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- VOLUME A-1 (Title 18)
- Chapter II - Regulations of the Department of Social Services
- SubChapter B - Public Assistance
- Article 2 - Determination of Eligibility--Categorical
- Part 360 - MEDICAL ASSISTANCE
- SubPart 360-2 - APPLICATION PROCESS
- Title: Section 360-2.1 - Introduction.
Title: Section 360-2.1 - Introduction.
Section 360-2.1 Introduction. This Subpart explains the application/recertification process for MA including:
Volume
VOLUME A-1 (Title 18)
- VOLUME A-1 (Title 18)
- Chapter II - Regulations of the Department of Social Services
- SubChapter B - Public Assistance
- Article 2 - Determination of Eligibility--Categorical
- Part 360 - MEDICAL ASSISTANCE
- SubPart 360-1 - INTRODUCTION AND DEFINITIONS
- SubPart 360-2 - APPLICATION PROCESS
- Section 360-2.1 - Introduction.
- Section 360-2.2 - Applying for MA.
- Section 360-2.3 - Investigation of eligibility.
- Section 360-2.4 - Decision.
- Section 360-2.5 - Notification of acceptance/denial.
- Section 360-2.6 - Changes in circumstances affecting classification or eligibil
- Section 360-2.7 - Termination of MA; notification of discontinuance.
- Section 360-2.8 - Right to a conference.
- Section 360-2.9 - Right to a fair hearing.
- SubPart 360-3 - ELIGIBILITY REQUIREMENTS
- Section 360-3.1 - Introduction.
- Section 360-3.2 - Conditions of eligibility.
- Section 360-3.3 - Who is eligible for MA.
- Section 360-3.4 - Who is excluded from receiving MA.
- Section 360-3.5 - MA for State residents outside their district of residence.
- Section 360-3.6 - Eligibility of persons temporarily in the State.
- Section 360-3.7 - Presumptive eligibility.
- SubPart 360-4 - FINANCIAL ELIGIBILITY
- Section 360-4.1 - Introduction.
- Section 360-4.2 - Size of MA household.
- Section 360-4.3 - Available income.
- Section 360-4.4 - Available resources.
- Section 360-4.5 - Availability of assets held in trust.
- Section 360-4.6 - Net available income and resources.
- Section 360-4.7 - Standard exemptions.
- Section 360-4.8 - Determination of financial eligibility; effect of excess
- Section 360-4.9 - Post-eligibility utilization of income.
- Section 360-4.10 - Treatment of income and resources of institutionalized spouses
- SubPart 360-5 - ELIGIBILITY BASED ON DISABILITY
- Section 360-5.1 - Introduction.
- Section 360-5.2 - Definitions.
- Section 360-5.3 - Medical criteria for disability determination.
- Section 360-5.4 - Reapplication.
- Section 360-5.5 - Examination.
- Section 360-5.6 - Grandfathered cases.
- Section 360-5.7 - Pending of disability cases.
- Section 360-5.8 - Effective date of disability.
- Section 360-5.9 - Trial work period.
- Section 360-5.10 - Medically determined drug addicts and alcoholics.
- Section 360-5.11 - Evaluation of disability.
- Section 360-5.12 - Determination of blindness status.
- SubPart 360-6 - ENTITLEMENT TO MEDICAL ASSISTANCE
- Section 360-6.1 - Introduction.
- Section 360-6.2 - Authorization for MA.
- Section 360-6.3 - Free choice by recipient guaranteed.
- Section 360-6.4 - Restriction of recipient access to services (recipient restriction program)
- Section 360-6.5 - Fair hearing requirements in utilization review cases.
- Section 360-6.6 - Where care and services may be provided.
- Section 360-6.7 - REPEALED
- Section 360-6.8 - Medical care coordinator program (MCCP).
- SubPart 360-7 - PAYMENT FOR MA SERVICES
- Section 360-7.1 - Introduction.
- Section 360-7.2 - MA program as payment source of last resort.
- Section 360-7.3 - Use of health, hospital or accident insurance.
- Section 360-7.4 - Liability of third parties.
- Section 360-7.5 - Method of payment for medical care
- Section 360-7.6 - Payment for services or supplies.
- Section 360-7.7 - Payments of deductibles and coinsurance under title XVIII of
- Section 360-7.8 - Payments of premiums under Title XVIII of the Social Security
- Section 360-7.9 - Special needs of MA recipients subject to chronic care budget
- Section 360-7.10 - Reserved
- Section 360-7.11 - Medical assistance liens and recoveries.
