§ 19-14A-01

Maryland § 19-14A-01

• Jurisdiction: Maryland
• Article ghg: Health - General
• Title: 19

Text

(a) In this subtitle the following words have the meanings indicated.

(b) “Final report” means the third party liability audit report issued to a nursing home stating the total amount due to the Department as a result of the completed audit.

(c) “Nursing home” has the meaning stated in § 19-1401(e) of this title.

(d) (1) “Third party” means any individual, entity, or program that is or may be liable to pay all or part of the medical cost of any medical assistance furnished to a recipient under the Medical Assistance Program.

(2) “Third party” includes private health insurance, employment-related health insurance, medical support from absent parents, automobile insurance, court judgments or settlements from a liability insurer, State workers’ compensation, first party probate-estate recoveries, or any federal programs.

(e) “Third party liability audit” means a financial review of Medical Assistance payments to a provider to ascertain the legal liability of third parties to pay for care and services available under the Medical Assistance Program.

(f) “Third party liability review” means a financial review of the credit balances of a nursing home to ascertain the legal liability of third parties to pay for care and services available under the Medical Assistance Program.