reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0111 - INPATIENT PSYCHIATRIC HOSPITAL SERVICES (TRANSFERRED TO 10A NCAC 25C .0301)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0112 - REPEALED - PSYCHIATRIC ADMISSION CRITERIA/MEDICAID BENEFICIARIES UNDER AGE 21

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-25(b);
					 108A-54;
					 42 C.F.R.
					 441, Subpart D;
					 42 C.F.R.
					 441.151;
Eff. October 1,
					 1993;
Amended Eff. February 1, 1996;
Repealed Eff. July
					 1, 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0113 - NC MEDICAID CRITERIA FOR CONTINUED ACUTE STAY IN AN INPATIENT PSYCHIATRIC FACILITY (TRANSFERRED TO 10A NCAC 25C .0302)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0114 - NORTH CAROLINA SPECIALTY HOSPITAL SERVICES (TRANSFERRED TO 25M .0201(E))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0115 - CLINIC SERVICES (TRANSFERRED TO 10A NCAC 25P .0402)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0116 - SKILLED NURSING FACILITY (TRANSFERRED TO 10A NCAC 25M .0401(A)-(C))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0117 - ABORTION (TRANSFERRED TO 10A NCAC 25P .0405)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0118 - PHARMACY SERVICES (TRANSFERRED TO 10A NCAC 25K .0201)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0119 - OUT OF STATE SERVICES (TRANSFERRED TO 10A NCAC 25S .0201)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0120 - PERSONAL CARE SERVICES (TRANSFERRED TO 10A NCAC 25O .0202(A)-(B))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0121 - REPEALED - DURABLE MEDICAL EQUIPMENT

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-25(b);
					 42 C.F.R.
					 440.70(b)(3);
Eff. March 1, 1990;
Amended Eff. March 1, 1993;
Recodified from
					 10 NCAC
					 26B .0120 Eff. October 1, 1993;
Recodified from
					 10 NCAC
					 26B .0121 Eff. January 1, 1998;
Repealed Eff. September 1, 2005.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0122 - PRIVATE DUTY NURSING (TRANSFERRED TO 10A NCAC 25O .0204)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0123 - CASE MGMT SVCS/ADULTS/CHILDREN AT-RISK/ABUSE/NEGLECT/EXPOITATION (TRANSFERRED TO 10A NCAC 25F .0201)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0124 - HIV CASE MANAGEMENT (TRANSFERRED TO 10A NCAC 25F .0301)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0100 - GENERAL › Section 22O .0125 - HOME INFUSION THERAPY (TRANSFERRED TO 10A NCAC 25O .0203)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0201 - DEFINITIONS (TRANSFERRED TO 10A NCAC 25H .0201)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0202 - STANDARDS FOR PARTICIPATION (TRANSFERRED TO 10A NCAC 25H .0203)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0203 - ELIGIBILITY (TRANSFERRED TO 10A NCAC 25H .0202)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0204 - AMOUNT: DURATION: AND SCOPE OF SERVICES (TRANSFERRED TO 10A NCAC 25H .0204)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0205 - RESTRICTIONS AND PRIOR APPROVAL (TRANSFERRED TO 10A NCAC 25H .0205)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0206 - GUIDELINES ON SERVICES (TRANSFERRED TO 10A NCAC 25H .0301)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0207 - SPECIFIC GUIDELINES (TRANSFERRED TO 10A NCAC 25H .0302)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0208 - ANESTHESIA (TRANSFERRED TO 10A NCAC 25H .0303)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0209 - ANALGESIA (TRANSFERRED TO 10A NCAC 25H .0304)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0210 - DRUGS (TRANSFERRED TO 10A NCAC 25H .0305)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0200 - DENTAL SERVICES › Section 22O .0211 - PRIOR APPROVAL (TRANSFERRED TO 10A NCAC 25H .0206)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0300 - AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0301 - MEDICAL SERVICES (TRANSFERRED TO 10A NCAC 25A .0201)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0401 - INPATIENT HOSPITAL SERVICES (PARAGRAPHS (A)-(D) TRANSFERRED TO 10A NCAC 25M .0201 AND PARAGRAPH (E) TRANSFERRED TO 10A NCAC 25P .0201))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0402 - OUTPATIENT HOSPITAL SERVICES (TRANSFERRED TO 10A NCAC 25P .0301)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0403 - SKILLED NURSING FACILITY SERVICES (TRANSFERRED TO 10A NCAC 25M .0401(D))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0404 - PHYSICIAN SERVICES (TRANSFERRED TO 10A NCAC 25P .0401)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0405 - PODIATRIST SERVICES (TRANSFERRED TO 10A NCAC 25P .0404)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0406 - HOME HEALTH SERVICES (TRANSFERRED TO 10A NCAC 25O .0201(B)-(E))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0407 - REPEALED - PRESCRIBED DRUGS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-25(b);
					 143B-10; S.L. 1985, c. 479, s.
					 86; 42 C.F.R.
					 440.120;
					 42 C.F.R. 440.230(d)
Eff. February 1, 1976
Amended Eff. October 1, 1977;
Readopted Eff. October 31, 1977
Amended Eff. May 1, 1990; August 1,
					 1983; April 1, 1982;
Repealed Eff. April 1,
					 2010.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0408 - INTERMEDIATE CARE FACILITIES (TRANSFERRED TO 10A NCAC 25D .0201(C)-(J))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0409 - THERAPEUTIC LEAVE (TRANSFERRED TO 10A NCAC 25M .0501)

