907 KAR 1:005. Nonduplication of payments

Section 1. Nonduplication of Payment. (1) In accordance with 42 C.F.R. 447.15, a payment to a provider for a service provided to a recipient shall be payment in full to the provider for the service. (2) Â (a) A provider shall not seek payment from a recipient for a covered service provided to the recipient. (b) A recipient shall not be financially liable to a provider for a covered service provided by the provider to the recipient. Section 2. Third-party Liability. (1) The department shall comply with 42 C.F.R. Part 433, Subpart D, and consider any third-party liability as a resource. (2) A recipient shall cooperate with the department for third-party liability purposes in accordance with 42 U.S.C. 1396k, 42 C.F.R. 433.138, and 42 C.F.R. 433.145. (3) If payment for a covered service is due and payable from a third-party source such as Medicare, an insurance plan, or some other third-party with a legal obligation to pay, the amount payable by the cabinet shall be reduced by the amount of the third-party obligation.