Minnesota Administrative Rules

4685.0900 SUBROGATION AND COORDINATION OF BENEFITS.

The health maintenance organization may require an enrollee to reimburse it for the reasonable value of health maintenance services provided to an enrollee who is injured through the act or omission of a third person or in the course of employment to the extent the enrollee collects damages or workers' compensation benefits for the diagnosis, care, and treatment of an injury. The subrogation clause in an evidence of coverage must contain the information required by Minnesota Statutes, section 62A.095, subdivision 2. The health maintenance organization may be subrogated to the enrollee's rights against the third person or the enrollee's employer to the extent of the reasonable value of the health maintenance services provided including the right to bring suit in the enrollee's name.

The health maintenance organization shall provide covered health services first, and coordinate benefits according to parts 4685.0905 to 4685.0950.

Statutory Authority:

MS s 62D.08; 62D.182; 62D.20

History:

14 SR 901; 23 SR 1238

Published Electronically:

October 11, 2007