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Mississippi Medicaid Recovery

a service of HMS

Overview

Welcome to the Subrogation website for the Mississippi Division of Medicaid (DOM) operated by Health Management Systems, Inc. (HMS). HMS has contracted with DOM to operate the Subrogation Unit.

Subrogation Unit

The Subrogation Unit is responsible for enforcing DOM’s statutory right to recovery in subrogation claims, and for ensuring the State receives its reimbursement. The Subrogation Unit’s purpose is to recover the cost of medical expenditures from liable third parties when beneficiaries are involved in a personal injury action. These suits may be related to an auto accident, medical malpractice claim, general liability, workers’ compensation, mass torts, or any other tort claim where a settlement has been reached or a judgment has been awarded.

To notify DOM of an action, please fax your standard letter of representation to our office at 1-844-388-0653. The Subrogation Unit will contact you with the subrogation amount to help you settle your claim. If you require a breakdown of the bills paid by DOM, please include a signed medical authorization.

DOM has a statutory right to recovery. As a condition of eligibility, beneficiaries assign their rights to DOM for any third party payments.

Official Mississippi Code Annotated and Code of Federal Regulations

The authority and subrogation recovery rights can be referenced in the following state and federal cites:

– See more at: http://hms.com/ms/medicaidrecovery/#sthash.FGfqvxOa.dpuf

Forms

The Transmittal Form can be used to notify DOM that your office represents a Medicaid beneficiary who has an injury claim. It will begin the process of verifying whether Medicaid has a claim, the amount of the Medicaid claim, and the resolution of the claim. Simply complete the form and fax it to the Subrogation Unit at the number below. If you would prefer, you can fax a letter of representation on your firm’s letterhead.

Attn: Subrogation Unit
Fax: 844-388-0653

Transmittal Form (PDF)

Transmittal Form

Medical Authorization Form

If you would like the DOM Subrogation Unit to provide your attorney, legal representative, or claim adjuster with a list of the providers paid for services related to your accident or injury, please print the following form and sign, date, and fax it to: 844-388-0653.

Click here for the Medical Authorization Form (PDF)

– See more at: http://hms.com/ms/forms/#sthash.EiX1J2cT.dpuf

Subrogation FAQ

  1. What do you do if your client is involved in an accident?

    Ask your client if he or she is covered under Medicaid. You may also contact our office to verify that your client is covered under these programs. You should also check with your client to see if he or she is covered under Mississippi Coordinated Access Network (MississippiCAN), Medicaid’s managed care program. If so, you will also need to contact the appropriate managed care provider for its claim amount.

  2. What are the attorney’s responsibilities?

    Pursuant to Miss. Code Ann. § 43-13-125, attorneys, beneficiaries and insurance companies have a number of responsibilities. For instance, attorneys shall certify to DOM a copy of the pleadings at the time of the institution of suit, and proof of that notice shall be filled in that action. Attorneys should also notify DOM in advance of any potential settlement, which may have been reached prior to or without the necessity of the institution of suit. Beneficiaries and attorneys shall execute and deliver instruments and papers to do whatever is necessary to secure DOM’s rights and shall do nothing after Medicaid is provided to prejudice DOM’s subrogation rights. Any applicable court orders or agreements for reimbursement of DOM’s interest shall direct those payments to DOM.

    Please remember that any Medicaid application is a binding legal document. When a beneficiary signs this application, he or she acknowledges that medical benefits paid on his or her behalf must be reimbursed to DOM if he or she is entitled to benefits from a third party.

  3. What will the Subrogation Unit do for you and your client?

    Upon contact by an attorney’s office, the Subrogation Unit will verify the beneficiary’s eligibility status at the time of the accident or injury, determine whether DOM incurred any medical expenses as a result of the accident or injury, and generate a complete medical history of injury-related claims. This information is available to attorneys who submit a written request along with a signed medical authorization from the client granting the attorney access to the beneficiary’s medical records.

  4. What medical assistance costs are recovered?

    The Subrogation Unit will request reimbursement only for injury-related charges. A reimbursable injury/loss may be related to an auto accident, medical malpractice, general liability, workers’ compensation, or any other tort claim where a settlement has been reached or a judgment has been awarded.

  5. What happens if the beneficiary fails to pay the Division’s claim?

    Failing to reimburse DOM may impact the beneficiary’s present and future Medicaid eligibility. Medicaid is entitled to bring a lawsuit against any person, firm or corporation who fails to protect Medicaid’s claim and recover double the amount of benefits paid to a beneficiary or the amount of the policy limits, whichever is lesser, as well as attorney’s fees and costs of court.

  6. How do you repay the Mississippi Division of Medicaid?

    Make your check payable to the Mississippi Division of Medicaid and mail it to DOM at:

    Mississippi Division of Medicaid
    P.O. Box 1035
    Jackson, MS 39201-9820

– See more at: http://hms.com/ms/subrogation-faq/#sthash.GEcZEXFK.dpuf

Contact Information

Subrogation Unit

Mississippi Division of Medicaid
P.O. Box 1035
Jackson, MS 39201-9820

Phone: 1-855-547-4984

Fax: 1-844-388-0653

– See more at: http://hms.com/ms/contact-information/#sthash.9UAIPQSc.dpuf