<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.09.83.04" title_num="10" subtitle_num="09" chapter_num="83" heading="Notice to the Department.">
  <paragraph num="A.">
    <text>An attorney representing a recipient in a cause of action that gives rise to the Department’s right of subrogation under Regulation .02 of this chapter shall notify the Program’s Division of Recoveries and Financial Services in writing before:</text>
    <paragraph num="(1)">
      <text>Filing a claim;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Commencing an action; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Negotiating a settlement.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The notice required under §A of this regulation shall include submission of the following information:</text>
    <paragraph num="(1)">
      <text>The recipient's name, Social Security Number, date of birth, last known address, and telephone number;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The name of any person against whom the recipient is making a claim;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The identification of each potentially liable third party, including that party's name, last known address, and telephone number;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The name of any insurer of any person against whom the recipient is making a claim, if known;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The date of the injury or illness giving rise to the claim;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>A short statement identifying the nature of the recipient’s claim or the terms of any settlement, judgment or award;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Copies of the pleadings and other papers related to the action or claim; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>A valid release of the confidentiality of the recipient’s medical records from the date of the injury until the date of the notice.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>In any action or claim by a recipient to recover damages for an injury or illness that has resulted in the Department providing or paying for Program benefits, an attorney who represents a recipient shall give the Program’s Division of Recoveries and Financial Services written notice:</text>
    <paragraph num="(1)">
      <text>Not later than 30 calendar days after any judgment or award in such action or claim; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Before the resolution of the cause of action or claim.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>In addition to the notices required in §§A and C of this regulation, an attorney required to give notice under §A or C of this regulation shall give the Program’s Division of Recoveries and Financial Services additional written notice not later than 30 calendar days after judgment, award, or settlement of the action or claim stating the amount and terms of any judgment, award, or settlement of the action or claim.</text>
  </paragraph>
  <paragraph num="E.">
    <text>Upon receiving the notice required pursuant to §A of this regulation, the Department shall, within 3 business days, acknowledge in writing its claim to the recipient or the attorney of the recipient and to the third party. The Department shall provide the amount of the claim and an itemized list of charges within 15 business days pursuant to Regulation .06 of this chapter. Nothing herein shall prevent the Department from thereafter updating the amount of the claim and itemized list of charges within a reasonable time after the recipient’s provider notifies the Department of additional charges.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Upon receiving the notice required pursuant to §A of this regulation, the Department shall, within 3 business days, advise the recipient or the attorney of the recipient and the third party, in writing, whether the recipient is:</text>
    <paragraph num="(1)">
      <text>A Medicaid recipient;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A member of a Medicaid Managed Care Organization (MCO); or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Not a Medicaid recipient.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Under Regulation .06 of this chapter, the Department shall provide the amount of the claim and an itemized list of charges within 15 business days of receipt of the notice required under §A of this regulation. Nothing in this regulation shall prevent the Department from updating the amount of the claim and itemized list of charges within a reasonable time after the recipient’s provider notifies the Department of additional charges.</text>
  </paragraph>
</regulation>