(1) As used in this section, “medical services” means medical or medically related institutional or noninstitutional services which are provided or paid for by the Department of Health, except for services provided or paid for pursuant to chapter 394 or chapter 397.
(2)(a) Third-party coverage for medical services shall be primary coverage.
(b) An applicant for or the recipient of medical services shall inform the department of any rights which the applicant or recipient has to third-party payments for medical services. The department shall automatically be subrogated to any rights the recipient has to third-party payments for medical services. The department shall recover for medical services directly from:
1. Any third party who is liable to make a medical benefit payment to the provider of the recipient’s medical services or to the recipient under the terms of any contract, settlement, or award;
2. The recipient, if he or she has received third-party payment for medical services provided to him or her; or
3. The provider of the recipient’s medical services if third-party payment for medical services has been recovered by the provider.
(c) An applicant for or the recipient of medical services who receives medical services shall be deemed to have made an assignment to the department of any right such person has to any payments for such medical services from a third party.
(d) An applicant for or the recipient of medical services who receives medical services shall be deemed to have provided the department the authority to release medical information with respect to such medical services for the sole purpose of obtaining reimbursement.
(e) The department may, in order to enforce its subrogation rights under this section, institute, intervene in, or join any legal proceeding against any third party against whom recovery rights arise. No action taken by the department shall operate to deny the recipient’s recovery for that portion of his or her damages not subrogated to the department, and no action of the recipient shall prejudice the subrogation rights of the department.
(f) When the department provides, pays for, or becomes liable for medical services, it shall have a lien for the amount of medical services upon any and all causes of action which accrue to the person to whom care was furnished, or which accrue to his or her legal representatives, as a result of sickness, injury, disease, disability, or death due to the liability of a third party which necessitated the medical services. The department shall have 1 year from the date when the last item of medical services relative to a specific accident or spell of illness was paid in which to file its verified lien statement. The statement shall be filed with the clerk of the circuit court in the recipient’s county of residence. The verified lien statement shall contain the name and address of the person to whom medical services were furnished; the date of injury; the name and address of the vendor or vendors furnishing medical services; the dates of the service; the amount claimed to be due for the care; and, to the best knowledge of the department, the names and addresses of all persons, firms, or corporations claimed to be liable for damages arising from the injuries. The department’s failure to file a lien shall not affect its subrogation rights provided in paragraph (b).
(g) In recovering any payments in accordance with this subsection, the department is authorized to make appropriate settlements.
(h) The department shall promulgate rules to implement the provisions of this section.
History.—s. 68, ch. 86-220; s. 27, ch. 93-39; s. 810, ch. 95-148; s. 142, ch. 99-8.
Structure Florida Statutes
Chapter 402 - Health and Human Services: Miscellaneous Provisions
402.04 - Award of Scholarships and Stipends; Disbursement of Funds; Administration.
402.05 - Requisites for Holding Scholarship and Stipend.
402.06 - Notes Required of Scholarship Holders.
402.115 - Sharing Confidential or Exempt Information.
402.12 - National Community Mental Health Centers Act.
402.16 - Proceedings by Department.
402.161 - Authorization for Sale of Property.
402.164 - Legislative Intent; Definitions.
402.165 - Florida Statewide Advocacy Council; Confidential Records and Meetings.
402.166 - Florida Local Advocacy Councils; Confidential Records and Meetings.
402.17 - Claims for Care and Maintenance; Trust Property.
402.18 - Welfare Trust Funds; Creation, Use.
402.181 - State Institutions Claims Program.
402.185 - Productivity Enhancing Technology.
402.19 - Photographing Records; Destruction of Records; Effect as Evidence.
402.24 - Recovery of Third-Party Payments for Medical Services.
402.26 - Child Care; Legislative Intent.
402.301 - Child Care Facilities; Legislative Intent and Declaration of Purpose and Policy.
402.3025 - Public and Nonpublic Schools.
402.3026 - Full-Service Schools.
402.305 - Licensing Standards; Child Care Facilities.
402.30501 - Modification of Introductory Child Care Course for Community College Credit Authorized.
402.3054 - Child Enrichment Service Providers.
402.3055 - Child Care Personnel Requirements.
402.307 - Approval of Licensing Agency.
402.308 - Issuance of License.
402.309 - Provisional License or Registration.
402.3115 - Elimination of Duplicative and Unnecessary Inspections; Abbreviated Inspections.
402.312 - License Required; Injunctive Relief.
402.313 - Family Day Care Homes.
402.3131 - Large Family Child Care Homes.
402.314 - Supportive Services.
402.315 - Funding; License Fees.
402.317 - Prolonged Child Care.
402.33 - Department Authority to Charge Fees for Services Provided.
402.40 - Child Welfare Training and Certification.
402.402 - Child Protection and Child Welfare Personnel; Attorneys Employed by the Department.
402.403 - Child Protection and Child Welfare Personnel Tuition Exemption Program.
402.404 - Child Protection and Child Welfare Personnel Student Loan Forgiveness Program.
402.41 - Educational Materials and Training Concerning HIV Infections and Aids.
402.49 - Mediation Process Established.
402.56 - Children’s Cabinet; Organization; Responsibilities; Annual Report.
402.57 - Direct-Support Organization.
402.62 - Strong Families Tax Credit.
402.70 - Interagency Agreement Between Department of Health and Department of Children and Families.
402.71 - Transfer of Funds, Positions, and Budget Authority Within Department.
402.73 - Contracting and Performance Standards.
402.80 - Office of Community Partners.
402.81 - Pharmaceutical Expense Assistance.
402.82 - Electronic Benefits Transfer Program.
402.86 - Rulemaking Authority for Refugee Assistance Program.