Section 2525. Insurance subrogation  


Latest version.
  • 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.