Third Party Liability

The Third Party Liability unit is comprised of seven programs that are responsible for ensuring Medicaid is the payer of last resort through recovery and cost avoidance efforts. DPHHS is required by federal law to take all reasonable measures to ascertain the legal liability of “third parties” for payment of health care items and services provided to Medicaid recipients.  “Third parties” include but are not limited to: health insurance carriers, self-insured plans, pharmacy benefit managers and other legally responsible parties, such as the recipient’s estate, workers’ compensation, auto insurance, and liability insurance plans.

  • Benefit Over-Issuance: Establishment of repayment agreements for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Needy Families (TANF) and Medicaid benefits improperly paid on an individual’s behalf. Processing of Hardship Compromise applications for Supplemental Nutrition Assistance Program (SNAP) overpayments caused by agency or client error.
  • Coordination of Health Care Benefits: Oversees the coordination of benefits between a Medicaid and a Medicaid recipient’s other health care insurance policies.
  • Estate Recovery: Sections 53-6-167 through 169 and 178 through 188 , MCA, require the TPL program to recover Medicaid payments made on behalf of certain Medicaid recipients after the recipient’s death.
  • Lien Recovery: Sections 53-6-170 through 177, MCA, require the TPL program to place a lien on real property belonging to certain Medicaid recipients to recover Medicaid payments made on the recipient’s behalf.
  • Medicare Buy-in: Federal law stipulates that DPHHS use Medicaid funds to pay certain Medicare premiums for Medicaid recipients participating in the Medicare Savings Program (MSP).
  • Tort Recovery: Medicaid recipients injured through the acts or omissions of another party may sue the liable party for damages. Section 53-2-612, MCA, grants DPHHS a lien on any third party payment, settlement, or reward received by a Medicaid recipient, to reimburse the Department for medical expenses paid by Medicaid.


To contact the Third Party Liability Programs

Benefit Over-Issuance
(406) 444-9440, option 2

Coordination of Health Care Benefits Contractor

Estate Recovery Program
(406) 444-9440, option 1 

Health Insurance Premium Payment Program
(406) 444-9440, option 2

Lien Recovery Program
(406) 444-9440, option 3

Medicare Buy-in Program
(406) 444-9440, option 3 

Tort Recovery Contact 
(406) 444-9440

Option 4- Attorneys with issues on existing case
Option 5- To notify Medicaid of legal representation or determine Medicaid's interest in a casualty insurance claim
Option 6- Attorneys needing information on open case,
Option 7- Insurance companies or Medicaid recipients needing information


Third Party Liability Supervisor
Olivia Roussan
(406) 444-6004