D.C. Mun. Regs. tit. 29, r. 29-1400

Current through Register Vol. 71, No. 37, September 13, 2024
Rule 29-1400 - RIGHT TO REIMBURSEMENT
1400.1

Whenever the District provides health-care assistance to a beneficiary who has suffered an injury or illness under circumstances that would have created a liability upon a third party had the beneficiary instead of the District incurred the expense of the health-care assistance, the District shall have an independent, direct cause of action against that third party for the unreimbursed value and/or cost of the health-care assistance provided.

1400.2

As soon as the District begins providing health-care assistance to a beneficiary, it shall become subrogated to any right or claim that the beneficiary has against a third party for the care and treatment it has undertaken to provide or pay for as health-care assistance. Alternatively, or in addition to the legal subrogation effected under this subsection, the Department may require a beneficiary to execute a written assignment of that same right or claim.

1400.3

In determining the unreimbursed value of health and health related care and treatment that the District undertakes to provide directly to a beneficiary, the Department shall refer directly to the agency or institution which rendered service to determine health or health-related cost for care and treatment.

D.C. Mun. Regs. tit. 29, r. 29-1400

Final Rulemaking published at 33 DCR 1320 (March 7, 1986)
AUTHORITY: Unless otherwise noted, the authority for this chapter is.