ARTICLE 3.5. Third Party Liability

Article 3.5 added by Stats. 1976, Ch. 621.

§§ 14124.70–14124.94 · 24 sections

§ 14124.70 As used in this article: (a) “Carrier” includes any insurer as defined in Section 23 of the Insurance Code, including any private company, corporation, mutual…
§ 14124.71 (a) When benefits are provided or will be provided to a beneficiary under this chapter because of an injury for which another party is liable, or for which a…
§ 14124.72 (a) If an action is brought by the director pursuant to Section 14124.71, it shall be commenced within the period prescribed in Section 338 of the Code of…
§ 14124.73 (a) If either the beneficiary or the director brings an action or claim against such third party or carrier, the beneficiary or the director shall within 30…
§ 14124.74 In the event of a settlement, judgment, or award in a suit or claim against a third party or carrier: (a) If the action or claim is prosecuted by the…
§ 14124.75 The court or agency shall, upon further application at any time before the judgment or award is satisfied, allow as a further lien the reasonable value of…
§ 14124.76 (a) No settlement, judgment, or award in any action or claim by a beneficiary to recover damages for injuries, where the director has an interest, shall be…
§ 14124.77 When the director has perfected a lien upon a judgment or award in favor of a beneficiary against any third party for an injury for which the beneficiary has…
§ 14124.78 Notwithstanding any other provision of law, in no event shall the director recover more than the beneficiary recovers after deducting, from the settlement…
§ 14124.785 The director’s recovery is limited to the amount derived from applying Section 14124.72, 14124.76, or 14124.78, whichever is less, to the total settlement,…
§ 14124.79 In the event that the beneficiary, his guardian, conservator, personal representative, estate or survivors or any of them brings an action against the third…
§ 14124.791 (a) Subject to the director’s prior right of recovery, a provider who has rendered services to a beneficiary because of an injury for which a third party is…
§ 14124.792 If any provision of this article, or the application of any provision of this article to any person, firm, corporation, or other entity or to any circumstance…
§ 14124.795 It is the intent of the Legislature to comply with federal law requiring that when a beneficiary has other available health coverage or insurance, the Medi-Cal…
§ 14124.81 (a) The department shall administer the provisions of Sections 14124.82 to 14124.86, inclusive, pertaining to the State Department of Health Care Services’…
§ 14124.82 (a) The department, in its reasonable discretion, may execute one or more at-risk performance contracts to identify, quantify, or recover, or any combination…
§ 14124.83 The agreement shall include, but is not limited to, the following provisions: (a) The agreement shall stipulate when the contractor may identify, quantify, or…
§ 14124.84 The department shall provide the contractor with such information as is reasonably necessary for the contractor to perform its obligations under the contract,…
§ 14124.86 The contractor shall retain its rights to compensation upon recovery for completed duties under the contract with respect to any claims or liens processed in…
§ 14124.89 (a) (1) This section applies to all of the following entities: (A) Health insurer, or any health care entity licensed through the Department of Insurance. (B)…
§ 14124.90 (a) (1) It is the intent of the Legislature to comply with federal law requiring that when a beneficiary has third-party health coverage or insurance, the…
§ 14124.91 The State Department of Health Services shall, whenever it is cost-effective, pay the premium for third-party health coverage for beneficiaries under this…
§ 14124.92 (a) The department may pay administrative expenses and make incentive payments to any county, state, or federal agency, or a contracting agent of the…
§ 14124.94 (a) When the rights of a Medi-Cal beneficiary to health care benefits from an insurer have been assigned to the department, an insurer shall not impose any…