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§ 1409.1. Federal law recovery of medical assistance reimbursement

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 62 P.S. Poor Persons and Public WelfareEffective: September 2, 2008

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 62 P.S. Poor Persons and Public Welfare (Refs & Annos)
Chapter 1. Human Services Code (Refs & Annos)
Article XIV. Fraud and Abuse Control (Refs & Annos)
Effective: September 2, 2008
62 P.S. § 1409.1
§ 1409.1. Federal law recovery of medical assistance reimbursement
(a) To the extent that Federal law limits the department's recovery of medical assistance reimbursement to the medical portion of a beneficiary's judgment, award or settlement in a claim against a third party, the provisions of this section shall apply.
(b) In the event of judgment, award or settlement in a suit or claim against a third party or insurer:
(1) If the action or claim is prosecuted by the beneficiary alone, the court or agency shall first order paid from any judgment or award the reasonable litigation expenses, as determined by the court, incurred in preparation and prosecution of the action or claim, together with reasonable attorney fees. After payment of the expenses and attorney fees, the court or agency shall allocate the judgment or award between the medical portion and other damages and shall allow the department a first lien against the medical portion of the judgment or award, the amount of the expenditures for the benefit of the beneficiary under the medical assistance program.
(2) If the action or claim is prosecuted both by the beneficiary and the department, the court or agency shall first order paid from any judgment or award the reasonable litigation expenses incurred in preparation and prosecution of the action or claim, together with reasonable attorney fees based solely on the services rendered for the benefit of the beneficiary. After payment of the expenses and attorney fees, the court or agency shall allocate the judgment or award between the medical portion and other damages and shall make an award to the department out of the medical portion of the judgment or award the amount of benefits paid on behalf of the beneficiary under the medical assistance program.
(3) The department shall be given reasonable advance notice before the court makes any allocation of a judgment or award under this section.
(4) The provisions of section 1409(b)(7)(iii) shall apply to this section.

Credits

1967, June 13, P.L. 31, No. 21, art. 14, § 1409.1, added 2008, July 4, P.L. 557, No. 44, § 10, effective in 60 days [Sept. 2, 2008].
62 P.S. § 1409.1, PA ST 62 P.S. § 1409.1
Current through 2022 Regular Session Act 20. Some statute sections may be more current, see credits for details.
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