Providers shall make all reasonable efforts to determine if there is a liable third-party source, including Medicare, and in the case of a liable third-party source, utilize that source for payments and benefits prior to applying for Medicaid payments. Third party payments received after billing Medicaid for service for a Medicaid recipient shall be refunded to the Alabama Medicaid Agency.

Author: Willie J. Johnson

Statutory Authority: 42 C.F.R., §441, Subpart G; Home- and Community-Based Waiver for the Mentally Retarded and Developmentally Disabled.

History: Rule effective July 9, 1985. Amended: effective November 18, 1987, June 6, 1990.