Casualty recovery's function is to identify and recover money paid on behalf of a Medicaid member for services resulting from any accident or incident for which a third party is liable.
These situations include vehicular accidents, injuries caused by defective products (product liability), job-related injuries and medical malpractice. All of these are referred to as casualty or tort cases.
The South Carolina Department of Health and Human Services (SCDHHS) must recover money from out-of-court settlements or court awards that include compensation for medical expenses, since a third party is liable for the medical care provided to beneficiaries due to the cause of action.
Both Fee-for-Service Medicaid and Managed Care Plans are required to pursue casualty recoveries, just as they are required to pursue other types of third-party liability (TPL).
Attorneys should contact the member's plan directly for information about a casualty case.
Contact
SCDHHS
Casualty Department
Post Office Box 100127
Columbia, SC 29202
(803) 898-2977
(803) 462-2579 (fax)
| SCDHHS Managed Care Plans | Casualty |
|---|---|
| Absolute Total Care | Rawlings (888) 285-1276 (502) 440-1100 (fax) Attention: Manual File Coordinator |
| Healthy Blue | Optum 9390 Bunsen PKWY Louisville, KY 40220 (502) 338-8728 (248) 443-4804 (fax) |
| Humana | Humana 500 West Main Street Louisville, KY 40202 (866) 444-1771 (920) 632-5221 (fax) |
| Molina | Optum Toll-Free Phone Number: (866) 569-4685 Fax Number: (877) 200-0207 |
| Select Health | Claritev 535 East Diehl Road Suite 100 Naperville, IL 60563 (866) 223-9974 (630) 799-3046 (fax) |