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter O - MEDICAL ASSISTANCE PROVIDED › Section .0400 - LIMITATION OF AMOUNT, DURATION, AND SCOPE OF ASSISTANCE › Section 22O .0410 - PERSONAL CARE SERVICES (TRANSFERRED TO 10A NCAC 25O .0202(C)-(E))

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0100 - GENERAL INFORMATION › Section 22P .0101 - EXPIRED - PURPOSE AND SCOPE

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0200 - DEFINITIONS › Section 22P .0201 - EXPIRED - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0300 - MEDICAL SERVICE REQUIREMENTS › Section 22P .0301 - EXPIRED - SERVICE DELIVERY

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0300 - MEDICAL SERVICE REQUIREMENTS › Section 22P .0302 - EXPIRED - ACCESS TO CARE

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0300 - MEDICAL SERVICE REQUIREMENTS › Section 22P .0303 - EXPIRED - COORDINATION OF BENEFITS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0401 - EXPIRED - CERTIFICATION REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0402 - EXPIRED - GOOD STANDING

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0403 - EXPIRED - MEDICAL DIRECTOR REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0404 - EXPIRED - CLINICAL DIRECTOR

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0405 - EXPIRED - QUALITY MANAGEMENT DIRECTOR

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0406 - EXPIRED - TRAINING DIRECTOR

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0407 - EXPIRED - EXCEPTION PROCESS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0400 - CERTIFICATION AND STAFFING REQUIREMENTS › Section 22P .0408 - EXPIRED - MEDICAL SCHOOL/ TEACHING HOSPITAL EXCEPTION

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0500 - CERTIFICATION PROCEDURES › Section 22P .0501 - EXPIRED - LETTER OF ATTESTATION AND DESK REVIEW

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0500 - CERTIFICATION PROCEDURES › Section 22P .0502 - EXPIRED - INTERVIEW

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0500 - CERTIFICATION PROCEDURES › Section 22P .0503 - EXPIRED - VERIFICATION REVIEW

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0500 - CERTIFICATION PROCEDURES › Section 22P .0504 - EXPIRED - EXISTING CRITICAL ACCESS BEHAVIORAL HEALTH AGENCIES

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0600 - MONITORING, DECERTIFICATION AND APPEAL PROCEDURES › Section 22P .0601 - EXPIRED - MONITORING

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0600 - MONITORING, DECERTIFICATION AND APPEAL PROCEDURES › Section 22P .0602 - EXPIRED - DECERTIFICATION AND SUSPENSION

