Okla. Stat. tit. 63, § 63-5051.1

expenses of injured and diseased persons - Liens or other legal

action.

A. 1. The payment of medical expenses by the Oklahoma Health

Care Authority for or on behalf of or the receipt of medical

assistance by a person who has been injured, passed away, or who has

suffered a disease as a result of the negligence or act of another

person creates a debt to the Authority, subject to recovery by legal

action pursuant to this section. Damages for medical costs are

considered a priority over all other damages and shall be paid by

the tortfeasor prior to all other damages being allocated or paid.

2. The payment of medical expenses by the Authority for or on

behalf of a person who has been injured or who has suffered a

disease, and either has a claim or may have a claim against an

insurer, to the extent recoverable, creates a debt to the Authority

whether or not such person asserts or maintains a claim against an

insurer:

a. such claim or possible claim cannot be assigned by the

person receiving medical care to any provider, and

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b. no provider may require assignment of subrogation

rights against any possible liable third party as a

condition for providing medical care.

B. The Authority shall provide notice to all recipients of

medical assistance at the time of application for such assistance of

their obligation to report any claim or action, and any judgment,

settlement or compromise arising from the claim or action, for

injury or illness for which the Authority makes payments for medical

assistance.

C. The recipient of medical assistance from the Authority for

an injury or disease who asserts a claim or maintains an action

against another on account of the injury or disease, or the

recipient's legal representative, shall notify the Authority of the

claim or action and of any judgment, settlement or compromise

arising from the claim or action prior to the final judgment,

settlement or compromise.

D. If the injured or diseased person asserts or maintains a

claim against another person or tortfeasor on account of the injury

or disease, the Authority:

1. Shall have a lien upon payment of the medical assistance to

the extent of the total amount so paid upon that part going or

belonging to the injured or diseased person of any recovery or sum

had or collected or to be collected by the injured or diseased

person up to the amount of the damages for the total medical

expenses, or by the heirs, personal representative or next of kin in

case of the death of the person, whether by judgment or by

settlement or compromise. The lien authorized by this subsection

shall:

a. have priority over all other liens except any lien by

CMS/Medicare and be inferior only to a lien or claim

of the attorney or attorneys handling the claim on

behalf of the injured or diseased person, the heirs or

personal representative,

b. not be applied or considered valid against any

temporary or permanent disability award of the

claimant due under the Workers' Compensation Act,

c. be applied and considered valid as against any insurer

adjudged responsible for medical expenses under the

Workers' Compensation Act, and

d. be applied and considered valid as to the entire

settlement, after the claim of the attorney or

attorneys for fees and costs, unless a more limited

allocation of damages to medical expenses is shown by

clear and convincing evidence;

2. A lien reduction pursuant to Section 994.2 of Title 12 of

the Oklahoma Statutes may be negotiated further by the Authority

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provided that the injured person, the personal representative, or

attorney has made a good-faith effort to negotiate a reduction;

3. May take any other legal action necessary to recover the

amount so paid or to be paid to the injured or diseased person or to
12 of

the Oklahoma Statutes may be negotiated further by the Authority

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provided that the injured person, the personal representative, or

attorney has made a good-faith effort to negotiate a reduction;

3. May take any other legal action necessary to recover the

amount so paid or to be paid to the injured or diseased person or to

the heirs, personal representative or next of kin in case of the

death of the person; and

4. Shall have the right to file a written notice of its lien in

any action commenced by the injured or diseased person.

E. The Authority, to secure and enforce the right of recovery

or reimbursement on behalf of the injured or diseased person, may

initiate and prosecute any action or proceeding against any other

person or tortfeasor who may be liable to the injured or diseased

person, if the injured or diseased person has not initiated any

legal proceedings against the other person or tortfeasor.

F. Any person or insurer that has been notified by the

Authority of a claim of lien authorized by this section and who,

directly or indirectly, pays to the recipient any money as a

settlement or compromise of the recipient's claim arising out of the

injury shall be liable to the Authority for the money value of the

medical assistance rendered by the Authority in an amount not in

excess of the amount to which the recipient was entitled to recover

from the tortfeasor or insurer because of the injury.

G. A Medicaid special needs trust for the purposes of

establishing or maintaining Medicaid eligibility shall not be

approved until such time as the Authority has been made whole and

paid in full for all paid medical claims which are associated with

the action.

H. A Medicaid recipient must notify the Authority prior to a

compromise or settlement against a third party in which the

Authority has provided or has become obligated to provide medical

assistance.

I. As used in this section:

1. "Medical expenses" includes the cost of hospital, medical,

surgical and dental services, care and treatment, rehabilitation,

and prostheses and medical appliances, and nursing and funeral

services;

2. "Person" includes, in addition to an individual, the

guardian of an individual, and the administrator or executor of the

estate of an individual, and a corporation; and

3. "Insurer" means any insurance company that administers

accident and health policies or plans or that administers any other

type insurance policy containing medical provisions, and any

nonprofit hospital service and indemnity and medical service and

indemnity corporation, actually engaged in business in the state,

regardless of where the insurance contract is written, or plan is

administered or where such corporation is incorporated.

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