It is a requirement of the Medicaid program that each applicant or recipient assign to DOH, all rights to medical support and payments for medical care from any third party, including health insurance benefits, available to the Medicaid applicant or recipient. The recipient must also cooperate with any third party liability (TPL) recovery efforts of the department. See section 814 for policy on third party liability and recovery. The applicant’s signature on the application for Medicaid benefits is the agreement to assign rights. Assignment of rights ends when the recipient’s eligibility for Medicaid ends.
Assignment means the recipient has transferred to DOH the right to collect and retain third party and medical support payments for medical services paid for under the Medicaid program.
Cooperation in Assignment of Medical Support means an applicant or recipient must assist the DOH and CSSD in securing medical support payments and third party payments. Cooperation also includes assisting in establishing paternity and establishing or modifying medical support orders and third party payments.
811 B. COOPERATION AND ASSIGNMENT REQUIREMENTS
An applicant or recipient must assign rights and cooperate in assignment of medical support for all household members for whom the applicant or recipient can legally do so.
A parent/caretaker relative who is a Medicaid recipient and who fails to cooperate in the assignment of medical support for an individual in their household when he or she can legally assign rights will be ineligible for any category of Medicaid, unless good cause is established or an exemption from cooperation is met (see section 812 B). The parent/caretaker relative remains ineligible for Medicaid until he or she cooperates in the assignment of medical support.
The parent/caretaker relative may regain eligibility immediately upon cooperating.
A child under age 18 is not penalized for the noncooperation of a parent or other adult applying on the child’s behalf.
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