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will be cost-effective, the reasonable value of benefits provided | | to the extent that there are proceeds available for such recovery | | after the deduction of reasonable attorney's fees and litigation | | costs from the gross award or settlement. In determining whether | | collection will be cost-effective, the commissioner shall consider | | all factors that diminish potential recovery by the department, | | including but not limited to questions of liability and comparative | | negligence or other legal defenses, exigencies of trial that reduce | | a settlement or award in order to resolve the recipient's claim and | | limits on the amount of applicable insurance coverage that reduce | | the claim to the amount recoverable by the recipient. The | | department's statutory lien may not be reduced to reflect an | | assessment of a pro rata share of the recipient's attorney's fees | | or litigation costs. The commissioner may compromise, or settle | | and execute a release of, any claim or waive any claim, in whole or | | in part, if the commissioner determines the collection will not be | | cost-effective or that the best possible outcome requires | | compromise, release or settlement. |
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| | | Sec. 95. 22 MRSA §14, sub-§2-A, as amended by PL 1991, c. 9, Pt. N, | | §2, is further amended to read: |
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| | | 2-A. Assignment of rights of recovery. The receipt of | | benefits under the Medicaid program administered by the | | department pursuant to the United States Social Security Act, | Title XIX, or under the Maine Health Program, section 3189, | | constitutes an assignment by the recipient or any legally liable | | relative to the department of the right to recover from 3rd | | parties for the medical cost of injury, disease, disability or | | similar occurrence for which the recipient receives medical | | benefits. The department's assigned right to recover is limited | | to the amount of medical benefits received by the recipient and | | does not operate as a waiver by the recipient of any other right | | of recovery against a 3rd party that a recipient may have. |
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| | | The recipient is also deemed to have appointed the commissioner | | as the recipient's attorney in fact to perform the specific act | | of submitting claims to insurance carriers or endorsing over to | | the department any and all drafts, checks, money orders or any | | other negotiable instruments connected with the payment of 3rd- | | party medical claims. |
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| | | Sec. 96. 22 MRSA §14, sub-§§2-B and 2-C, as amended by PL 1991, c. 9, | | Pt. N, §3, are further amended to read: |
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| | | 2-B. Direct reimbursement to health care provider. When an | | insured is eligible under the Medicaid program administered by | | the Department of Human Services, pursuant to the United States | Social Security Act, Title XIX, or under the Maine Health |
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