Laws of New York (Last Updated: November 21, 2014) |
PBH Public Health |
Article 25. MATERNAL AND CHILD HEALTH |
Title 2. PRENATAL CARE |
Section 2525. Insurance subrogation
Latest version.
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1. Upon acceptance into a prenatal care assistance program established pursuant to section two thousand five hundred twenty-two of this title or section seven of the Prenatal Care Act of 1987, an eligible service recipient shall advise the prenatal care service provider, the department of health or the organization administering the pilot programs, of any individual, group or blanket accident and health insurance policy under which she is covered. 2. The private health insurance covering an eligible service recipient or an eligible woman participating in a prenatal care program or a pilot program, shall be used before any funds are expended from state funds. (a) The commissioner or his designee shall be subrogated, to the extent of expenditures for services provided to the recipient pursuant to a prenatal care assistance program or pursuant to a pilot program, to any rights such recipient may have to medical support or third party reimbursement. For purposes of this section, the term medical support shall mean the right to support for the purpose of medical care by a court order or an administrative order. The right of subrogation does not attach to insurance benefits paid or provided under any health insurance policy prior to the receipt of written notice of the exercise of such subrogation rights by the carrier. No right of subrogation to insurance benefits available under any health insurance policy shall be enforceable unless written notice of the exercise of such subrogation right is received by the carrier within two years from the date services for which benefits are provided under the policy or contract are rendered. The commissioner or his designee shall also notify the carrier when the exercise of subrogation rights has terminated because a person is no longer receiving program services under this title or a pilot program. Such carrier shall establish mechanisms to maintain the confidentiality of all individually identifiable information or records for the specific purpose for which such disclosure is made, and shall not further disclose such information or records. (b) Nothwithstanding any inconsistent provisions of this chapter or any other law to the contrary, no employer or organization who has a plan providing care and other medical benefits for persons, whether by insurance or otherwide, shall exclude a person from eligibility, coverage or entitlement to benefits under such plan by reason of the eligibility of such person for services under this title or under a pilot program, or by reason of the fact that such person would, except for such plan, be eligible for services under this title or under a pilot program. Where an eligible recipient has health insurance in force covering care and other medical benefits provided under this title or under a pilot program, payment or part-payment of the premium for such insurance may also be made by the commissioner or his designee when deemed appropriate pursuant to regulations promulgated by the commissioner.