North Dakota Administrative Code

The department will work with public and private entities in identifying target population members in order to inform them about home and community-based service options. A public or private entity may not require target population members and their guardians or legal representat…

The department has the following powers and duties under this chapter: 1. To assign a case manager to complete the informed choice process. 2. To provide information through a person-centered planning process led by the case manager to target population members and their guardian…

Public and private entities enrolled as North Dakota Medicaid providers have the following powers and duties to assist the department in identifying target population members and informing target population members about home and community-based service options: 1. To make a refe…

The extent to which appropriate services other than informed choice services are available to target population members are dependent upon legislative appropriations and resources. Eligibility for informed choice services does not create an entitlement to services other than info…

Public and private entities may disclose target population members individually identifiable health information to the department or its contractors for referral purposes and the disclosure is a disclosure for treatment, including the provision, coordination, and management of he…

1. "Child" means any child, by birth or adoption, to whom a parent owes a duty of support. 2. "Child living with the obligor" means the obligor's child who lives with the obligor most of the year. 3. "Children's benefits" means a payment, to or on behalf of a child of the person …

1. Except as provided in section 75-02-04.1-08.2, calculations of child support obligations provided for under this chapter consider and assume that one parent acts as a primary caregiver and the other parent contributes a payment of child support to the child's care. Calculation…

residential responsibility. A child support obligation must be determined and specifically ordered for the child or children for whom each parent has primary residential responsibility pursuant to a court order or, if there is no court order, for whom each parent has primary phys…

Repealed effective January 1, 2018.

1. Net income from self-employment means total income, for internal revenue service purposes, of the obligor: a. Reduced by that amount, if any, of: (1) That total income that is not the obligor's income or that is otherwise included in gross income; and (2) With respect to a par…

The cost of supporting a child living with the obligor, who is not also a child of the obligee, may be deducted from net income under subsection 4 of section 75-02-04.1-06.1 and is determined by applying the obligor's net income and the total number of children living with the ob…

1. This section must be used to determine the child support amount presumed to be the correct amount of child support in all cases involving an obligor who: a. Owes duties of support payable to two or more obligees; or b. Owes a duty of support to at least one obligee and also ow…

1. For purposes of this section: a. "Earnings" includes in-kind income and amounts received in lieu of actual earnings, such as social security benefits, workers' compensation wage replacement benefits, unemployment insurance benefits, veterans' benefits, and earned income tax cr…

The income and financial circumstances of the spouse of an obligor may not be considered as income for child support purposes unless the spouse's income and financial circumstances are, to a significant extent, subject to control by the obligor as where the obligor is a principal…

1. For purposes of this section, "extended parenting time" means parenting time between an obligor and a child living with an obligee scheduled by court order to exceed an annual total of one hundred overnights. If a child support order includes an adjustment for extended parenti…

A child support obligation must be determined as described in this section in all cases in which a court orders each parent to have equal residential responsibility for their child or children. Equal residential responsibility means each parent has residential responsibility for …

1. The child support amount provided for under this chapter, except for subsection 2, is presumed to be the correct amount of child support. No rebuttal of the guidelines may be based upon evidence of factors described or applied in this chapter, except in subsection 2, or upon: …

The amount of child support payable by the obligor is determined by the application of the following schedule to the obligor's monthly net income and the number of children for whom support is being sought in the matter before the court. Obligor's Six or Monthly Net One Two Three…

It is important that parents maintain a tie to and responsibility for their child when that child is in foster care. Financial responsibility for the support of that child is one component of the maintenance of the relationship of parent and child. Parents of a child subject to a…

In a proceeding where the obligor appears, but does not resist the child support amount sought by the obligee, and in proceedings where the parties agree or stipulate to a child support amount, credible evidence describing the obligor's income and financial circumstances, which d…

The child support guideline schedule amount is rebuttably presumed to be the correct amount of child support in all child support determinations, including both temporary and permanent determinations, and including determinations necessitated by actions for the support of childre…

The terms used in this chapter have the same meaning as in North Dakota Century Code chapter 14-09 or 50-09 unless the context indicates otherwise. In addition: 1. "Child support case" means the combination of a noncustodial parent or putative father, custodial parent, and childr…

1. For purposes of this section, "year" means federal fiscal year. 2. Unless subsection 3 applies, an individual who is an obligee in a IV-D case and who has never received assistance under the aid to families with dependent children program or temporary assistance for needy fami…

The purpose underlying administrative remedies and sanctions in the Medicaid and children's health insurance program is to ensure the proper and efficient utilization of Medicaid and children's health insurance program funds by those individuals providing medical and other health…

Under authority of North Dakota Century Code chapters 50-24.1 and 50-29, the department of human services is empowered to promulgate such rules and regulations necessary to qualify for federal funds under section 1901 specifically, title XIX and title XXI generally of the Social …

