title: Medicaid program; state plan requirements and other provisions relating to state third party liability programs--HCFA. Final rule.
abstract: This final rule implements certain Medicaid State plan requirements and other provisions relating to State third party liability (TPL) programs. Its provisions deal with: (1) The integration of a State's pursuit of third party claims with its Mechanized Claims Processing and Information Retrieval System; (2) exceptions to the cost avoidance method of claims payment in TPL situations; and (3) provider restrictions and penalties related to attempts at collection of cost sharing or portions of those amounts from Medicaid recipients when TPL has been established. These regulations implement portions of section 9503 of the Consolidated Omnibus Budget Reconciliation Act of 1985.
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D007341:Insurance / Q000331:legislation & jurisprudence*; D007344:Insurance Claim Reporting / Q000331:legislation & jurisprudence*; D008484:Medicaid / Q000331:legislation & jurisprudence*; D013219:State Government; D014481:United States