1. (1) A third party is another insurance company or agency that may be responsible for paying all or part of the cost for medical services provided to a Medicaid recipient. Some examples of third parties are Medicare, CHAMPUS, CHAMPVA, major medical insurance, dental insurance, cancer insurance, automobile insurance, and worker's compensation.
2. (2) Medicaid shall be considered the "payer of last resort." The hospice provider must bill all third parties which might pay for services provided before billing Medicaid.
3. (3) See Chapter 20, Third Party, for additional Third Party procedures.

Author: Theresa D. Richburg

Statutory Authority: Title XIX, Social Security Act; 42 C.F.R. §418.56(d); State Plan.

History: Emergency Rule effective October 1, 1990. Permanent Rule effective February 13, 1991.