R527-936-1. Definition and Purpose

A third party is an individual, institution, corporation, public or private agency, trust, estate, insurance carrier, employee welfare benefit plan, health maintenance organization, health service organization, preferred provider organization, governmental program such as Medicare, CHAMPUS, and workers' compensation, which may be obligated to pay all or part of the medical costs of injury, disease, or disability of a recipient, and a spouse or a parent who:

(i) may be obligated to pay all or part of the medical costs of a recipient under law or by court or administrative order; or

(ii) has been ordered to maintain health, dental, or disability insurance to cover medical expenses of a spouse or dependent child by court or administrative order. The Utah Third Party Liability Program has been established to assure that all private medical resources have been exhausted before a claim is paid by Medicaid; or that when the agency discovers a liable third party after payment of a claim, reimbursement is sought.

The Utah Third Party Liability Program has been established to assure that all private medical resources have been exhausted before a claim is paid by Medicaid; or that when the agency discovers a liable third party after payment of a claim, reimbursement is sought.