (4) Conducting or assisting an investigation, prosecution, or civil or criminal proceeding related to the administration of the Program.