Section 5H. Notwithstanding any other provision of general or special law, rule or regulation, the department shall be subrogated to the right of any recipient of medical assistance provided pursuant to chapter one hundred and eighteen E to proceed against any health care insurer that is or may be liable to pay for covered services obtained by a recipient of medical assistance to the extent of any medical benefits provided by the department on behalf of the recipient or his dependents.
A recipient of medical assistance or any person legally obligated to support and having actual or legal custody of a recipient of medical assistance shall inform the department of any health insurance available to such recipient upon initial application and redetermination for eligibility for assistance and shall make known the nature and extent of any health insurance coverage to any person or institution that provides medical benefits to the recipient or his dependent.
No policy for health insurance for health care delivery administered, issued or renewed in the commonwealth shall contain any provision denying or reducing benefits to a person who is eligible for or who is receiving medical assistance under said chapter one hundred and eighteen E.
A provider of medical assistance under said chapter one hundred and eighteen E shall determine whether any recipient for whom it provides medical benefits that are or may be eligible for reimbursement pursuant to said chapter one hundred and eighteen E is a subscriber or beneficiary of a health insurance plan. The department is the payor of last resort, and accordingly a provider shall request payment for medical benefits it provides from a health insurer which is or may be liable for the medical benefits so provided, before payment is requested from the department.
Payment by the department under the medical assistance program shall constitute payment in full; subsequent to any such payment a provider may not recover from any health insurer an amount greater than the amount so paid by the department for any service for which the department is to be the payor of last resort.
Notwithstanding any provision of law, all health insurers doing business in the commonwealth shall provide information to the department to the extent sufficient to identify persons who are recipients of assistance under said chapter one hundred and eighteen E and who are also beneficiaries under any policy for health insurance in force and effect in the commonwealth.
Structure Massachusetts General Laws
Part I - Administration of the Government
Title II - Executive and Administrative Officers of the Commonwealth
Chapter 18 - Department of Transitional Assistance
Section 1 - Department of Transitional Assistance
Section 2 - Comprehensive Financial Assistance Program; Services
Section 2a - Food Stamp Employment and Training Plan; Maximization of Federal 50–50 Match Program
Section 2b - Educational Program; Services
Section 3 - Commissioner; Appointment; Qualifications; Salary
Section 4 - Deputy Commissioner; Assistant Commissioners; Qualifications; Salaries; Succession; Bond
Section 5 - Organization of Department; Regional Offices; Community Service Areas
Section 5b - False Representations or Failure to Disclose Facts; Penalty
Section 5c - Vendors' Bill for Services; Perjury
Section 5d - Vendors; Violations
Section 5e - Return of Unlawful Payments
Section 5f - Father's Leaving Family to Obtain Assistance; Penalty
Section 5g - Claimant; Subrogation
Section 5l - Food Stamp Benefits Trafficking; Penalty
Section 5m - Organizational Food Stamp Benefits Trafficking; Penalty
Section 5n - Fraud Hotline; Sign Display
Section 7 - Community Service Area Boards
Section 8 - Civil Service Status of Commissioners; Restoration
Section 9 - Employees of Department; Delegation of Responsibilities
Section 10 - Reports; Rules and Regulations; Federal Aid
Section 11 - Lists of Recipients; Publication; Records; Rules and Regulations
Section 14 - Reciprocal Agreements
Section 18 - Reimbursement of Department; Recipient Arrearages; Furniture Payments
Section 18a - Failure of Custodial Parent to Cooperate With Iv–d Agency
Section 19 - Eviction From Furnished Apartment; Furniture; Relocation
Section 20 - Purchase of Home or Income Producing Property
Section 21 - Support and Maintenance; Subrogation of Department; Termination of Assistance; Notice
Section 22 - Verification of Categorical and Financial Eligibility
Section 26 - Direct Payment of Rent; Public Housing; Appeal
Section 27 - Direct Payment of Rent; Request of Landlord or Recipient
Section 27a - Direct Deposit of Assistance Checks at Banking Institutions; Option of Recipient
Section 29 - Repayment of Fraudulently Obtained Assistance; Lien
Section 30 - Overpayments of Assistance; Repayment Agreement; Assignment of Income
Section 31 - Job Diversion Program; Services
Section 32 - Participation in Pathways to Self-Sufficiency Program Required; Exceptions
Section 33 - Providing of Social Security Number Required; Exceptions; Penalty for Noncompliance
Section 34 - Tracking of Outcomes of Individuals Served by Training and Employment Service Programs
Section 35 - Availability of Caseworker via Telephone to Recipient of Cash Assistance
Section 36 - Fraud Detection Program