6.3.1 THIRD PARTY LIABILITY

6.3.1 Introduction

Third Party Liability ( TPL ) means that another party, not MA or the client, is obliged to pay the bills for a MA recipient’s medical services.  

MA is the payor of last resort for the cost of medical care.  All MA clients must sign over to the State of Wisconsin their rights to payments for medical services from third party payors (including health insurers, court ordered medical  support payments and any other third party payor.)  A client complies with this requirement by signing the application form.

At application the Income Maintenance (IM) Agency  must give a Notice of Assignment ( DWSW-2477 ) to each client.  If the client refuses to sign this form, the  (IM)  must complete the lower portion of the form and file it in the case record.  Do this no later than at the time of the interview.  Give the client a copy of the notice.  Do not delay processing a Medicaid application while waiting for the form to be signed.   Do not penalize the client for not signing this form.  File the original in the case record.

This page last updated in Release Number: 04-01

Release Date: 02/27/04

Effective Date: 02/27/04