12-006 RECOUPMENT OF THIRD-PARTY RESOURCES

1. In order to claim reimbursement for benefits paid by Medicaid that should have been paid by a third-party resource, the Department must send a letter informing the client that s/he must reimburse the Department or the provider. The client is allowed ten (10) days from the date of notification to reimburse the medical payment. For an applicant, the Department must not delay determination of eligibility pending the applicant's reimbursement. At the time the application is approved, the client must be notified of the number of days left in which to reimburse the payment; 2. If the client tenders the third-Party Resource within the ten (10) days, no further action is taken; or 3. If the client fails or refuses to refund the third-party resource within the ten (10) days, the entire amount is considered unearned income in the first month possible, taking into account adequate and timely notice. Any balance remaining is considered a resource in the following month.