Tort and Casualty
The Tort and Casualty Unit in the Benefits Coordination section of the Department recovers money from a legally responsible third party when the Department has paid claims on behalf of a Medicaid client. These circumstances commonly include payments, awards, or settlements from auto, homeowners' and malpractice insurance carriers intended to compensate the clients for their injuries. Medicaid has an automatic lien by statute in these circumstances. We are required by state and federal law to take all reasonable measures to identify parties and to seek reimbursement from those legally responsible parties.
By law, you or your representative must provide the Department written notice within fifteen (15) days after the filing of an action or claim against a third party. Section 25.5-4-301(6), C.R.S.
To report an incident or accident, submit a form or letter which includes the following information:
To notify the Department of a claim on behalf of a Medicaid client, the Department must also receive:
Insurance company representatives
When providing notice of a Medicaid client's claim, include the information described above for clients on company letterhead.
Mail or Fax to:Colorado Department of Health Care Policy and Financing Attention: Benefits Coordination Department 1570 Grant Street Denver, CO 80203 Fax number: 303-866-3552
Note: Under Colorado State Law, failure to comply with providing notice of an action within fifteen (15) days or failure by a party to a judgment award or settlement to satisfy Medicaid's lien shall make the recipient, legal guardian, executor, adminstrator, attorney, or other representative liable for the entire amount of medical assistance furnished to or on behalf of the recipient for the injuries that gave rise to the action or claim. Sections 25.5-4-301(5) & (6), C.R.S.
Click here for more information: Tort and Casualty Presentation
Or contact:Deborah Sorenson Phone: 303-866-3109 Fax: 303-866-3552