Title 50 — Public Welfare
62 chapters · 605 sections in this title.
N.D.C.C. § 50-24.1-17 Medical assistance for breast or cervical cancer
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The department may provide medical assistance for individuals screened and found to have breast or cervical cancer in accordance with the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000 [Pub. L. 106-354; 114 Stat. 1381; 42 U.S.C. 1396a et seq.]. The depart…
N.D.C.C. § 50-24.1-18.1 Consumer-directed health maintenance services - Residing at home
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Repealed by S.L. 2021, ch. 12, § 35.
N.D.C.C. § 50-24.1-19 Oral maxillofacial services - Medical necessity
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Repealed by S.L. 2019, ch. 408, § 39.
N.D.C.C. § 50-24.1-20 Home and community-based living - Choice of options
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Any aged or disabled individual who is eligible for home and community-based living must be allowed to choose, from among all service options available, the type of service that best meets that individual's needs. To the extent permitted by any applicable waiver, the individual's…
N.D.C.C. § 50-24.1-21 Department to submit plans and seek waivers
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Repealed by S.L. 2007, ch. 421, § 3.
N.D.C.C. § 50-24.1-22 Long-term care facility information
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Repealed by S.L. 2019, ch. 408, § 39.
N.D.C.C. § 50-24.1-23 Long-term care facility resident - Medical assistance eligibility
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An individual is not ineligible for medical assistance if application of disqualifying transfer provisions would deprive the individual of nursing care and services and the individual makes a satisfactory showing that: 1. For periods after the return, all income or assets constit…
N.D.C.C. § 50-24.1-24 Provider appeals - Definitions
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1. For purposes of this section: a. "Denial of payment" means that the department has denied payment for a medical assistance claim or reduced the level of service payment for a service provided to an individual who was an eligible medical assistance recipient at the time the ser…
N.D.C.C. § 50-24.1-25 Operating costs for developmental disabilities service providers
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Repealed by S.L. 2019, ch. 408, § 39.
N.D.C.C. § 50-24.1-26 Medicaid waivers - In-home services
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The department shall administer Medicaid waivers to provide in-home services to children with extraordinary medical needs and to children diagnosed with an autism spectrum disorder who are under the age of twenty-one and would otherwise meet institutional level of care. The depar…
N.D.C.C. § 50-24.1-27 Medical assistance program management
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Repealed by S.L. 2019, ch. 408, § 39.
N.D.C.C. § 50-24.1-28 Medical assistance and Medicare prescription drug management program
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The department may not pay for: 1. A prescription drug that is within a class of drugs covered under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 [Pub. L. 108-173; 117 Stat. 2066; 42 U.S.C. 1396kk-1] and which is prescribed to a medical assistance re…
N.D.C.C. § 50-24.1-28.1 Pharmacy management program
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The department shall establish a pharmacy management program to be used by the medical assistance program for Medicaid expansion for prescription drug coverage. The department shall process claims through the department's existing pharmacy claims system and Medicaid management in…
N.D.C.C. § 50-24.1-29 Insurers to provide certain information to the department
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1. For purposes of this section: a. "Department" means the department of health and human services or its agent. b. "Health insurer" includes self-insured plans, group health plans as defined in section 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1167…
N.D.C.C. § 50-24.1-30 Third-party liability recovery
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1. The department shall seek recovery of reimbursement from a third party up to the full amount of medical assistance paid. 2. A medical assistance recipient shall inform the department of any rights the recipient has to third-party benefits and shall inform the department of the…
N.D.C.C. § 50-24.1-31 Optional medical assistance for families of children with disabilities
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1. The department shall establish and implement a buyin program under the federal Family Opportunity Act enacted as part of the Deficit Reduction Act of 2005 [Pub. L. 109-171; 120 Stat. 4; 42 U.S.C. 1396] to provide medical assistance and other health coverage options to families…
N.D.C.C. § 50-24.1-33 Brain injury - Home and community-based services - Quality control
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1. As part of the personal care services program for eligible medical assistance recipients and as part of the department's services for eligible disabled and elderly individuals, the department shall provide home and community-based services to individuals who have a brain injur…
N.D.C.C. § 50-24.1-34 Processing of claims submitted on behalf of inmates
