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2006 Georgia Code - 49-4-148
49-4-148. (a) Should medical assistance be paid in behalf
of a recipient of medical assistance on account of any sickness,
injury, disease, or disability for which another person is legally
liable, the Department of Community Health may seek reimbursement
for such medical assistance from such other person. The department
shall be subrogated, but only to the extent of the reasonable value
of the medical assistance paid and attributable to such sickness,
injury, disease, or disability, to the rights of the recipient of
medical assistance against the person so legally liable; the
commissioner of community health may compromise, settle, and
execute a release of any such claim or waive, expressly, any such
claim, in whole or in part, for the convenience of the Department
of Community Health. This Code section is cumulative of the
remedies of the Department of Community Health which specifically
include, but are not limited to, the use of hospital liens as
provided in Code Sections 44-14-470 through 44-14-477; and further,
the payment of medical assistance to a hospital provider shall in
no way be construed to discharge the obligation of a third party to
satisfy a hospital lien. (b)
All insurers, as defined in Code Section 33-24-57.1, including but
not limited to group health plans as defined in Section 607(1) of
the federal Employee Retirement Security Act of 1974 and managed
care entities as defined in Code Section 33-20A-3, which offer
health benefit plans, as defined in Code Section 33-24-59.5, shall
comply with this subsection. Those insurers shall:
(1) Cooperate with the department in
determining whether a person who is a recipient of medical
assistance may be covered under that insurer´s health benefit
plan and eligible to receive benefits thereunder for the medical
services for which that medical assistance was provided;
(2) Accept the department´s
authorization for the provision of medical services on behalf of a
recipient of medical assistance as the insurer´s
authorization for the provision of those services; and
(3) Comply with the requirements of
Code Section 33-24-59.5, regarding the timely payment of claims
submitted by the department for medical services provided to a
recipient of medical assistance and covered by the health benefit
plan, subject to the payment to the department of interest as
provided in that Code section for failure to comply.
The requirements of paragraphs (2)
and (3) of this subsection shall only apply to a health benefit
plan which is issued, issued for delivery, delivered, or renewed on
or after April 28, 2001.
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