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter P › Section .0600 - MONITORING, DECERTIFICATION AND APPEAL PROCEDURES › Section 22P .0603 - EXPIRED - APPEAL PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-54;
					 42 U.S.C.
					 1396a;
					 42 C.F.R. 431.51; S.L. 2009-451,
					 Section 10.58(d);
Temporary Adoption Eff. December 28,
					 2010;
Temporary Adoption Expired October 15,
					 2011.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter Q - DISTRIBUTION OF FEDERAL DISPROPORTIONATE SHARE ADJUSTMENT RECEIPTS ARISING FROM CERTIFIED PUBLIC EXPENDITURES › Section 22Q .0101 - SCOPE

Current through Register Vol. 39, No. 2, July 15, 2024
This Subchapter establishes the requirements for the
				  distribution of federal disproportionate share adjustment receipts as
				  established by 42 CFR
				  447.298 arising from certified public
				  expenditures.
Authority
				  G.S.
				  108A-54;
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter Q - DISTRIBUTION OF FEDERAL DISPROPORTIONATE SHARE ADJUSTMENT RECEIPTS ARISING FROM CERTIFIED PUBLIC EXPENDITURES › Section 22Q .0102 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) "Certifying
				Hospital" means an institution that meets all of the following criteria:
(1) meets the definition in
				G.S.
				131E-176(13);
(2) is licensed by the State of North
				Carolina; and
(3) certifies as a
				public agency that its expenditures are eligible for Federal Financial
				Participation in accordance with
				42 CFR
				433.51(b), which is
				incorporated by reference, including subsequent amendments and editions. This
				document may be accessed at
https://www.ecfr.gov
at no charge.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter Q - DISTRIBUTION OF FEDERAL DISPROPORTIONATE SHARE ADJUSTMENT RECEIPTS ARISING FROM CERTIFIED PUBLIC EXPENDITURES › Section 22Q .0103 - DISTRIBUTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
After distributions are made pursuant to an act appropriating
				  funds for the operation of the North Carolina Medicaid Program and the "Basic
				  Disproportionate Share Hospital (DSH) Payment" section of the North Carolina
				  Medicaid State Plan, Attachment 4.19-A, which is incorporated by reference,
				  including subsequent amendments and editions, and may be accessed free of
				  charge at https://medicaid.ncdhhs.gov/media/973/download?attachment, the
				  Department shall make distributions of the remaining DSH funds in the following
				  order to:
(1) Certifying hospitals;
				and
(2) The Hospital Uncompensated
				Care Fund.
Authority
				  G.S.
				  108A-54;
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter Q - DISTRIBUTION OF FEDERAL DISPROPORTIONATE SHARE ADJUSTMENT RECEIPTS ARISING FROM CERTIFIED PUBLIC EXPENDITURES › Section 22Q .0104 - CERTIFYING HOSPITAL DISTRIBUTION