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The department of health and human services shall process claims submitted by enrolled medical providers on behalf of inmates at county jails. Each county shall pay the department for the paid amount for the claims processed and also a processing fee for each claim submission. Th…
N.D.C.C. § 50-24.1-35 Department to expand Medicaid coverage
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The department shall ensure Medicaid coverage includes Medicaid-covered services provided to an inmate of the department of corrections and rehabilitation or a county jail who would be eligible for Medicaid if the inmate were not incarcerated and who is admitted to an inpatient s…
N.D.C.C. § 50-24.1-36 Civil sanction - Costs recoverable - Interest - Appeals
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1. For purposes of this section: a. "Affiliate" means a person having an overt or covert relationship each with another person in a manner that one person directly or indirectly controls or has the power to control another. b. "Provider" means any individual or entity furnishing …
N.D.C.C. § 50-24.1-38 Health-related services - Licensed emergency medical services personnel
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1. Medical assistance must cover services provided by community emergency medical services personnel, and other similarly licensed personnel who are licensed or certified under section 23-27-04.3, if the services are provided to an eligible recipient as defined by rule. Community…
N.D.C.C. § 50-24.1-39 Behavioral health services - Licensed marriage and family therapists
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Beginning January 1, 2016, the department shall allow licensed marriage and family therapists to enroll and be eligible for payment for behavioral health services provided to recipients of medical assistance, subject to limitations and exclusions the department determines necessa…
N.D.C.C. § 50-24.1-41 Medical assistance benefits - Pregnant women - Postpartum
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The department shall seek the necessary approval from the centers for Medicare and Medicaid services to expand medical assistance coverage for pregnant women with income below one hundred seventy-five percent of the federal poverty level. Services under this section must be for t…
N.D.C.C. § 50-24.1-43 Medical assistance benefits - Metabolic supplements
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Medical assistance coverage must include coverage of a metabolic supplement if: 1. The metabolic supplement has been identified and agreed to be covered by the department; 2. The metabolic supplement is part of a standard recommendation for treatment; 3. A suitable metabolic supp…
N.D.C.C. § 50-24.1-44 Interpreter services
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Medical assistance coverage, including Medicaid expansion, must include payment for sign and oral language interpreter services for assistance in providing covered health care services to a recipient of medical assistance who has limited English proficiency or who has hearing los…
N.D.C.C. § 50-24.1-46 Dual special needs plan
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By January 1, 2025, the department shall implement at least one dual special needs plan for Medicare and Medicaid dual-eligible Medicaid recipients. The department shall establish standards for care coordination services the dual special needs plan must provide to recipients. 50-…
N.D.C.C. § 50-24.1-48 Reimbursement of psychiatric residential treatment facilities
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The department shall amend the rules for medical assistance reimbursement of psychiatric residential treatment facilities for direct care costs, including the applicable costs related to clinical supervisors, medical directors, engagement of families in care, therapeutic leave da…
N.D.C.C. § 50-24.3-01 Targeted case management
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The department of health and human services shall establish a targeted case management service for disabled and elderly individuals eligible for benefits under chapter 50-24.1 who are at risk of requiring long-term care services to ensure that an individual is informed of alterna…
N.D.C.C. § 50-24.3-02 Assessment process - Professional involvement
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Repealed by S.L. 2003, ch. 427, § 4.
N.D.C.C. § 50-24.3-03 Targeted case management - Powers and duties
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The department of health and human services has the following powers and duties which it may delegate to any entity that provides targeted case management services approved by the department: 1. To seek cooperation from other public and private entities in the community that offe…
N.D.C.C. § 50-24.3-03.1 Assessment services - Powers and duties
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The department of health and human services has the following powers and duties which it may delegate to any entity that provides assessment services approved by the department: 1. To seek cooperation from other public and private agencies in the community which offer services to…
N.D.C.C. § 50-24.3-04 Preadmission assessment of persons
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Repealed by S.L. 1991, ch. 514, § 1.
N.D.C.C. § 50-24.3-05 Facility's duties - Preadmission assessment - Alternative care
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Repealed by S.L. 1991, ch. 514, § 1.
