Assignment of Rights to Recover Medical Costs 510-05-10-20

(Revised 8/1/05 ML #2981)

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(N.D.A.C. Section 75-02-02.1-09)

The assignment of rights to benefits is automatic under North Dakota Century Code sections 50-24.1-02 and 50-24.1-02.1. The assignment is effective to the extent of actual costs of care paid under the North Dakota Medicaid Program. As a condition of eligibility, the applicant or recipient may be required to execute a written assignment whenever appropriate to facilitate establishment of liability of a third party or private insurer. Form SFN 560, "Assignment of Benefits," (05-100-05) may be used for this purpose. If it becomes necessary to secure signatures on additional documents, specific instructions will be provided on a case-by-case basis.

The Department and county agency must take reasonable measures to obtain from the applicant or recipient health coverage information to determine the liability of third parties and private insurers.

For purposes of this section:

"Private insurer" includes any commercial insurance company offering health or casualty insurance to individuals or groups, including both experience-related insurance contract and indemnity contracts; any profit or nonprofit prepaid plan offering either medical services or full or partial payment for services covered by the Medicaid program; and any organization administering health or casualty insurance plans for professional associations, employer-employee benefit plans, or any similar organization offering these payments or services, including self-insured and self-funded plans.

"Third party" means any individual, entity, or program that is or may be liable to pay all or a part of the expenditures for services furnished under Medicaid, including a parent or other person who owes a duty to provide medical support to or on behalf of a child for whom Medicaid benefits are sought.