Current through Register Vol. 39, No. 2, July 15, 2024
The Department shall distribute available funds to certifying
				  hospitals in two parts:
(1) An amount
				equal to 10 percent of expenditures certified by the hospital pursuant to
				42 CFR
				433.51; and
(2) An amount equal to the hospital's
				proportionate share, calculated pursuant to Rule .0106 of this Section, of the
				available funds based on the hospital's share of outpatient costs for uninsured
				patients as a percentage of the Statewide aggregate of outpatient costs for
				uninsured patients. To be eligible for a proportionate share, a hospital shall
				file with the Department 90 days prior to the date of payment as determined by
				the Department, a form prescribed by the Department attesting to the
				hospital's:
(a) Qualification for
				disproportionate share status under the "Disproportionate Share Hospital (DSH)
				Payment" section of the North Carolina Medicaid State Plan, Attachment
				4.19-A;
(b) Unreimbursed charges
				and payments for outpatient services provided to uninsured patients;
				and
(c) Aggregate Medicaid
				outpatient cost-to-charge ratio.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter Q - DISTRIBUTION OF FEDERAL DISPROPORTIONATE SHARE ADJUSTMENT RECEIPTS ARISING FROM CERTIFIED PUBLIC EXPENDITURES › Section 22Q .0105 - CERTIFYING HOSPITALS' OUTPATIENT COSTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				certifying hospital's outpatient costs for uninsured patients will be
				determined by multiplying the hospital's outpatient cost-to-charge ratio in
				Rule .0104(2)(c) of this Section by the hospital's outpatient charges for
				uninsured patients from Rule .0104(2)(b) of this Section.
(b) From the product calculated in Paragraph
				(a) of this Rule, the Department will then subtract payments that the hospital
				received from uninsured patients for outpatient services in Rule .0104(2)(b) of
				this Section.
(c) The Department
				will bring the uncompensated care cost data forward to the end of the payment
				period by applying the applicable Centers for Medicare and Medicaid Services'
				Prospective Payment System Hospital Input Price Indices, which are incorporated
				by reference, including subsequent amendments and editions and available at no
				cost at
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareProgramRatesStats/MarketBasketData
.
Authority
				  G.S.
				  108A-54;
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter Q - DISTRIBUTION OF FEDERAL DISPROPORTIONATE SHARE ADJUSTMENT RECEIPTS ARISING FROM CERTIFIED PUBLIC EXPENDITURES › Section 22Q .0106 - CERTIFYING HOSPITAL'S PROPORTIONATE SHARE

Current through Register Vol. 39, No. 2, July 15, 2024
The Department shall calculate the certifying hospital's
				  proportionate share of outpatient costs as follows:
(1) Adding the certifying hospitals'
				outpatient costs and each of the eligible hospitals' as defined in
				10A NCAC
				22R .0103, eligible outpatient costs under
				10A NCAC
				22R .0104. The sum represents the total of
				the outpatient costs.
(2) The sum
				of all certifying hospitals' outpatient costs under Rule .0105 of this Section
				shall be divided by the total outpatient costs in Item (1) of this Rule. The
				quotient represents the certifying hospitals' proportionate share, expressed as
				a decimal.
(3) The amount of
				available funds shall be multiplied by the certifying hospitals' proportionate
				share in Item (2) of this Rule. The product represents the funds available for
				distribution to individual certifying hospitals.
(4) A certifying hospital shall be eligible
				for a payment from funds available for distribution in Item (3) of this Rule.
				In each payment period, a certifying hospital shall receive a proportional
				payment of the available funds based on the certifying hospital's share of
				outpatient costs for uninsured patients as a percentage of the aggregate of
				outpatient costs for uninsured patients for certifying hospitals.
(5) Hospitals receiving payments pursuant to
				this Subchapter shall be subject to the audit and reporting requirements of the
				North Carolina Medicaid State Plan, Attachment 4.19-A.
Authority
				  G.S.
				  108A-54;
				  108A-55(c);
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter R - DISTRIBUTION OF HOSPITAL UNCOMPENSATED CARE FUND › Section 22R .0101 - SCOPE

Current through Register Vol. 39, No. 2, July 15, 2024
This Subchapter establishes the requirements for the
				  distribution of funds allocated to the Hospital Uncompensated Care Fund
				  pursuant to
				  G.S.
				  143C-9-9 after distributions of available
				  funds have been made pursuant to
				  10A NCAC
				  22Q.
Authority
				  G.S.
				  108A-54;
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter R - DISTRIBUTION OF HOSPITAL UNCOMPENSATED CARE FUND › Section 22R .0102 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) "Department"
				means the North Carolina Department of Health and Human Services.
(b) "Eligible hospital" means an institution
				that meets the requirements of Rule .0103 of this Section.
(c) "Eligible hospital cost" means the values
				calculated pursuant to Rule .0104 of this Section.
(d) "Hospital Uncompensated Care Fund" means
				the fund established by
				G.S.
				143C-9-9 and governed by
				10A NCAC
				22R.
(e) "Outpatient services" means the medical
				care and items as defined by 42 CFR 440.20(a),
				which is incorporated by reference in
				10A NCAC
				22Q .0102.
(f) "Uninsured patient" means a recipient of
				medical care who has no health insurance, Medicaid or Medicare, or other
				third-party coverage. State and local government payments made to a hospital
				for services provided to indigent patients shall not be considered third-party
				coverage.
(g) "Payment period"
				means the 12-month term ending September 30th of
				each year.
Authority
				  G.S.
				  108A-54;
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter R - DISTRIBUTION OF HOSPITAL UNCOMPENSATED CARE FUND › Section 22R .0103 - ELIGIBLE HOSPITAL