N.D.C.C. § 50-24.4-01 Definitions
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For the purposes of this chapter: 1. "Actual allowable historical operating cost per diem" means the per diem operating costs allowed by the department for the most recent reporting year. 2. "Actual resident day" means a billable, countable day as defined by the department. 3. "D…
N.D.C.C. § 50-24.4-02 Authority
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The department shall establish, by rule, procedures for determining rates for care of residents of nursing homes which qualify as vendors of medical assistance and for implementing the provisions of this chapter. The procedures must be based on methods and standards which the dep…
N.D.C.C. § 50-24.4-03 Federal requirements - Supremacy
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If any provision of this chapter is determined by the United States government to be in conflict with existing or future requirements of the United States government with respect to federal participation in medical assistance, the federal requirements prevail.
N.D.C.C. § 50-24.4-04 Payment rates
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Payment rates paid to any nursing home receiving medical assistance payments must be those rates established pursuant to this chapter and rules adopted under it.
N.D.C.C. § 50-24.4-05 Requirements
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No medical assistance payments may be made to any nursing home unless the nursing home is certified to participate in the medical assistance program under title XIX of the federal Social Security Act and has in effect a provider agreement with the department meeting the requireme…
N.D.C.C. § 50-24.4-06 Rate determination
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1. The department shall determine prospective payment rates for resident care costs. The department shall develop procedures for determining operating cost payment rates that take into account the mix of resident needs and other factors as determined by the department. 2. The dep…
N.D.C.C. § 50-24.4-07 Nonallowable costs
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1. The following costs may not be recognized as allowable: political contributions; salaries or expenses of a lobbyist, as defined in section 54-05.1-02, for lobbying activities; advertising designed to encourage potential residents to select a particular nursing home; fines and …
N.D.C.C. § 50-24.4-08 Notice of increases to private-paying residents
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No increase in nursing home rates for private-paying residents is effective unless the nursing home notifies the resident or person responsible for payment of the increase in writing thirty days before the increase takes effect. A nursing home may adjust its rates without giving …
N.D.C.C. § 50-24.4-09 Interim rates
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Repealed by S.L. 2005, ch. 432, § 10.
N.D.C.C. § 50-24.4-10 Operating costs
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1. The department shall establish procedures for determining per diem reimbursement for operating costs. 2. The department shall analyze and evaluate each nursing home's cost report of allowable operating costs incurred by the nursing home during the reporting year immediately pr…
N.D.C.C. § 50-24.4-11 Adjustment of historical operating costs
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1. The department may allow a one-time adjustment to historical operating costs of a nursing home that has been found by the department to be significantly below care-related minimum standards appropriate to the mix of resident needs in that nursing home when it is determined by …
N.D.C.C. § 50-24.4-12 Avoiding detrimental effect on quality of care
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If the department learns that expenditures for direct resident care have been reduced in amounts large enough to indicate a possible detrimental effect on the quality of care, the licensing division shall be notified.
N.D.C.C. § 50-24.4-13 Exclusion
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Until procedures for determining operating cost payment rates according to mix of resident needs are established for nursing homes that exclusively provide residential services for nongeriatric individuals with physical disabilities or units within nursing homes which exclusively…
N.D.C.C. § 50-24.4-14 General and administrative costs
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All general and administrative costs must be included in general and administrative costs in total, without direct or indirect allocation to other cost categories. In a nursing home of sixty or fewer beds, part of an administrator's salary may be allocated to other cost categorie…
N.D.C.C. § 50-24.4-15 Property-related costs
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1. The department shall include in the ratesetting system for nursing homes a fair rental value payment mechanism for the use of real and personal property. 2. The department shall establish a per bed property cost limitation considering single and double occupancy construction. …
N.D.C.C. § 50-24.4-16 Special rates
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1. For nursing homes with a significant capacity increase and for newly constructed nursing homes, which first provide services on or after July 1, 1988, and which are not included in the calculation of the limits of any cost category, the department shall establish procedures fo…
N.D.C.C. § 50-24.4-17 Adjustments and reconsideration procedures
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1. Rate adjustments may be made to correct errors subsequently determined and must also be retroactive to the beginning of the facility's rate year except with respect to rates paid by private-paying residents. 2. Any requests for reconsideration of the rate must be filed with th…