North Carolina Administrative Code

SECTION .0700 - AVAILABILITY OF MANUALS 10A NCAC 21A .0701 AVAILABILITY OF MANUALS (TRANSFERRED TO 10A NCAC 23A .0104)

subchapter 21B – eligibility determination SECTION .0100 – COVERAGE GROUPS 10A NCAC 21B .0101 MANDATORY (TRANSFERRED TO 10A nCAC 23D .0101)

10A ncac 21B .0102 OPTIONAL (TRANSFERRED TO 10A NCAC 23D .0102)

SECTION .0200 - APPLICATION PROCESS 10A NCAC 21B .0201 ACCEPTANCE OF APPLICATION (TRANSFERRED TO 10A NCAC 23C .0101)

10A NCAC 21B .0202 face-to-face INTERVIEW (TRANSFERRED TO 10A NCAC 23C .0102)

10A NCAC 21B .0203 APPLICATION PROCESSING STANDARDS (TRANSFERRED TO 10A NCAC 23C .0201)

10A NCAC 21B .0204 EFFECTIVE DATE OF ASSISTANCE (a) The first month of Medicaid coverage shall be: (1) the month of application, or for SSI recipients, the month of application for SSI; (2) as much as three months prior to the month of application when the client received medical…

10A NCAC 21B .0205 RECOMMENDATION FOR DISPOSITION (TRANSFERRED TO 10A NCAC 23C .0103)

10A NCAC 21B .0206 DISPOSITION (TRANSFERRED TO 10A NCAC 23C .0104)

10A NCAC 21B .0207 REFERRALS at a face-to-face interview (TRANSFERRED TO 10A NCAC 23C .0105)

10A NCAC 21B .0208 MANDATORY USE OF OUTREACH LOCATIONS (TRANSFERRED TO 10A NCAC 23C .0106)

10A NCAC 21B .0209 hours for accepting financial and medical assistance applications (TRANSFERRED TO 10A ncac 23c .0107)

SECTION .0300 - CONDITIONS FOR ELIGIBILITY 10A NCAC 21B .0301 AGE (TRANSFERRED TO 10A NCAC 23E .0101)

10A NCAC 21B .0302 UNITED STATES CITIZEN (TRANSFERRED TO 10A NCAC 23E .0102)

10A NCAC 21B .0303 RESIDENCE (TRANSFERRED TO 10A NCAC 23E .0103)

10A NCAC 21B .0304 DEPRIVATION (TRANSFERRED TO 10A NCAC 23E .0104)

10A NCAC 21B .0305 DISABILITY (TRANSFERRED TO 10A NCAC 23E .0105)

10A NCAC 21B .0306 BLINDNESS (TRANSFERRED TO 10A NCAC 23E .0106)

10A NCAC 21B .0307 CARETAKER RELATIVE (TRANSFERRED TO 10A nCAC 23E .0107)

10a NCAC 21B .0308 INMATE OF PUBLIC INSTITUTION OR PRIVATE PSYCHIATRIC HOSPITAL (TRANSFERRED TO 10A nCAC 23E .0108)

10A NCAC 21B .0309 APPLYING FOR ALL BENEFITS AND ANNUITIES (TRANSFERRED TO 10A NCAC 23E .0201)

10A NCAC 21B .0310 RESERVE (TRANSFERRED TO 10A NCAC 23E .0202)

10A NCAC 21B .0311 TRANSFER OF RESOURCES History Note: Authority G.S. 108A-54; 108A-58; P.L. 100-360; P.L. 100-485; 42 U.S.C. 1396p(c); 42 C.F.R. 435.121; 42 C.F.R. 435.840; 42 C.F.R. 435.841; 42 C.F.R. 435.845; S.L. 2002-126; Eff. September 1, 1984; Amended Eff. December 1, 1991…

10A NCAC 21B .0312 INCOME (TRANSFERRED TO 10A NCAC 23E .0203)

10A NCAC 21B .0313 PERSONAL NEEDS ALLOWANCE (TRANSFERRED TO 10A nCAC 23E .0204)

SECTION .0400 - BUDGETING PRINCIPALS 10A NCAC 21B .0401 BUDGET UNIT MEMBERSHIP (TRANSFERRED TO 10A NCAC 23E .0205)

10A NCAC 21B .0402 FINANCIAL RESPONSIBILITY AND DEEMING (TRANSFERRED TO 10A NCAC 23E .0206)

