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COB/TPL Resources
CMS Guidance | Legislation | Issues | Resources | 2006 COB/TPL Conference Materials | 2007 COB/TPL Conference Materials
- CMS Memo on Distribution of Third Party Collections (7/28/1995)
- State Policies for Recovery from Legal Alien Sponsors and Carrier Overpayments
- NASMD Issues 2006 Coordination of Benefits/Third Party Liability Survey
- DRA Third Party Liability Provisions Q&A
- SMD Letter on Third Party Liability 12-15-2006
- Third Party Liability Enclosure
CMS Memo on Reimbursing Beneficiaries for Out of Pocket Costs (12/5/2006) (.pdf)
CMS Guidance Pursuing Medical Reimbursement Global Settlements (.pdf)
CMS Guidance on Digital Health Care (.pdf)
CMS Advisory Ahlborn Settlement Options (July 2006) (.doc)
CMS Memo on Distribution of Third Party Collection (July 1995)
CMS Memo on Indemnity Plans (2/20/1992)
Summary of Call on DRA TPL Provisions (5/12/2006) (.doc)
Title 19 - TPL Markup with new DRA Provisions (.doc)
State Legislation
State Laws to Meet DRA’s New TPL Requirements, Non-Compliance Penalties (8/10/2007)
Summary of States’ TPL Legislation as Required by DRA (4/4/2007)
Florida:
Definition of third-party (#26)
Third-Party Liability Act
Kentucky
KRS 205.623 -- Information on claims paid for insurance policyholders and dependents; use of data; confidentiality of information (.pdf)
Oklahoma
“Oklahoma Medicaid Healthcare Program Reform Act of 2003” (.rtf)
Pennsylvania
Act 42 of 2005 (House Bill 1168, Printer Number 2560) Amending the Public Welfare Code (P.L. 31, No. 21) (.pdf)
Amending language (.doc)
Colorado
Colorado Revised Statutes:
26-4-403 – Recoveries, overpayments, penalties, interest, adjustments, liens
26-4-518 - Payments by third parties, co-payments by clients, review, appeal
Colorado Code of Regulations:
10 CCR 2505-10, 8.000 et seq. | 10 CCR 2505-10, sec 8.012 | 10 CCR 2505-10 sec 8.205.4.I
South Dakota
Transmission of information, SL 2005, ch 263, § 1
Application for/ acceptance of medical assistance for release of information to facilitate COB, SL 2005, ch 263, § 2
Refusal of reimbursement, SL 2005, ch 263, § 3
Reimbursement to department for cost of services, SL 2005, ch 263, § 4
Insurer defined, SL 2005, ch 263, § 5
Department defined, SL 2005, ch 263, § 6
Zypreza
Zyprexa: Judge Weinstein Order – July 28, 2006 (.pdf)
Zyprexa Amicus Brief July2006 (.pdf)
Zyprexa Hearing Transcript - June 29, 2006 (.tif)
Zyprexa Status Report To Court with Exhibits 7-14-06 (.pdf)
Zyprexa_Settlement Overview (July 2006) (.pdf)
Ahlborn
Ahlborn Decision May 2006 (.pdf)
Ahlborn Oklahoma Guidance (.doc)
Washington State Plan Amendment (.pdf)
CMS Third Party Liability Resource
CMS National Provider Identifier Resource
GAO Report: Medicaid Third-Party Liability: Federal Guidance Needed to Help States Address Continuing Problems. (9/15/2006)
2006 COB/TPL Conference Materials
Florida Case Study (.pdf)
Society for Professional Business Administrators speech (.pdf)
HMS Presentation on the COB Portions of the DRA (.pdf)
CORE: Simplifying Eligibility and Administrative Data Exchange (.pdf)
Implementing the DRA: Sharing Plan Eligibility (.pdf)
Iowa Medicaid Estate Recovery (.pdf)
Transfer of Assets, Home Equity, Long Term Care Partnerships, and Annuities (.pdf)
Estate Recovery Best Practices (.pdf)
Oklahoma Medicaid: TPL and Estate Recovery (.pdf)
The DRA and Long Term Clients (.pdf)
What Does the Ahlborn Decision Really Mean? (.pdf)
Zyprexa Status Report to Court, July 14, 2006 (.pdf)
Texas Pharmacy Benefit Data Matching (.pdf)
COBManager: New Jersey's Approach to Control Medicaid Pharmacy Approach (.pdf)
Pharmacy and COB: Technology Advancements (.pdf)
Managed Care and TPL: A Texas Perspective (.pdf)
Bureau of TennCare: TPL (.pdf)
Medicare Managed Care Primary to Medicaid (.pdf)
Society of Professional Benefit Administrators