Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 195 - LIENS, OVERPAYMENTS AND IPVS › Section 461-195-0321 - Assigning a Lien

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Personal
			 Injury Liens Unit may assign a lien to a CCO (see OAR
			 461-195-0301) or prepaid managed
			 care health services organization (see
			 461-195-0301) for the amount of
			 covered health services (as defined in Oregon Health Plan Rules, OAR Division
			 410-141 and the General Rules, OAR Division 410-120, or other Department (see
			 461-195-0301) rules establishing
			 covered medical assistance) for a recipient (see
			 461-195-0301) arising from a
			 personal injury (see 461-195-0301) during the period
			 the Department paid a CCO or prepaid managed care health services organization
			 to provide covered health services to a recipient.
(2) A CCO or prepaid managed care health
			 services organization, within 30 days of receiving notice that an applicant
			 (see OAR 461-195-0301) or recipient has a
			 claim (see 461-195-0301) or action (see
			 461-195-0301), must give notice
			 to the Personal Injury Liens Unit, and provide additional information as
			 requested by the Personal Injury Liens Unit.
(3) A CCO or prepaid managed care health
			 services organization shall not use loan receipts (see OAR
			 461-195-0301), trust agreements
			 (see 461-195-0301), or similar
			 arrangements to seek reimbursement from an applicant, recipient, or third
			 party.
(4) The assignment
			 described in section (1) of this rule is made only if the CCO or prepaid
			 managed care health services organization makes a request for an assignment
			 from the Personal Injury Liens Unit, after giving the notice required in
			 section (2) of this rule.
(5) The
			 amount of the lien that may be assigned does not include amounts excluded from
			 a lien according to OAR
			 461-195-0305(3) and
			 (4),
			 461-195-0320, or
			 461-195-0350.
(6) For purposes of ORS
			 416.510 to
			 416.610, assignment of the lien
			 establishes the CCO or prepaid managed care health services organization as a
			 designee of the Department in relation to the lien, pursuant to ORS
			 416.540(5),
			 which designation shall include the following:
(a) As the Department's designee, the CCO or
			 prepaid managed care health services organization is subject to these rules in
			 the pursuit of the assigned lien and any actions taken by the CCO or prepaid
			 managed care health services organization to settle, compromise (see OAR
			 461-195-0301), or release the
			 assigned lien.
(b) The CCO or
			 prepaid managed care health services organization shall copy the Personal
			 Injury Liens Unit on all documentation related to the assigned lien, including
			 communications with the person or public body, agency or commission against
			 whom a claim is made or an action is brought in relation to settlement (see OAR
			 461-195-0301), compromise, or
			 release of the assigned lien. This requirement may be met by listing the
			 Personal Injury Liens Unit on the "cc" portion of the documentation or
			 certificate of service, and sending a copy to the Personal Injury Liens Unit
			 when the document is sent or filed.
(c) The Personal Injury Liens Unit may
			 require the use of forms and procedures related to the assignment of liens and
			 notices and the efficient administration of these rules to minimize redundancy
			 in communications with a recipient and the parties to a claim or action.