R527-936-3. Payor of Last Resort

Medicaid shall be the payor of last resort pursuant to 42 CFR 433.138 and 42 CFR 433.139. R527-936-4 Utah Third-Party Liability Program. (1) The Utah Third-Party Liability Program establishes: (a) that private medical resources have been exhausted before a claim is paid by Medicaid; or (b) the agency shall seek reimbursement when the agency discovers a liable third-party after the payment of a claim. (2) Where appropriate, ORS provides third-party liability fund recovery required by the state plan for Medicaid by: (a) verifying private health care coverage for Medicaid recipients; (b) billing private health care coverage to reimburse Medicaid funds; (c) recovering Medicaid expenditures from tort settlements; and (d) recovering Medicaid expenditures from the estates of Medicaid beneficiaries.