10A NCAC 21B .0403 RESERVE (TRANSFERRED TO 10A NCAC 23E .0207)

10A NCAC 21B .0404 INCOME (TRANSFERRED TO 10A NCAC 23E .0208)

10A NCAC 21B .0405 CERTIFICATION AND AUTHORIZATION (TRANSFERRED TO 10A NCAC 23G .0101)

10A NCAC 21B .0406 DEDUCTIBLE (TRANSFERRED TO 10A NCAC 23E .0209)

10a NCAC 21B .0407 PATIENT LIABILITY (TRANSFERRED TO 10A NCAC 23E .0210)

10A NCAC 21B .0408 CLASSIFICATION (TRANSFERRED TO 10A NCAC 23D .0201)

10A NCAC 21B .0409 CHANGE IN SITUATION (TRANSFERRED TO 10A nCAC 23G .0304)

10A NCAC 21B .0410 ALIEN SPONSOR DEEMING (TRANSFERRED TO 10A NCAC 23E .0211)

SECTION .0500 - REDETERMINATION 10A NCAC 21B .0501 TIME AND CONTENT (TRANSFERRED TO 10A NCAC 23G .0301)

10A NCAC 21B .0502 INTERVIEW (TRANSFERRED TO 10A NCAC 23G .0302)

10a NCAC 21B .0503 RECOMMENDATION (TRANSFERRED TO 10A NCAC 23G .0303)

SUBCHAPTER 21C - BENEFITS SECTION .0100 - MEDICAID I.D. CARD 10A NCAC 21C .0101 MEDICAID IDENTIFICATION CARD (TRANSFERRED TO 10A NCAC 23B .0101)

10A NCAC 21C .0102 ISSUANCE (TRANSFERRED TO 10A NCAC 23B .0102)

10A NCAC 21C .0103 PHARMACY OF RECORD History Note: Authority G.S. 108A-54; Eff. September 1, 1984; Amended Eff. August 1, 1990; Repealed Eff. April 1, 2010.

SECTION .0200 - RECONSIDERATION REVIEW 10A NCAC 21D .0201 RECONSIDERATION REVIEW History Note: Authority G.S. 108A-70.5; 42 U.S.C. 1396p.; Temporary Adoption Eff. May 6, 1996 to expire on July 1, 1996, or the last day of the 1996 session of the General Assembly, whichever is late…

Chapter 22 - Medical Assistance Eligibility SUBCHAPTER 22A – IDENTIFYING INFORMATION 10A NCAC 22A .0101 SCOPE The Division of Health Benefits shall administer and supervise the administration of medical services under Title XIX of the Social Security Act, commonly referred to as …

10A NCAC 22A .0102 reserved for future codification

subchapter 22B – provider issues section .0100 - general 10A NCAC 22B .0101 INSTITUTIONAL HEALTH SERVICES No provider shall be enrolled in the Medicaid Program to provide any new institutional health service for which a Certificate of Need is required under G.S. 131E, Article 9 w…

10A NCAC 22B .0102 COORDINATION WITH TITLE XVIII The entire range of benefits under Part B of Title XVIII of the Social Security Act, which is adopted and incorporated by reference with subsequent changes or amendments and available free of charge at http://uscode.house.gov/, to …

10a NCAC 22B .0103 INSTITUTIONAL STANDARDS Institutions shall meet standards prescribed for participation in Titles XVIII, XIX, and XXI of the Social Security Act, which is adopted and incorporated by reference with subsequent changes or amendments and available free of charge at…

10A NCAC 22B .0104 TIME LIMITATION (a) To receive payment, claims shall be filed either: (1) within 365 days of the date of service for services other than inpatient hospital, home health, or nursing home services; (2) within 365 days of the date of discharge for inpatient hospit…

10A NCAC 22B .0105 OVERUTILIZER IDENTIFICATION History Note: Authority G.S. 108A-25(b); Eff. January 1, 1978; Amended Eff. May 1, 1990; October 4, 1979; Repealed Eff. July 1, 2018.

Section .0200 - MANUALS AND FORMS 10A NCAC 22B .0201 MANUALS Manuals and bulletins explaining Medicaid procedures are available through the private contractor mentioned in 10A NCAC 22A .0101. History Note: Authority G.S. 108A-25(b); Eff. February 1, 1976; Readopted Eff. October 3…