Md. Code Regs. 10.09.62.05

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.62.05 - Application - Additional Requirements

A. Third-Party Liability.

(1) A participant shall notify the Department or its designee within 10 working days when medical treatment has been provided as a result of a motor vehicle accident or other occurrence in which a third party might be liable for the participant's medical expenses.

(2) A participant shall cooperate with the Department or its designee in completing a form designated by the Department to report all pertinent information and in collecting available health insurance benefits and other third-party payments.

(3) In accident situations, a participant shall notify the Department or its designee of the:

(a) Time, date, and location of the accident;

(b) Name and address of the participant's attorney;

(c) Names and addresses of all parties and witnesses to the accident; and

(d) Police report number if an investigation is made.

B. The Department or its designee shall:

(1) Maintain a written or electronic record including documentation of any required elements of eligibility; and

(2) Restrict disclosure of information concerning a participant to purposes directly connected with the administration of the Medical Assistance Program, including:

(a) Establishing eligibility;

(b) Determining the extent of coverage under Medical Assistance;

(c) Providing services for participants; and

(d) Conducting or assisting an investigation, prosecution, or civil or criminal proceeding related to the administration of the Medical Assistance Program.

C. An applicant or participant shall give consent to verify information needed to establish eligibility to the Department or its designee, by submitting a written, telephonic, or electronic application.

Md. Code Regs. 10.09.62.05

Regulations .05 adopted effective 50:22 Md. R. 974, eff. 11/13/2023