Or. Admin. Code § 410-200-0225

Current through Register Vol. 63, No. 11, November 1, 2024

Section 410-200-0225 - Assignment of Rights

(1) The signature of the applicant or authorized representative on the application for assistance signifies the applicant's agreement to assign the rights to reimbursement for medical care costs to the Agency.

(2) As a condition of eligibility, each applicant shall:

(a) Assign to the Agency any rights of each EDG member receiving benefits to reimbursement for medical care costs to the Agency including any third party payments for medical care and any medical care support available under an order of a court or an administrative agency;

(b) Assign to the Agency any rights to payment for medical care from any third party and, once they receive assistance, to assist the Agency in pursuing any third party who may be liable for medical care or services paid by the Agency, including health services paid for pursuant to ORS 414.706 to 414.750 as set forth in OAR 410-200-0220, 461-195-0303 and 461-195-0310;

(c) Unless good cause exists as established in OAR 410-200-0220 (Requirement to Pursue Assets), failure to assign the right to reimbursement for medical care costs to the Agency shall result in ineligibility for the EDG until the requirements of this rule are met.

(3) Except for the MAGI CHIP program, and eligibility granted under Cover All Kids (OAR 410-200-0240):

(a) An applicant shall assign to the state the right of any Medicaid-eligible individual in the EDG to receive any cash medical support that accrues while the individual receives assistance, not to exceed the total amount of assistance paid; and

(b) Cash medical support received by the Agency shall be retained as necessary to reimburse the Agency for medical assistance payments made on behalf of an individual with respect to whom such assignment was executed.

Or. Admin. Code § 410-200-0225

DMAP 54-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14; DMAP 4-2014(Temp), f. & cert. ef. 1-15-14 thru 3-30-14; DMAP 20-2014, f. & cert. ef. 3-28-14; DMAP 67-2014(Temp), f. 11-14-14, cert. ef. 11-15-14 thru 5-13-15; DMAP 3-2015, f. & cert. ef. 1/30/2015; DMAP 23-2020, amend filed 05/07/2020, effective 5/8/2020

Statutory/Other Authority: ORS 411.402, 411.404 & 413.042

Statutes/Other Implemented: 411.402, 411.404, 411.406, 413.032, 414.025, 414.231, 414.706 & ORS 411.400