Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 389 First Substitute (2021GS)

Sponsor

Rep. Birkeland, K.

Final action

Governor Signed 3/17/2021

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• prohibits the Department of Health (department) from recovering Medicaid funds from a third-party obligor that is required to pay for injuries to a child in foster care if certain conditions are met;
• provides that the department is responsible for repayment to the federal government for the Medicaid funds the department is prohibited from recovering; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

MEDICAID RECOVERY AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Kera Birkeland
Senate Sponsor: 
Ann Millner
LONG TITLE
General Description:
This bill addresses recovery of Medicaid funds from certain third-party obligors.
Highlighted Provisions:
This bill:
▸ prohibits the Department of Health (department) from recovering Medicaid funds
from a third-party obligor that is required to pay for injuries to a child in foster care
if certain conditions are met;
▸ provides that the department is responsible for repayment to the federal government
for the Medicaid funds the department is prohibited from recovering; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-19-201
, as renumbered and amended by Laws of Utah 2018, Chapter 443
26-19-401
, as renumbered and amended by Laws of Utah 2018, Chapter 443
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-19-201
 is amended to read:
26-19-201.
Assignment of rights to benefits.
(1) (a) [
To
] 
Except as provided in Subsection 
26-19-401
(1), to
 the extent that medical
assistance is actually provided to a recipient, all benefits for medical services or payments from
a [
third-party
] 
third-party
 otherwise payable to or on behalf of a recipient are assigned by
operation of law to the department if the department provides, or becomes obligated to provide,
medical assistance, regardless of who made application for the benefits on behalf of the
recipient.
(b) The assignment:
(i) authorizes the department to submit its claim to the [
third-party
] 
third-party
 and
authorizes payment of benefits directly to the department; and
(ii) is effective for all medical assistance.
(2) The department may recover the assigned benefits or payments in accordance with
Section 
26-19-401
 and as otherwise provided by law.
(3) 
(a)
 The assignment of benefits includes medical support and [
third-party
]
third-party
 payments ordered, decreed, or adjudged by any court of this state or any other state
or territory of the United States. [
That
]
(b) The
 assignment is not in lieu of, and does not supersede or alter any other court
order, decree, or judgment.
(4) When an assignment takes effect, the recipient is entitled to receive medical
assistance, and the benefits paid to the department are a reimbursement to the department.
Section 2. Section 
26-19-401
 is amended to read:
26-19-401.
Recovery of medical assistance from third party -- Lien -- Notice --
Action -- Compromise or waiver -- Recipient's right to action protected.
(1) (a) [
When
] 
Except as provided in Subsection (1)(c), if
 the department provides or
becomes obligated to provide medical assistance to a recipient that a third
-
party is obligated to
pay for, the department may recover the medical assistance directly from [
that
] 
the
 third
-
party.
(b) 
(i)
 [
Any
] 
A
 claim [
arising
] under Subsection (1)(a) or Section 
26-19-201
 to recover
medical assistance provided to a recipient is a lien against any proceeds payable to or on behalf
of the recipient by [
that
] 
the
 third
-
party. [
This
]
(ii) The
 lien 
described in Subsection (1)(b)(i)
 has priority over all other claims to the
proceeds, except claims for attorney fees and costs authorized under Subsection
26-19-403
(2)(c)(ii).
(c) (i) The department may not recover medical assistance under Subsection (1)(a) if:
(A) the third-party is obligated to pay the recipient for an injury to the recipient's child
that occurred while the child was in the physical custody of the child's foster parent;
(B) the child's injury is a physical or mental impairment that requires ongoing medical
attention, or limits activities of daily living, for at least one year;
(C) the third-party's payment to the recipient is placed in a trust, annuity, financial
account, or other financial instrument for the benefit of the child; and
(D) the recipient makes reasonable efforts to mitigate any other medical assistance
costs for the recipient to the state.
(ii) The department is responsible for any repayment to the federal government related
to the medical assistance the department is prohibited from recovering under Subsection
(1)(c)(i).
(2) (a) The department shall mail or deliver written notice of [
its
] 
the department's
claim or lien to the third
-
party at [
its
] 
the third-party's
 principal place of business or last-known
address.
(b) The notice shall include:
(i) the recipient's name;
(ii) the approximate date of illness or injury;
(iii) a general description of the type of illness or injury; and
(iv) if applicable, the general location where the injury is alleged to have occurred.
(3) The department may commence an action on [
its
] 
the department's
 claim or lien in
[
its own
] 
the department's
 name, but [
that
] 
the
 claim or lien is not enforceable as to a
third
-
party unless:
(a) the third
-
party receives written notice of the department's claim or lien before [
it
]
the third-party
 settles with the recipient; or
(b) the department has evidence that the third party had knowledge that the department
provided or was obligated to provide medical assistance.
(4) The department may:
(a) waive a claim or lien against a third party in whole or in part; or
(b) compromise, settle, or release a claim or lien.
(5) An action commenced under this section does not bar an action by a recipient or a
dependent of a recipient for loss or damage not included in the department's action.
(6) [
The
] 
Except as provided in Subsection (1)(c), the
 department's claim or lien on
proceeds under this section is not affected by the transfer of the proceeds to a trust, annuity,
financial account, or other financial instrument.