Introduction
Third party liability
(TPL) is another eligibility requirement that must be applied when determining MA and MA payment of LTC services. This module will provide you with additional information regarding TPL that you must be aware of when working with a person requesting MA-LTC.
EPM 2.1.1.2.1.3 Third Party Liability Definition: People, entities or programs that are, or may be, liable to pay all or part of the medical costs provided to Medical Assistance (MA) enrollees. Examples of TPL include group or private health care coverage, auto insurance, worker's compensation, and personal liability insurance.When you have completed this module, you will be able to:
- Determine when a parental fee is required.
- Explain Medicare coverage as it pertains to people requesting MA-LTC.
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Third Party Liability