OAR 461-195-0310
Notice of Claim or Action by Applicant or Recipient
(1)
An applicant (see OAR 461-195-0301 (Definitions)) for or recipient (see OAR 461-195-0301 (Definitions)) of assistance (see OAR 461-195-0301 (Definitions)) who has a claim (see OAR 461-195-0301 (Definitions)) for a personal injury (see OAR 461-195-0301 (Definitions)) or begins an action (see OAR 461-195-0301 (Definitions)) to enforce such claim — or the attorney, personal representative (see OAR 407-014-0000 (Definitions)), or authorized representative (see OAR 410-200-0015 (General Definitions) and 461-115-0090 (Authorized Representatives; General)) for the applicant or recipient — must notify the Department (see OAR 461-195-0301 (Definitions)) and the CCO (see OAR 461-195-0301 (Definitions)) of the recipient, if the recipient is receiving services from the CCO, within ten days of initiating that claim or action, unless the action was initiated prior to the application for assistance.(a)
If the action was initiated prior to the application for assistance, the applicant must notify the Department at the time of application.(b)
The notification must include:(A)
The names and addresses of all parties against whom the action is brought or claim is made;(B)
A copy of each claim demand; and(C)
If an action is brought, the case number and the county where the action is filed.(c)
A parent, guardian, foster parent, caretaker relative, attorney, personal representative, or authorized representative must make the notification on behalf of an individual under the age of 18 or an incompetent adult.(2)
Notification required under section (1) of this rule must be sent to the Personal Injury Liens Unit, Office of Payment Accuracy and Recovery, Department of Human Services, by mail or facsimile (see sections (4) and (5) of this rule).(3)
Notices required by ORS 416.530 (Notice of claim to department, authority or coordinated care organization) to be sent to the Oregon Health Authority (Authority) may be consolidated with similar notices to the Department and sent to the Personal Injury Liens Unit. A consolidated notice is considered notice to the Authority if the Authority’s interest or claim in the matter is identified in the notice consistent with requirements in the applicable statute. (See also OAR 943-001-0020 (Oregon Health Authority Shared Service and Cooperative Relationships with Department of Human Services)(2)(e).)(4)
The mailing address for the Personal Injury Liens Unit is: Personal Injury Liens Unit, PO Box 14512, Salem OR 97309-0416.(5)
The facsimile number for the Personal Injury Liens Unit is (503) 378-2577 and the telephone number is (503) 378-4514.(6)
If an applicant for or recipient of assistance— or the attorney, personal representative, or authorized representative for the applicant or recipient — fails to give the notification as required by this rule, the Department or the CCO of the recipient, if the recipient is receiving services from the CCO, has a cause of action under ORS 416.610 (Action against recipient who fails to provide notice of claim) against the recipient for amounts received by the recipient pursuant to a judgment (see OAR 461-195-0301 (Definitions)), settlement (see OAR 461-195-0301 (Definitions)), or compromise (see OAR 461-195-0301 (Definitions)) to the extent that the Department or the CCO could have had a lien against such amounts had such notice been given. At least 30 days prior to commencing an action under ORS 416.610 (Action against recipient who fails to provide notice of claim), the Personal Injury Liens Unit and the CCO, if any, must consult with each other.
Source:
Rule 461-195-0310 — Notice of Claim or Action by Applicant or Recipient, https://secure.sos.state.or.us/oard/view.action?ruleNumber=461-195-0310.