General Laws of Massachusetts - Chapter 118E Division of Medical Assistance - Section 35 Reimbursement for covered claims; submission of information

Section 35. No claim for medical care or services provided for under this chapter shall be reimbursed if any health insurance company, non-profit hospital service corporation, medical service corporation, or other health insurer is liable for such claim under the terms of a group or individual policy providing coverage for such claim to a person eligible for assistance under this chapter. The division shall establish procedures to ensure that no such unauthorized claims are paid, including the soliciting of information regarding alternative health coverage from all applicants and recipients.

Notwithstanding the provisions of any general or special law to the contrary, chronic hospitals and skilled nursing facilities shall seek certification for Title XVIII of the Social Security Act for those services reimbursed under Title XVIII of the Social Security Act.

Notwithstanding any law to the contrary, all health insurers governed by chapters one hundred and seventy-five, one hundred and seventy-six A, one hundred and seventy-six B, one hundred and seventy-six C, one hundred and seventy-six E, one hundred and seventy-six F, and one hundred and seventy-six G, shall provide information to the division which is necessary to carry out the purposes of this section, including the names and addresses of their policyholders or subscribers.

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Last modified: September 11, 2015