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37.82.207    RECIPIENT OVERPAYMENTS

(1) The department shall take reasonable and appropriate actions to recover each recipient overpayment, as defined in ARM 37.82.102, of medicaid benefits when the recipient overpayment is the result of the recipient's intentional or unintentional act or omission. The department shall also take reasonable and appropriate actions to recover overpayments that result from continued benefits which were paid pending the outcome of a fair hearing that is ultimately decided, at least in part, in the department's favor.

(2) The department shall not seek to recover a recipient overpayment, as defined in ARM 37.82.102, of medicaid benefits when the entire recipient overpayment is the result of an error made by the department.

(3) A recipient overpayment shall be calculated to include:

(a) the total amount of medicaid benefits paid to or on behalf of an ineligible recipient; or

(b) the difference between the amount of an accurately calculated monthly incurment and the amount of monthly incurment the recipient paid toward an incorrectly calculated incurment.

(4) The medicaid recipient and any other individual who has a legal obligation to support the medicaid recipient is liable to the department for any recipient overpayment sought to be recovered by the department. The department may use all legal means to recover the overpayment.

History: Sec. 53-2-201, 53-4-212 and 53-6-113, MCA; IMP, Sec. 53-6-111, MCA; NEW, 2003 MAR p. 15, Eff. 1/17/03.

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