64C-3.002. Recovery of Third Party Payments

(1) Except as otherwise provided in subsection (2), below, the Department shall recover in full on its rights under Sections 391.047 and 402.24, F.S., and this rule, for payment for funded services and medical services.

(2) Where undue financial hardship would result to the individual who received funded services or medical services as a result of the Department recovering in full on its rights under subsection (1), above, a request may be made to the Department to accept less than full recovery in satisfaction of its rights thereunder. Such request must be based upon the following factors:

(a) The amount of relevant judgments, settlements, or awards;

(b) The lien amount of funded services and medical services;

(c) The nature of funded services and medical services;

(d) Employment status of the individual;

(e) Cost to the individual of living independently, if applicable;

(f) The amount paid or to be paid to satisfy other valid liens for medical or rehabilitation services provided to such individual;

(g) The amount by which such other lienors have reduced their liens;

(h) The amount of attorney’s fees and costs to generate the relevant judgments, settlements, or awards;

(i) The amount by which the attorney’s reduced their fees or absorbed their costs; and,

(j) Other sources of income available to the individual.

(3) The Department’s rights under Sections 391.047 and 402.24, F.S., and this rule are continuing in nature and survive beyond the date of any judgment, settlement, or award, or court approval thereof. Judgments, settlements, or award amounts funded in whole or in part from claims bills or other acts of local, state, federal or foreign established under 42 U.S.C. Section 1396p(d)(4), for the benefit of recipients of funded services or medical services, remain subject to the Department’s rights under Sections 391.047 and 402.24, F.S., and this rule.

Rulemaking Authority 402.24(2)(h) FS. Law Implemented 391.026(9), 402.24 FS. History–New 3-11-87, Amended 6-22-94, 3-28-96, Formerly 10J-3.007, Amended 1-20-03, 2-18-14.