Glossary for Medicaid Recovery
Bureau of Medical Collections (BMC)
An ORS program that collects medical reimbursement from responsible third parties to reimburse the government for the cost of Medicaid and avoid unnecessary costs to the program.
Employer-sponsored Health Insurance (ESI)
A health policy selected and purchased by your employer and offered to eligible employees and their dependents. The employer often splits the cost of the premiums with you.
Estate Recovery (also called Probate)
The process that, in some circumstances, allows the State of Utah to recover funds from a Medicaid recipient’s estate or a trust.
In the context of Medicaid recovery, the requirement to seek reimbursement for paid Medicaid claims from third parties that should rightfully pay them. The third parties in these cases are often employer-sponsored health insurance companies.
A legal right or claim against property to secure payment of an obligation
Personal Injury (Tort)
In the context of Medicaid recovery, the requirement to seek reimbursement from potentially liable third parties for Medicaid claims related to trauma. The third parties in these cases are usually the person or entities that caused the trauma.
Personal Injury Lien (also called Tort Lien)
A lien that covers all or part of the proceeds of a settlement in a personal injury case. The lien is intended to cover the cost of Medicaid made to treat the trauma.
A resolution reached between parties either before or after court action begins.
TEFRA Lien (Tax Equity and Fiscal Responsibility Act of 1982 Lien)
A lien on the property of a Medicaid recipient. Normally placed before the recipient’s death, the lien is intended to cover the cost of Medicaid claims paid for the recipient’s care.
Third-Party Liability (TPL)
Individuals or entities that have financial liability for a Medicaid recipient’s medical costs.