- Alaska Statutes.
- Title 47. Welfare, Social Services and Institutions
- Chapter 5. Administration of Welfare, Social Services and Institutions
- Section 70. Third Party Liability Subrogation.
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. Duty of a Medical Assistance Recipient. [See Conditional Effective Date Note]..
AS 47.05.070. Third Party Liability Subrogation.
- (a) The department may not pay medical claims that are payable by a third party payor. Medical providers shall attempt
collection from the third party payor before billing Medicaid. Before payment by Medicaid, evidence of third-party
denial or partial payment shall be presented with the claim.
- (b) If the department provides or pays for medical assistance for injury or illness under this title, the department is
subrogated to the rights of the recipient of that medical assistance for any claim arising from the injury or illness
and to the proceeds of an insurance policy covering the injury or illness to the extent of the value of the medical
assistance provided. A recipient of medical assistance or the recipient's attorney must notify the department in
writing of any action or claim against a third-party payor if medical assistance was provided by the department to
treat an injury or illness for which the third party may be liable. Notwithstanding the assertion of any action or
claim by the recipient of medical assistance, the department may bring an action in the superior court against an
alleged third-party payor to recover an amount subrogated to the department for medical assistance provided on behalf
of a recipient.
- (c) If a recipient of medical assistance under this title settles a claim or obtains an award or judgment arising from the
injury or illness for which the medical assistance was received, the amount of the claim to which the department is
entitled under (b) of this section shall be reduced by a pro rata share of the attorney fees and litigation costs.
Regardless of the manner in which the amount of the attorney fees is derived in the particular case, the pro rata
reduction of the subrogated claim for reimbursement of attorney fees shall be calculated in accordance with the
applicable rules of court governing the award of attorney fees in civil matters.
- (d) The department is authorized to enter into contracts for the collection of medical expenses already paid by Medicaid
from potential third-party payors. The department may pay, from the funds recovered by the contractor, any amounts
owing to the federal government as its share of the Medicaid paid claim, and the costs of collecting the funds.
- (e) Notwithstanding (b) of this section, the department may waive the subrogation rights to all or part of the amount of
medical assistance paid on behalf of a recipient of medical assistance in cases of undue hardship.
- (f) The department may adopt regulations to interpret and implement this section.
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