§ 42-4-202 — Third party liability; authority; enforcement; notice; costs

Wyoming § 42-4-202

• Jurisdiction: Wyoming
• Title 42: Welfare
• Ch. 4: MEDICAL ASSISTANCE AND SERVICES
• Art. 2: MEDICAID BENEFIT RECOVERY

Text

(a) When the department provides, pays for or becomes
liable for medical care, it shall have a lien for the cost of
the medical assistance provided upon any and all causes of
action which accrue to the person to whom the care was
furnished, or to the person's legal representatives, as a result
of the injuries which necessitated the medical care.
(b) The department may perfect and enforce its lien by
following the procedures set forth in W.S. 29-1-312 and
29-1-313, and its verified lien statement shall be filed with
the appropriate clerk in the county of financial responsibility.
The verified lien statement shall contain the following:
(i) The name and address of the person to whom
medical care was furnished;
(ii) The date of injury;
(iii) The name and address of the vendor or vendors
furnishing medical care;
(iv) The dates of the service;
(v) The amount claimed to be due for the care;
(vi) To the best of the department's knowledge, the
names and addresses of all persons, firms or corporations
claimed to be liable for damages arising from injuries.
(c) This section shall not affect the priority of any
attorney's lien. The department shall not be subject to any
limitations period referred to in title 1 or 29 of the Wyoming
statutes to file its verified lien statement.
(d) The department shall be given notice of monetary
claims against a person, firm or corporation that may be liable
to pay part or all of the cost of medical care when the
department has paid or become liable for the cost of that care.
Notice shall be given as follows:
(i) Applicants for medical assistance shall notify
the state or local agency of any possible claims when they
submit the application. Recipients of medical assistance shall
notify the department of any possible claims when those claims
arise. A recipient's noncooperation in providing information to
the department to assist in pursuing liable third parties shall
result in denial or termination of eligibility per federal law;
(ii) An enrolled medicaid provider shall notify the
department when the person has reason to believe that a third
party may be liable for payment of the cost of medical care. If
the person providing medical care services fails to notify the
department when a third party is liable for payment of the cost
of medical care and the department, because of lack of notice
from the provider, does not receive reimbursement for the cost
of medical care, the department may adjust the value of those
claims from future payments to that provider;
(iii) An attorney representing an applicant for or a
recipient of medical assistance in a claim upon which the
department may have a reimbursement right under this chapter
shall notify the department of its potential claim for
reimbursement before filing a claim, commencing an action, or
negotiating a settlement. Any attorney who fails to notify the
department of any settlement or fails to ensure the state is
reimbursed, to the extent of its reimbursement right, from the
proceeds of any settlement or judgment under this section shall
be reported to the state board of professional responsibility
for the Wyoming state bar. If the attorney knowingly failed to
report and insure reimbursement to the state, the department
shall have a claim for relief against the attorney for the
amount of the reimbursement right under this chapter;
(iv) Insurers shall not disburse any settlement
payment for a personal injury claim made to a recipient of
medical assistance under this act until seven (7) working days
after the department has received written notice from the
insurer of the proposed settlement or judgment and failed to
provide a written objection to the insurer. Failure to provide
notice under this paragraph shall commence the tolling of any
applicable statute of limitations.
(e) Notice given to the local agency is not sufficient to
meet the requirements of paragraphs (d)(ii) through (iv) of this
section.
(f) Repealed By Laws 1999, ch. 125, § 2.