reglab/housing_qa huggingface dataset:
NC Gen Stat § 108A-62 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-62 - Therapeutic leave for medical assistance patients.

 108A-62. Therapeutic leave for medical assistance patients.(a) A medical assistance beneficiary at an intermediate care facility or skilled nursing facility may take therapeutic leave in accordance with this section without the facility losing reimbursement under the medical assistance program.(b) The maximum amount of therapeutic leave days that may be taken in a calendar year by a medical assistance beneficiary are as follows:(1) Ninety days for a beneficiary in an intermediate care facility.(2) Sixty days for a beneficiary in a skilled nursing facility.(c) No more than 15 consecutive days of therapeutic leave may be taken by a medical assistance beneficiary without the approval of one of the following:(1) The Division of Health Benefits of the Department.(2) The local management entity/managed care organization with which the beneficiary is enrolled under Chapter 122C of the General Statutes.(3) The prepaid health plan with which the beneficiary is enrolled under Chapter 108D of the General Statutes.  (1979, c. 925; 1981, c. 275, s. 1; 1985 (Reg. Sess., 1986), c. 1014, s. 120; 1991, c. 126, s. 1; 1997-443, s. 11A.118(a); 2019-81, s. 15(a); 2021-62, s. 3.1(a).)
NC Gen Stat § 108A-63.1 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-63.1 - Health care fraud subpoena to produce documents.

 108A-63.1. Health care fraud subpoena to produce documents.(a) The Attorney General, acting through the Medicaid Investigations Unit of the Department of Justice, may, when engaged in an investigation of an alleged violation of G.S. 108A-63 and prior to the arrest of a suspect, issue in writing and cause to be served a subpoena to produce documents upon any corporation or governmental entity requiring the production of any records, books, papers, electronic media, objects, or other documents which may be relevant to a criminal investigation of a violation of G.S. 108A-63.(b) A subpoena under this section may require the custodian of records of the corporation or governmental entity to produce an affidavit certifying that the custodian made a thorough and diligent search for the documents requested and that the documents produced constitute all the records requested to the best of the custodian's knowledge, information, and belief.(c) A subpoena under this section shall describe the documents required to be produced and prescribe a return date within a reasonable period of time, of no less than 20 days from the date of service, within which the documents can be assembled and made available.(d) A corporation or governmental entity may comply with a subpoena issued under this section by delivering the documents to the Medicaid Investigations Unit by any of the following methods:(1) By hand delivery.(2) By mailing the documents by certified mail.(3) By making the documents reasonably available for transfer to an agent of the Medicaid Investigations Unit at a place of business of the corporation or governmental entity.(4) If agreed to by the Medicaid Investigations Unit and the corporation or governmental entity, by any other means.(e) A corporation or governmental entity may move to quash or modify a subpoena issued under this section if it is oppressive or unreasonable or does not comply with the requirements of this section. The motion must be made before the time specified in the subpoena for production and may be made before a judge of the superior court.(f) In the case of failure by any corporation or governmental entity without adequate excuse to obey a subpoena issued under this section, the Attorney General may invoke the aid of a judge of the superior court. The court may issue an order requiring the subpoenaed corporation or governmental entity to appear before the Attorney General to produce records. Failure to obey the order of the court may be punished as contempt of court.  (2009-554, s. 2.)
NC Gen Stat § 108A-64 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-64 - Medical assistance recipient fraud.

 108A-64. Medical assistance recipient fraud.(a) It shall be unlawful for any person to knowingly and willfully and with intent to defraud make or cause to be made a false statement or representation of a material fact in an application for assistance under this Part, or intended for use in determining entitlement to such assistance.(b) It shall be unlawful for any applicant, recipient or person acting on behalf of such applicant or recipient to knowingly and willfully and with intent to defraud, conceal or fail to disclose any condition, fact or event affecting such applicant's or recipient's initial or continued entitlement to receive assistance under this Part.(b1) It is unlawful for any person knowingly, willingly, and with intent to defraud, to obtain or attempt to obtain, or to assist, aid, or abet another person, either directly or indirectly, to obtain money, services, or any other thing of value to which the person is not entitled as a recipient under this Part, or otherwise to deliberately misuse a Medicaid identification card. This misuse includes the sale, alteration, or lending of the Medicaid identification card to others for services and the use of the card by someone other than the recipient to receive or attempt to receive Medicaid program coverage for services rendered to that individual.Proof of intent to defraud does not require proof of intent to defraud any particular person.(c) (1) A person who violates a provision of this section shall be guilty of a Class I felony if the value of the assistance wrongfully obtained is more than four hundred dollars ($400.00).(2) A person who violates a provision of this section shall be guilty of a Class 1 misdemeanor if the value of the assistance wrongfully obtained is four hundred dollars ($400.00) or less.(d) For purposes of this section the word "person" includes any natural person, association, consortium, corporation, body politic, partnership, or other group, entity or organization. (1981, c. 275, s. 1; 1993, c. 539, s. 817; 1994, Ex. Sess., c. 24, s. 14(c); 1995, c. 317, s. 1.)
NC Gen Stat § 108A-64.1 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-64.1 - Incentives to counties to recover fraudulent Medicaid expenditures.

