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Prepared by Christopher D. Adams.
James HB No. 814
(KEYWORD, SUMMARY, AND DIGEST as amended by Senate committee
amendments)
MEDICAID. Extends right of Medicaid recovery in cases of third party liability for
injury, illness, or death to Medicaid managed care organizations that provide covered
services to Medicaid enrollees
DIGEST
Present law provides that in cases of injury, illness, or death that create third party liability
or obligate third party payment of damages, the Department of Health and Hospitals (DHH)
shall have a cause of action against such third party to recover medical assistance payments
obligated or paid on behalf of the injured, ill, or deceased person in connection with the
injury, illness, or death. Provides for notice, pleadings, compromise, and prescription in such
recovery cases.
Proposed law retains present law and extends the right of Medicaid recovery conferred
therein upon DHH to Medicaid managed care organizations.
Proposed law provides DHH or Medicaid managed care organization shall be responsible for
the pro rata share of the attorney fees for any person or his spouse, representative, or
dependent for the recovery of damages or compensation.
Proposed law defines "Medicaid managed care organization" as any private entity that
contracts with DHH to provide Medicaid benefits and services to Medicaid enrollees.
(Amends R.S. 46:446)
Summary of Amendments Adopted by House
House Floor Amendments to the engrossed bill.
1. Changed inconsistent references to assistance and medical payments to the phrase
"medical assistance payments".
2. Specified that DHH, a Medicaid managed care organization, or both, shall have
a cause action to recover medical assistance payments.
3. Added technical amendments.
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to the
reengrossed bill
1. Adds DHH or Medicaid managed care organization shall be responsible for the
pro rata share of the attorney fees for any person or his spouse, representative, or
dependent for the recovery of damages or compensation.