Current through Register Vol. 39, No. 2, July 15, 2024
An institution licensed by the State of North Carolina that
				  meets the definition in
				  G.S.
				  131E-176(13) is eligible for
				  reimbursement from the Hospital Uncompensated Care Fund if it:
(1) is not a public agency qualified to
				certify expenditures in accordance
				42 CFR
				433.51(b), which is
				incorporated by reference in
				10A NCAC
				22Q .0102;
(2) received payment for more than 50 percent
				of their Medicaid inpatient discharges under the North Carolina Medicaid State
				Plan, Attachment 4.19-A discharge Diagnosis Related Groups methodology for the
				most recent payment period;
(3)
				files with the Department 90-days prior to the date of payment under this
				Subchapter forms prescribed by the Department attesting to the hospital's:
(a) qualification for disproportionate share
				status of the "Disproportionate Share Hospital (DSH) Payment" section of the
				North Carolina Medicaid State Plan, Attachment 4.19-A;
(b) unreimbursed charges and payments for
				outpatient services provided to uninsured patients; and
(c) aggregate Medicaid outpatient
				cost-to-charge.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter R - DISTRIBUTION OF HOSPITAL UNCOMPENSATED CARE FUND › Section 22R .0104 - ELIGIBLE OUTPATIENT COSTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An eligible
				hospital's eligible outpatient costs for uninsured patients will be determined
				by multiplying the hospital's outpatient cost-to-charge ratio in Rule
				.0103(3)(c) of this Section by the hospital's outpatient charges for uninsured
				patients from Rule .0103(3)(b) of this Section.
(b) From the product calculated in Paragraph
				(a) of this Rule, the Department will then subtract payments that the hospital
				received from uninsured patients for outpatient services from Rule .0103(3)(b)
				of this Section.
(c) The Department
				will bring the uncompensated care cost data forward to the end of the payment
				period by applying the applicable Centers for Medicare and Medicaid Services'
				Prospective Payment System Hospital Input Price Indices, which are incorporated
				by reference, including subsequent amendments and editions and available at no
				cost at
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareProgramRatesStats/MarketBasketData
.
Authority
				  G.S.
				  108A-54;
				  143C-9-9;
Temporary
				  Adoption Eff. December 29, 2021;
Eff. August 1,
				  2022.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 22 - MEDICAL ASSISTANCE ELIGIBILITY › Subchapter R - DISTRIBUTION OF HOSPITAL UNCOMPENSATED CARE FUND › Section 22R .0105 - DISTRIBUTION OF AVAILABLE FUNDS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An eligible
				hospital satisfying the requirements of Rule .0103 of this Section shall be
				eligible for a payment from funds available under this Subchapter. In a payment
				period, an eligible hospital shall receive a proportional payment of the
				available funds based on the eligible hospital's share of outpatient costs for
				uninsured patients as a percentage of the aggregate of outpatient costs for
				uninsured patients for all eligible hospitals.
(b) Based on the availability of funds,
				payments authorized by this Rule shall be made at least annually on a frequency
				determined by the Department in consultation with certifying
				hospitals.
(c) To confirm the
				hospital's eligibility to receive payments pursuant to this Subchapter and the
				accuracy of the hospital's attestation to unreimbursed charges for outpatient
				services provided to uninsured patients and the hospital's Medicaid outpatient
				cost-to-charge ratios, the Department may audit a hospital receiving more than
				two million dollars ($2,000,000) for compliance with the requirements of this
				Subchapter. Upon completion of the audit, the following shall occur when
				applicable:
(1) If a hospital received
				payments pursuant to Paragraph (a) of this Rule in excess of the percentage
				determined by the audit, the excess payments shall be refunded to the
				Department.
(2) The Department
				shall distribute any refunded amounts to eligible hospitals, excluding eligible
				hospitals from whom excess distributions were recovered pursuant to
				Subparagraph (c)(1) of this Rule, within 12 months of receipt using the
				distribution method set forth Paragraph (a) of this Rule.
(3) No additional payment shall be made to
				eligible hospitals in connection with the audit except for the redistribution
				of amounts refunded after an audit conducted by the Division of Health
				Benefits.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter A - GENERAL PROGRAM ADMINISTRATION › Section .0100 - GENERAL › Section 23A .0101 - EXPIRED - SUPERVISION

