2005 Vermont Code - § 1909. — Direct payments to agency; discharge of insurer\'s obligation

§ 1909. Direct payments to agency; discharge of insurer's obligation

(a) When a recipient who is covered by the recipient's or a legally liable representative's insurer receives medical benefits under this subchapter, payment for covered services or notice of denial shall be issued directly to the provider.

(b) A provider shall indicate on any claim form submitted to an insurer for covered services whether or not the person receiving treatment is a recipient.

(c) An insurer which receives notice that the agency has made payments to the provider shall pay benefits or send notice of denial directly to the agency. Receipt of an agency claim form by an insurer constitutes notice that payment of the claim was made by the agency to the provider and that form supersedes any contract requirements of the insurer relating to the form of submission.

(d) An insurer which has been notified of a claim by the agency under this section and proceeds to pay the claim to a person other than the agency is not discharged from payment of the agency's claim.

(e) Payment to the agency by an insurer under this section discharges the insurer's obligation for further payment on the claim to the extent of the amount paid. (Added 1995, No. 152 (Adj. Sess.), § 3.)