loading…
loading…
(a) The filing of an application for or receipt of medical assistance constitutes an assignment of the applicant's or recipient's right of recovery from:
(1) personal insurance;
(2) other sources; or
(3) another person for personal injury caused by the other person's negligence or wrong.
(b) A person who applies for or receives medical assistance shall inform the commission, at the time of application or at any time during eligibility and receipt of services, of any unsettled tort claim which may affect medical needs and of any private accident or sickness insurance coverage that is or may become available. A recipient shall inform the commission of any injury requiring medical attention that is caused by the act or failure to act of some other person. An applicant or a recipient shall inform the commission as required by this subsection within 60 days of the date the person learns of his or her insurance coverage, tort claim, or potential cause of action. An applicant or recipient who knowingly and intentionally fails to disclose the information required by this subsection commits a Class C misdemeanor.
(c) A claim for damages for personal injury does not constitute grounds for denying or discontinuing assistance under this chapter.
(d) A separate and distinct cause of action in favor of the state is hereby created, and the commission may, without written consent, take direct civil action in any court of competent jurisdiction. A suit brought under this section need not be ancillary to or dependent upon any other action.
(e) The commission's right of recovery is limited to the amount of the cost of medical care services paid by the commission. Other subrogation rights granted under this section are limited to the cost of the services provided.
(f) The executive commissioner may waive the commission's right of recovery in whole or in part when the executive commissioner finds that enforcement would tend to defeat the purpose of public assistance.
(g) The commission may designate an agent to collect funds the commission has a right to recover from third parties under this section. The commission shall use any funds collected to pay costs of administering the medical assistance program.
(h) The executive commissioner may adopt rules for the enforcement of the commission's right of recovery. Acts 1979, 66th Leg., p. 2352, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979. Amended by Acts 1979, 66th Leg., p. 2436, ch. 842, art. 2, Sec. 10, eff. Sept. 1, 1979. Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219 ), Sec. 4.109, eff. April 2, 2015.