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 108A-25(b);
					 108A-54;
Eff.
					 September 1, 1984;
Amended Eff. August 1, 1990; January 1,
					 1986;
Transferred from
					 10A NCAC
					 21A .0101 Eff. May 1, 2012;
Expired Eff. August 1, 2016 pursuant to
					 G.S.
					 150B-21.3A.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter A - GENERAL PROGRAM ADMINISTRATION › Section .0100 - GENERAL › Section 23A .0103 - QUALITY ASSURANCE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) County
				  department of social services eligibility actions on active and negative cases,
				  as defined by 42 C.F.R.
				  431.804, which is incorporated by reference
				  including subsequent amendments and editions, and available free of charge at
https://www.ecfr.gov/
, shall be
				  subject to review under State and federal quality control (QC) procedures by
				  the Division's Office of Compliance and Program Integrity (OCPI). A statistical
				  sample shall be selected from both active and negative case actions.
(b) The purpose of the QC review is to
				  identify client eligibility errors and erroneous payments resulting from:
(1) Ineligibility;
(2) Recipient liability understated or
				  overstated by the client or county;
(3) Third-party liability; and
(4) Claims processing errors.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter A - GENERAL PROGRAM ADMINISTRATION › Section .0100 - GENERAL › Section 23A .0104 - AVAILABILITY OF MANUALS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) One copy of the
				  Medicaid Eligibility Manual and other policy issuances affecting the public is
				  maintained in each county department of social services and each DSS Regional
				  Office for examination by the public on regular work days during regular work
				  hours.
(b) The state provides
				  copies of its current eligibility policy free of charge to agencies and
				  organizations described in 42 CFR 431.18.
(c) The state will charge agencies and groups
				  other than those covered by Paragraph (b) of this Rule an amount related to the
				  cost of reproduction.
Authority
					 G.S.
					 108A-54;
					 42 C.F.R.
					 431.18;
Eff. September 1,
					 1984;
Transferred from
					 10A NCAC
					 21A .0701 Eff. May 1, 2012;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 23,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter B - BENEFITS › Section .0100 - GENERAL › Section 23B .0101 - MEDICAID IDENTIFICATION CARD

