<?xml version='1.0' encoding='utf-8'?>
<section article="ghg" article_name="Health - General" number="19-14A-01" title_number="19" title_name="Health Care Facilities" subtitle_number="14A" subtitle_name="Third Party Liability Reviews and Audits of Nursing Homes">
  <level label="a">
    <text>In this subtitle the following words have the meanings indicated.</text>
  </level>
  <level label="b">
    <text>“Final report” means the third party liability audit report issued to a nursing home stating the total amount due to the Department as a result of the completed audit.</text>
  </level>
  <level label="c">
    <text>“Nursing home” has the meaning stated in § 19-1401(e) of this title.</text>
  </level>
  <level label="d">
    <level label="1">
      <text>“Third party” means any individual, entity, or program that is or may be liable to pay all or part of the medical cost of any medical assistance furnished to a recipient under the Medical Assistance Program.</text>
    </level>
    <level label="2">
      <text>“Third party” includes private health insurance, employment-related health insurance, medical support from absent parents, automobile insurance, court judgments or settlements from a liability insurer, State workers’ compensation, first party probate-estate recoveries, or any federal programs.</text>
    </level>
  </level>
  <level label="e">
    <text>“Third party liability audit” means a financial review of Medical Assistance payments to a provider to ascertain the legal liability of third parties to pay for care and services available under the Medical Assistance Program.</text>
  </level>
  <level label="f">
    <text>“Third party liability review” means a financial review of the credit balances of a nursing home to ascertain the legal liability of third parties to pay for care and services available under the Medical Assistance Program.</text>
  </level>
</section>
