Application for or acceptance of medical assistance paid by department operates as release of information to facilitate coordination of benefits--Request.

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58-12-23. Application for or acceptance of medical assistance paid by department operates as release of information to facilitate coordination of benefits--Request.

Notwithstanding any provision of a policy, plan, contract, or certificate, an insurer shall recognize that an application for medical assistance or acceptance of medical assistance, paid by the Department of Social Services operates as a release of any information kept by the insurer that would facilitate efficient coordination of benefits between the department and the insurer, which may include:

(1)The name, address, date of birth, social security number if available, and unique health care identification number of the covered individual;

(2)The name, address, date of birth, social security number if available, policy number, group identification number of the policyholder, sponsor, or subscriber;

(3)The name and address of the employer if it is an employer-employee benefit plan; types of services covered under the plan or policy; and the name and address of the claims administrator for the policy or plan;

(4)Previously paid benefits including the name and address of the payee; and

(5)The name and address of claims processing or administration centers, or both.

Upon written request by the department, the insurer shall provide the requested information in writing within thirty calendar days of receipt of the request.

Source: SL 2005, ch 263, §2; SL 2007, ch 286, §1.


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