Medicaid Third-Party Liability

HRD-92-21R: Published: Mar 3, 1992. Publicly Released: Mar 3, 1992.

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GAO provided information from previous reviews on Medicaid third-party liability. GAO noted that Medicaid could save millions of dollars if states ensured that liable third parties paid Medicaid recipients' medical bills. GAO also noted that to realize such savings, states need to: (1) improve compliance with federal requirements to identify and recover from liable health insurers by collecting health insurance information at the time of Medicaid eligibility determination and seeking payment recovery within 60 days; and (2) improve child support enforcement techniques to ensure that non-custodial children of medicaid children provide health insurance when it is available through employment. GAO also noted that: (1) federal guidance is needed to provide clearer standards for state medical support enforcement activities; (2) states have limited authority over out-of-state insurers and cannot effectively prohibit problem practices; and (3) states' limited authority over the Employee Retirement Income Security Act of 1974 may jeopardize future medical support efforts.

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