An Act To Allow the State Timely Opportunity To Participate in Settlement Negotiations for MaineCare Benefits
Maine Legislature, Session 123, LD 1566
Committee: Health and Human Services
Sponsors: WEBSTER
Amends: 22 MRSA §14

Legislative Document 
No. 1566 
H.P.1091 
House of Representatives, March 20,2007 
An Act To Allow the State Timely Opportunity To Participate in 
Settlement Negotiations for MaineCare Benefits 
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204. 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative WEBSTER of Freeport. 
Printed on recyded paper 
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MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §14, sub-§2-D, as amended by PL 2003, c. 20, Pt. K, §2, is 
further amended to read: 
2-D. Notification of claim. A recipient under the MaineCare program, or aay an 
agent, representative or attorney representing a recipient under the MaineCare program, 
who makes a claim to recover the medical cost of injury, disease, disability or similar 
occurrence for which the party received medical benefits under the MaineCare program 
shall ~ 
notify the department in writing with prior to settlement negotiations and 
provide information as required by the department of the existence of the claim. The 
notification must provide timely opportunity for the department, at its discretion, to 
participate in all settlement discussions and the allocation of settlement funds for 
MaineCare benefits paid. If adequate opportunity to participate is not given and the 
department's ability to recover for benefits paid is compromised, the department may 
institute legal proceedings against a recipient, including the agent, representative or 
attorney of that recipient, who has received a settlement or award from a 3rd party. The 
department may accept a letter of MaineCare claim protection in lieu of participation and 
allocation. 
Sec. 2. 22 MRS A §14, sub-§2-E, as amended by PL 2003, c. 20, Pt. K, §2, is 
further amended to read: 
2-E. Notification of pleading. In aay an action to recover the medical cost of 
injury, disease, disability or similar occurrence for which the party received medical 
benefits under the MaineCare program, the party bringing the action shall notify the 
department of that action at least 10 days prior to filing the pleadings. The notification 
must provide timely opportunity for the department, at its discretion, to intervene in all 
actions as an interested party. If adequate opportunity to intervene is not given and the 
department's ability to recover for benefits paid is compromised, the department may 
institute legal proceedings against a recipient, including the agent, representative or 
attorney of that recipient, who has received a settlement or award from a 3rd party. The 
department may accept a letter of MaineCare claim protection in lieu of intervention. 
Department records indicating medical benefits paid by the department on behalf of the 
recipient are prima facie evidence of the medical expenses incurred by the recipient for 
. the related medical services. 
SUMMARY 
Current Maine law requires recipients or their attorneys to notify the Department of 
Health and Human Services when they make a claim to recover the medical costs that 
were paid by MaineCare. The current law does not specify when the notification must be 
made. A recent U.S. Supreme Court decision, Arkansas v. Ahlborn, requires states to 
further refine their laws to allow states to participate in negotiations in a timely manner. 
This bill grants the State that authority by requiring that notification be made prior to 
when settlement negotiations begin. 
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