In this chapter, unless the context or subject matter otherwise requires: 1. "Abuse" means practices that: a. Are inconsistent with sound fiscal, business, or medical practices and result in an unnecessary cost to Medicaid and children's health insurance program; b. Elicit reimbu…

To assure quality medical care and services, Medicaid and children's health insurance program payments may be made only to providers meeting established standards. Providers who are certified for participation in Medicare are eligible for participation, providing no sanction has …

program provider. The department may deny an application to become a Medicaid or children's health insurance program provider if: 1. The applicant voluntarily withdraws the application; 2. The applicant is not in compliance with applicable federal law, federal regulation, state l…

The department may terminate the enrollment of a Medicaid or children's health insurance program provider under the following circumstances: 1. The individual is enrolled to provide transportation, but does not possess a current driver's license or has a driver's license that has…

Sanctions may be imposed by the department against a provider who: 1. Presents or causes to be presented for payment any false or fraudulent claim for care or services. 2. Submits or causes to be submitted false, intentionally misleading, or fraudulent information for the purpose…

1. Information from any source indicating that a provider has failed or is failing to fulfill the provider's responsibilities, as set forth in section 75-02-05-04; or that a provider has acted in a manner which forms a ground for sanction as set forth in section 75-02-05-05 must …

1. a. When the department determines that a provider has been rendering care or services in a form or manner inconsistent with program requirements or rules, or has received payment for which the provider may not be properly entitled, the department shall notify the provider in w…

Repealed effective July 1, 2012.

1. A provider may not request a review of a temporary sanction until further investigation has been completed and the department has made a final decision. 2. After completion of further investigation, if there is an imposition of a subsequent sanction, the provider may request a…

Repealed effective July 1, 2012.

1. The department shall provide fingerprint-based criminal background checks screenings for enrolled or newly enrolling providers and indirect owners with five percent or more ownership 12 in a high-risk provider, unless that provider and indirect owners has had a successful fing…

The department shall assess an application fee for all institutional providers who have not been assessed an application fee by centers for Medicare and Medicaid services or another state Medicaid agency. The amount of the application fee is determined by centers for Medicare and…

1. "Certification of compliance" means a facility is in at least substantial compliance and is eligible to participate in Medicaid as a nursing facility. 2. "Certification of noncompliance" means a facility is not in substantial compliance and is not eligible to participate in Me…

The following enforcement remedies may be imposed on a facility that is not in substantial compliance. 1. Category one remedies: a. A directed plan of care. b. Directed in-service training. c. State monitoring. 2. Category two remedies: a. Denial of payment for all new Medicaid a…

The department may impose the enforcement remedies described in section 75-02-05.2-02 if the facility is not in substantial compliance. The scope and severity matrix established by the health care financing administration must be used to determine the appropriate category of enfo…

1. The department may impose a civil money penalty for the number of days a provider is not in substantial compliance with one or more participation requirements. 2. The department may impose a civil money penalty for the number of days of past noncompliance since the last standa…

1. The survey agency shall recommend enforcement action. 2. The department shall consider the survey agency recommendation when determining the appropriate enforcement action, except the appointment of a receiver must be as provided in North Dakota Century Code chapter 23-16.1. T…

1. A written notice of enforcement action issued by the department must be hand delivered or mailed to the facility owner, administrator, or head of the facility's governing board. The notice must include: a. The basis for the decision; b. A statement of the deficiencies upon whi…

A facility subject to termination from participation or to any limitation or denial of payment may not submit claims for payment, either directly or indirectly through any clinic, group, corporation, or other association, to the department or any fiscal agent for any services or …

1. A nonstate-owned facility, participating only in Medicaid, dissatisfied with an informal dispute resolution decision of the survey agency may appeal the issue of whether or not a deficiency occurred in the manner provided in section 75-01-03-20. Correction of the deficiency ma…

The department is responsible for the application of this chapter to nonstate-operated nursing facilities participating only in the Medicaid program. The department may make recommendations to the regional office for the application of this chapter to other nursing facilities. Th…

In this chapter, unless the context or subject matter requires otherwise: 1. "Accrual basis" means the recording of revenue in the period when it is earned, regardless of when it is collected, and the recording of expenses in the period when incurred, regardless of when they are …

1. Records. a. The facility shall maintain on the premises the required census records and financial information in a manner sufficient to provide for a proper audit or review. For any cost being claimed on the cost report, sufficient data must be available as of the audit date t…

1. For ratesetting purposes, a cost must: a. Be ordinary, necessary, and related to resident care; b. Be what a prudent and cost-conscious business person would pay for the specific good or service in the open market in an arm's-length transaction; and c. Be for goods or services…

Direct care costs include only those costs identified in this section. 1. Therapies. a. Salary and employment benefits for speech, occupational, and physical therapists, or for personnel, who are not reported in subsection 2, performing therapy under the direction of a licensed t…