Current through Register Vol. 39, No. 2, July 15, 2024
The card shall be proof to medical providers of the
					 client's Medicaid eligibility for a specified time.
Authority
					 G.S.
					 108A-54;
Eff. September 1,
					 1984;
Amended Eff. August 1, 1990;
Transferred from
					 10A NCAC
					 21C .0101 Eff. May 1, 2012;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 23,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter B - BENEFITS › Section .0100 - GENERAL › Section 23B .0102 - ISSUANCE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Cards shall be
				  issued by the State at any time of the month for:
(1) Approved applications;
(2) Cases authorized after meeting a
				  deductible;
(3) Change in primary
				  care provider; or
(4) Change in
				  LME/MCO catchment area.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter C - APPLICATION FOR MEDICAID BENEFITS › Section .0100 - APPLICATION PROCESS › Section 23C .0101 - ACCEPTANCE OF APPLICATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  client shall be allowed to apply without delay. Without delay is the same day
				  the client appears at the county department of social services expressing a
				  financial or medical need.
(b) The
				  county department of social services shall not act to discourage any individual
				  from applying for Medicaid. It shall be considered discouragement if any
				  employee of the county department of social services:
(1) requires or suggests the individual wait
				  to apply until he applies for other benefits or until an application for other
				  benefits has been approved or denied; or
(2) incorrectly states or suggests the
				  individual is ineligible for Medicaid; or
(3) gives incorrect or incomplete information
				  about Medicaid programs; or
(4)
				  requires the individual provide or obtain any information needed to establish
				  eligibility prior to signing an application; or
(5) discourages a client from applying and
				  this is proven by facts to the satisfaction of the county agency or a hearing
				  officer; or
(6) suggests that the
				  individual make an appointment to apply when he appears at the agency;
				  or
(7) suggests that the individual
				  complete a mail-in application when he appears at the agency; or
(8) fails to explain the date of application
				  when he appears at the agency and requests a mail-in application; or
(9) fails to explain and offer Medicaid to
				  individuals requesting Work First Employment Services.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter C - APPLICATION FOR MEDICAID BENEFITS › Section .0100 - APPLICATION PROCESS › Section 23C .0103 - RECOMMENDATION FOR DISPOSITION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) When
				  all information necessary to determine eligibility has been obtained, the
				  Income Maintenance Caseworker shall recommend whether to approve or to deny
				  assistance. The recommendation shall be based on all reliable, relevant
				  information.
(b) The authority to
				  approve or deny assistance rests with the county board of social services. The
				  county board may, by appropriate resolution recorded in the board minutes,
				  delegate to the county director of social services the authority to process
				  applications, to determine eligibility, or to terminate assistance.
Authority
					 G.S.
					 108A-54;
					 42 C.F.R.
					 435.913;
Eff. September 1,
					 1984;
Amended Eff. August 1, 1990;
Transferred from
					 10A NCAC
					 21B .0205 Eff. May 1, 2012;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 23,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter C - APPLICATION FOR MEDICAID BENEFITS › Section .0100 - APPLICATION PROCESS › Section 23C .0104 - DISPOSITION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Disposition of
				  the application shall complete the application process and shall consist of one
				  of the following actions:
(1) Approval of
				  assistance;
(2) Denial of
				  assistance;
(3) Denial of
				  assistance for ineligible month or months of the certification period and
				  approval for eligible month or months of the certification period; or
(4) Voluntary withdrawal of the application
				  by the client. The Income Maintenance Caseworker shall not suggest to the
				  client that he withdraw his application and shall explain alternatives to
				  withdrawal. The Income Maintenance Caseworker shall explain the client's right
				  to reapply at anytime.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 23 - MEDICAL ASSISTANCE ADMINISTRATION › Subchapter C - APPLICATION FOR MEDICAID BENEFITS › Section .0100 - APPLICATION PROCESS › Section 23C .0105 - REFERRALS AT A FACE-TO-FACE INTERVIEW

Current through Register Vol. 39, No. 2, July 15, 2024
For all Medicaid applicants who have a face-to-face
					 interview at the county department of social services, the Income Maintenance
					 Caseworker shall explain and make referrals for:
(1) Health Check;
(2) Family planning services;
(3) Food stamps;
(4) Governmental benefits including RSDI,
				  SSI, VA;
(5) Women, Infants and
				  Children Program (WIC);
(6)
				  Carolina ACCESS;
(7) Medicaid
				  Transportation;
(8) Life
				  Line/Link-up;
(9) Health Insurance
				  Premium Payment program; and
(10)
				  Voter Registration.
Authority
					 G.S.
					 108A-54;
					 42 C.F.R.
					 441.56;
					 42 U.S.C. 1396a(a); Alexander v.
					 Bruton Consent Order dismissed Effective February 1, 2002;
Eff.
					 September 1, 1984;
Amended Eff. January 1, 1995; August 1,
					 1990;
Temporary Amendment Eff. March 1, 2003;
Amended
					 Eff. August 1, 2004;
Transferred from
					 10A NCAC
					 21B .0207 Eff. May 1, 2012;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 23,
					 2016.