 108A-64.1. Incentives to counties to recover fraudulent Medicaid expenditures.The Department of Health and Human Services, Division of Health Benefits, shall provide incentives to counties that successfully recover fraudulently spent Medicaid funds by sharing State savings with counties responsible for the recovery of the fraudulently spent funds.  (2013-360, s. 12H.5; 2019-81, s. 15(a).)
NC Gen Stat § 108A-67 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-67 - Medicare/Qualified Disabled Working Individuals.

 108A-67. Medicare/Qualified Disabled Working Individuals.Qualified disabled working individuals are eligible for the payment of the Medicare Part A premium. An individual is qualified for this payment:(1) If the Social Security Administration determines the individual to be a "Disabled Working Individual";(2) If the individual's income is less than two hundred percent (200%) of the current federal poverty level, as revised annually; and(3) If the individual is less than 65 years of age. (1991, c. 127.)
NC Gen Stat § 108A-68 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-68 - Drug Use Review Program; rules.

 108A-68. Drug Use Review Program; rules.Notwithstanding the provisions of Chapter 90 of the General Statutes or of any other provision of law, the Division of Health Benefits, Department of Health and Human Services, shall adopt rules implementing the drug use review provisions of the Omnibus Budget Reconciliation Act of 1990, as amended.  (1991 (Reg. Sess., 1992), c. 900, s. 128; 1997-443, s. 11A.118(a); 2019-81, s. 15(a).)
NC Gen Stat § 108A-68.1 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-68.1 - Certain prescription drugs exempt from prior authorization requirements.

 108A-68.1. Certain prescription drugs exempt from prior authorization requirements.Prior authorization shall not be required or utilized for any antihemophilic factor drugs prescribed for the treatment of hemophilia and blood disorders where there is no generically equivalent drug available. Nothing in this section shall prohibit the Secretary from implementing a disease management program. (2003-179, s. 1; 2005-83, s. 1; 2009-210, s. 1.)
NC Gen Stat § 108A-69 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-69 - Employer obligations.

 108A-69. Employer obligations.(a) As used in this section and in G.S. 108A-70:(1) "Health benefit plan" means an accident and health insurance policy or certificate; a nonprofit hospital or medical service corporation contract; a health maintenance organization subscriber contract; a plan provided by a multiple employer welfare arrangement; the State Health Plan for Teachers and State Employees under Chapter 135 of the General Statutes; or a plan provided by another benefit arrangement. "Health benefit plan" does not mean a Medicare supplement policy as defined in G.S. 58-54-1(5).(2) "Health insurer" means any health insurance company subject to Articles 1 through 63 of Chapter 58 of the General Statutes, including a multiple employee welfare arrangement, and any corporation subject to Articles 65 and 67 of Chapter 58 of the General Statutes; a group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974; and the State Health Plan for Teachers and State Employees under Chapter 135 of the General Statutes.(b) If a parent is required by a court or administrative order to provide health benefit plan coverage for a child, and the parent is eligible for family health benefit plan coverage through an employer, the employer:(1) Must allow the parent to enroll, under family coverage, the child if the child would be otherwise eligible for coverage without regard to any enrollment season restrictions.(2) Must enroll the child under family coverage upon application of the child's other parent or upon receipt of notice from the Department of Health and Human Services in connection with its administration of the Medical Assistance or Child Support Enforcement Program if the parent is enrolled but fails to make application to obtain coverage for the child.(3) May not disenroll or eliminate coverage of the child unless:a. The employer is provided satisfactory written evidence that:1. The court or administrative order is no longer in effect; or2. The child is or will be enrolled in comparable health benefit plan coverage that will take effect not later than the effective date of disenrollment; orb. The employer has eliminated family health benefit plan coverage for all of its employees.(4) Must withhold from the employee's compensation the employee's share, if any, of premiums for health benefit plan coverage, not to exceed the maximum amount permitted to be withheld under section 303(b) of the federal Consumer Credit Protection Act, as amended; and must pay this amount to the health insurer; subject to regulations, if any, adopted by the Secretary of the U.S. Department of Health and Human Services. (1993 (Reg. Sess., 1994), c. 644, s. 3; 1995, c. 193, s. 44; 1997-433, s. 3.2; 1997-443, s. 11A.118(a); 1998-17, s. 1; 1999-293, s. 8; 2007-323, s. 28.22A(o); 2007-345, s. 12.)
NC Gen Stat § 108A-70 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70 - Recoupment of amounts spent on medical care.

