| 1. Recovery procedures. When benefits are provided or will |
be provided to a beneficiary member under the Medicaid MaineCare |
| program administered by the department pursuant to the United |
States Social Security Act, Title XIX or under the elderly low- |
cost drug program under section 254, including any prescription |
| drug programs administered under the auspices of MaineCare, |
| referred to collectively in this section as MaineCare, for the |
| medical costs of injury, disease, disability or similar |
| occurrence for which a 3rd party is, or may be, liable, the |
commissioner may recover from that party the reasonable value |
| cost of the benefits provided. This right of recovery is |
| separate and independent from any rights or causes of action |
belonging to a beneficiary member under the Medicaid MaineCare |
program or under the elderly low-cost drug program under section |
254. For Medicaid MaineCare recipients who participated in the |
Medicaid MaineCare managed care program, "reasonable value cost" |
| means the total value of coverable medical services provided |
measured by the amount that Medicaid MaineCare would have paid to |
| providers directly for such services, were it not for the managed |
care system. The Medicaid MaineCare program and the elderly low- |
cost drug program under section 254 are is the payors payor of |
| last resort and shall provide medical coverage only when there |
| are no other available resources. The Attorney General, or |
| counsel appointed by the Attorney General, may, to enforce this |
| right, institute and prosecute legal proceedings directly against |
| the 3rd party in the appropriate court in the name of the |
| commissioner. |