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414 (07/2026) Chapter 2:Eligibility • Section 6: Non-financial eligibility Assignment of third party liability (TPL) and support Medical assignment ODHS|OHA has the authority to collect reimbursement for medical expenses it paid for anyone receiving Medicaid that should have been paid by another party or resource. This is called assignment of medical benefits. ODHS|OHA has the authority to refuse to pay medical expenses for anyone receiving benefits when another party or resource should pay first. The medical assignment process is a mandatory part of applying for and receiving medical benefits. By signing the application for assistance, individuals automatically agree to turn over any rights to health insurance or medical support to ODHS|OHA, as well as the rights of anyone for which they are legally responsible who is receiving Medicaid. ODHS|OHA does not need the individual’s express consent. This should be explained to applicants at initial application. The amount for which ODHS|OHA has the authority to collect reimbursement is equal to the full amount of medical services paid by ODHS|OHA on the individual’s behalf. See rule below for a list of whom ODHS|OHA has the authority to collect medical reimbursements from. ODHS|OHA authority does not include collecting reimbursements from Medicare benefits. Cooperation in identifying liable third parties and other information The second piece to medical assignment, which requires more active participation, is cooperating with ODHS|OHA in identifying third parties that are liable or potentially liable to pay for costs paid by the medical assistance program for anyone receiving medical assistance from the State of Oregon. The actual requirement to cooperate, however, only applies to the legally responsible individual and not, for example, a child who is not legally able to assign their own rights. This means, if Dad applies for QMBP and a son is receiving MAGI, and Dad refuses to cooperate in identifying the auto insurance company that is potentially liable to pay for the son’s hospital bills (that MAGI already covered), then Dad is ineligible for QMBP, but the child does not lose eligibility for MAGI. We cannot penalize someone who is not legally responsible for themselves. Legally responsible individuals must also provide any other information that ODHS|OHA, a CCO, or PMCH (prepaid managed care health service organization) needs in order to pursue payment from a liable third party. Medical cooperation Cooperation includes, but is not limited to, applying for, accepting and maintaining all available resources and identifying and providing information to assist ODHS|OHA in obtaining medical coverage. To be eligible for MSP, legally responsible adult individuals must: • Cooperate (unless good cause exists) in obtaining health care coverage (except for Medicare) and cash medical support for anyone for whom they are legally responsible who is receiving any type of medical assistance from the State of Oregon, • Cooperate with ODHS|OHA and the Oregon Child Support Program of the Department of Justice in establishing the identity of the parents of any child for which the QMBP applicant is legally responsible who is receiving any type of medical assistance,