 108A-70. Recoupment of amounts spent on medical care.(a) To the extent necessary to reimburse the Department or a PHP for expenditures for costs under this Part, and provided that claims for current and past due child support shall take priority over claims for those expenditures, the Department may garnish the wages, salary, or other employment income of, and the Secretary of Revenue shall withhold amounts from State tax refunds to, any person who meets all of the following criteria:(1) Is required by court or administrative order to provide health benefit plan coverage for the cost of health care services to a child eligible for medical assistance under Medicaid.(2) Has received payment from a third party for the costs of such services.(3) Has not used such payments to reimburse, as appropriate, either the other parent or guardian of the child or the provider of the services.(b) To the extent that payment for covered services has been made under G.S. 108A-55 for health care items or services furnished to an individual, in any case where a third party has a legal liability to make payments, the Department of Health and Human Services is considered to have acquired the rights of the individual to payment by any other party for those health care items or services.  (1993 (Reg. Sess., 1994), c. 644, s. 3; 1997-443, s. 11A.118(a); 2019-81, s. 5.)
NC Gen Stat § 108A-70.9C (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.9C - Informal review permitted.

 108A-70.9C. Informal review permitted.Nothing in this Part shall prevent the Department from engaging in an informal review of a contested Medicaid case with a recipient prior to issuing a notice of adverse determination under G.S. 108A-70.9A(c) or a notice of resolution under G.S. 108D-5.7.  (2010-31, s. 10.30(a); 2019-81, s. 6.)
NC Gen Stat § 108A-70.10 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.10 - Short title.

 108A-70.10. Short title.This Part may be cited as the Medical Assistance Provider False Claims Act. (1997-338, s. 1.)
NC Gen Stat § 108A-70.11 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.11 - Definitions.

 108A-70.11. Definitions.Definitions. - As used in this Part:(1) "Attorney General" means the Attorney General or any Deputy, Assistant, or Associate Attorney General.(2) "Claim" means an application for payment or approval or for use in determining entitlement to payment presented to the Medical Assistance Program in any form, including written, electronic, or magnetic, which identifies a service, good, or accommodation as reimbursable under the Medical Assistance Program.(3) "Damages" means the difference between what the Medical Assistance Program paid a provider and the amount it would have paid the provider in the absence of a violation of this section and may be established by statistical sampling methods.(4) "Knowingly" means that a provider, with respect to the information:a. Has actual knowledge of the information;b. Acts in deliberate ignorance of the truth or falsity of the information; orc. Acts in reckless disregard of the truth or falsity of the information. No proof of specific intent to defraud is required.(5) "Medical Assistance Program" means the Division of Health Benefits and its fiscal agent.  (1997-338, s. 1; 2019-81, s. 15(a).)
NC Gen Stat § 108A-70.15 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.15 - Employee remedies.

 108A-70.15. Employee remedies.(a) In the absence of fraud or malice, no person who furnishes information to officials of the State responsible for investigating false claims violations shall be liable for damages in a civil action for any oral or written statement made or any other action that is necessary to supply information required pursuant to this Part.(b) Any employee of a provider who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment by the employee's employer because of lawful acts done by the employee on behalf of the employee or others in furtherance of an action under G.S. 108A-70.12, including investigation for, initiation of, testimony for, or assistance in an action filed or to be filed under G.S. 108A-70.12, shall be entitled to all relief necessary to make the employee whole. Relief shall include reinstatement with the same seniority status as the employee would have had but for the discrimination, two times the amount of back pay, interest on the back pay, and compensation for any special damages sustained as a result of the discrimination, including litigation costs and reasonable attorneys' fees. An employee may bring an action in the appropriate court for the relief provided in this section. (1997-338, s. 1.)
NC Gen Stat § 108A-70.16 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.16 - Uniformity of interpretation.

 108A-70.16. Uniformity of interpretation.This Part shall be so interpreted and construed as to be consistent with the federal False Claims Act, 31 U.S.C. 3729, et seq., and any subsequent amendments to that act. (1997-338, s. 1.)
NC Gen Stat § 108A-70.18 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.18 - Definitions.

 108A-70.18. Definitions.As used in this Part, unless the context clearly requires otherwise, the term:(1) "Comprehensive health coverage" means creditable health coverage as defined under Title XXI.(2) "Family income" has the same meaning as used in determining eligibility for the Medical Assistance Program.(3) "FPL" or "federal poverty level" means the federal poverty guidelines established by the United States Department of Health and Human Services, as revised each April 1.(4) "Medical Assistance Program" means the State Medical Assistance Program established under Part 6 of Article 2 of Chapter 108A of the General Statutes.(4a) Repealed by Session Laws 2015-96, s. 1, effective June 19, 2015.(5) "Program" means The Health Insurance Program for Children established in this Part.(6) "State Plan" means the State Child Health Plan for the State Children's Health Insurance Program established under Title XXI.(7) "Title XXI" means Title XXI of the Social Security Act, as added by Pub. L. 105-33, 111 Stat. 552, codified in scattered sections of 42 U.S.C.(8) "Uninsured" means the applicant for Program benefits is not covered under any private or employer-sponsored comprehensive health insurance plan on the date of enrollment.  (1998-1, s. 1; 1998-166, s. 6; 2000-67, s. 11.8(a); 2000-140, s. 90(d); 2001-424, s. 21.22(b); 2008-107, s. 10.13(d); 2015-96, s. 1.)
NC Gen Stat § 108A-70.19 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.19 - Short title; purpose; no entitlement.

 108A-70.19. Short title; purpose; no entitlement.This Part may be cited as "The Health Insurance Program for Children Act of 1998." The purpose of this Part is to provide comprehensive health insurance coverage to uninsured low-income children who are residents of this State. Coverage shall be provided from federal funds received, State funds appropriated, and other nonappropriated funds made available for this purpose. Nothing in this Part shall be construed as obligating the General Assembly to appropriate funds for the Program or as entitling any person to coverage under the Program. (1998-1, s. 1.)
NC Gen Stat § 108A-70.20 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.20 - Program established.

 108A-70.20. Program established.The Health Insurance Program for Children is established. The Program shall be known as North Carolina Health Choice for Children, and it shall be administered by the Department of Health and Human Services in accordance with this Part and as required under Title XXI and related federal rules and regulations. Administration of claims processing shall be as described in 42 C.F.R. 447.45(d)(1).  (1998-1, s. 1; 2008-107, s. 10.13(e); 2015-96, s. 2.)
NC Gen Stat § 108A-70.25 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.25 - State Plan for Health Insurance Program for Children.

 108A-70.25. State Plan for Health Insurance Program for Children.(a) The NC Health Choice program shall be administered and operated in accordance with this Part and the NC Health Choice State Plan, as periodically amended by the Department of Health and Human Services and approved by the federal government.(b) The requirements in G.S. 108A-54.1A shall apply to NC Health Choice State Plan amendments in the same manner in which they apply to Medicaid State Plan amendments.  (1998-1, s. 1; 2011-291, s. 2.23; 2013-360, s. 12H.2(b).)
NC Gen Stat § 108A-70.26 (2021)
2021 North Carolina General Statutes|Chapter 108A - Social Services|Article 2 - Programs of Public Assistance.|§ 108A-70.26 - Application process; outreach efforts; appeals.

 108A-70.26. Application process; outreach efforts; appeals.(a) Application. - The Department shall use an application form for the Program that is concise, relatively easy for the applicant to comprehend and complete, and only as lengthy as necessary for identifying applicants, determining eligibility for the Program or Medicaid, and providing information to applicants on requirements for application submission and proof of eligibility. Application forms shall be obtainable from public health departments and county departments of social services. Applications shall be processed by the county department of social services and may be submitted by mail. The Department may adopt rules for the submission and processing of applications and for securing the proof of eligibility for benefits under this Part.The application form for the Program shall have printed on it or attached to it a notice stating substantially: "The Health Insurance Program for Children is a federally and State funded program that may be discontinued if federal funds are not provided for its continuation."(b) Outreach Efforts. - The Department shall adopt procedures to ensure that the Program is adequately publicized statewide and to comply with federal outreach requirements. The Department shall make information about the Program available through the Internet and shall explore the feasibility of securing a 24-hour toll-free telephone number to facilitate access to Program information. In order to avoid duplication of efforts, in developing outreach procedures the Department shall establish system linkages to ensure the collaboration and coordination of information between and among the Program and such ongoing programs and efforts as: WIC Program. Maternal and Child Health Block Grant. Children's Special Health Services. Smart Start. Head Start.The Department shall seek private and federal grant funds for outreach activities. The Department shall also seek the participation of the private sector in providing no-cost or low-cost avenues for publicizing the Program in local communities and statewide. The Department may work with the State Health Plan Purchasing Alliance Board to develop programs that utilize the expertise and resources of the Alliances in outreach activities to employees of small businesses.  (c) Appeals. - A person who is dissatisfied with the action of a county department of social services with respect to the determination of eligibility for benefits under the Program may appeal the action in accordance with G.S. 108A-79. (1998-1, s. 1.)