- Section 360-7.12 - Co-payments by recipients.
- SubPart 360-8 - CONFIDENTIALITY OF HIV- AND AIDS-RELATED INFORMATION
- SubPart 360-9 - Catastrophic Health Care Expense Program
- Section 360-9.1 - Scope.
- Section 360-9.2 - Demonstration applications.
- Section 360-9.3 - Definitions.
- Section 360-9.4 - Eligibility for the CHCEP Services.
- Section 360-9.5 - Responsibilities of the CHCEP applicant and recipient.
- Section 360-9.6 - Powers and responsibilities of the social services district.
- Section 360-9.7 - Powers and responsibilities of the department.
- SubPart 360-10 - Medicaid Managed Care Programs
- Section 360-10.1 - Introduction
- Section 360-10.2 - Scope
- Section 360-10.3 - Definitions
- Section 360-10.4 - Individuals required to enroll in an MMCO
- Section 360-10.5 - Individuals exempt or excluded from enrollment in an MMCO
- Section 360-10.6 - Good cause for changing or disenrolling from an MMCO
- Section 360-10.7 - Good cause for changing primary care practitioners
- Section 360-10.8 - Fair hearings
- Section 360-10.9 - Marketing/Outreach
- Section 360-10.10 - MMCO unacceptable practices
- Section 360-10.11 - MMCO sanctions and due process
- Section 360-10.12 REPEALED
- Section 360-10.13 REPEALED
- Section 360-10.14 REPEALED
- Section 360-10.15 REPEALED
- Section 360-10.16 REPEALED
- Section 360-10.17 REPEALED
- Subpart 360-11 REPEALED
- Part 361 - CASE MANAGEMENT ACTIVITIES FOR PREGNANT AND PARENTING ADOLESCENTS
- Section 361.0 Scope
- Section 361.1 - Definitions.
- Section 361.2 - Administrative requirements.
- Section 361.3 - Prohibited activities.
- Section 361.4 - Eligibility.
- Section 361.5 - Voluntary participation in case management activities.
- Section 361.6 - Intake and screening of cases.
- Section 361.7 - Initial contacts.
- Section 361.8 - Initial interviews and needs assessments; case openings; interim
- Section 361.9 - Comprehensive needs assessments; identifying goals, tasks and
- Section 361.10 - Referrals to, and monitoring of, services and assistance.
- Section 361.11 - Amending and reevaluating personal plans.
- Section 361.12 - Individual case records.
- Section 361.13 - Closing and reopening cases.
- Part 366 - CHILD ASSISTANCE PROGRAM - OTDA
- Part 368 - AID TO THE AGED, BLIND OR DISABLED
- Section 368.1 - Definitions.
- Section 368.2 - Application for AABD.
- Section 368.3 - Determination of initial eligibility.
- Section 368.4 - Financial factors.
- Section 368.5 - Non-financial factors.
- Section 368.6 - Planning for employment, rehabilitation and training--aid to the disabled.
- Section 368.7 - Special category requirements
- Section 368.8 - Decision.
- Section 368.9 - Determination of grant and its payment.
- Section 368.10 - Living arrangements.
- Section 368.11 - Character of aid.
- Section 368.12 - Protective payments in the AABD program.
- Section 368.13 - Determination of continuing eligibility.
- Section 368.14 - Reapplication.
- Part 369 - FAMILY ASSISTANCE OTDA
- Part 370 - SAFETY NET ASSISTANCE
- Section 370.1 - Application.
- Section 370.2 - Determination of initial eligibility.
- Section 370.3 - Emergency and short-term cases.
- Section 370.4 - Determination and payment of the grant.
- Section 370.5 - Determination of continuing eligibility.
- Section 370.6 - Appeals by social services officials.
- Section 370.7 - Safety net assistance supplementation.
- Section 370.8 - Shelter residents.
- Section 370.9 - Referral to local child support enforcement unit of applicants for or recipients of safety net assistance
- Section 370.10 - Temporary Shelter Supplements (TSS)
- Part 371 - PUBLIC INSTITUTIONAL CARE - OTDA & CFS
- Part 372 - EMERGENCY ASSISTANCE TO NEEDY FAMILIES WITH CHILDREN - OTDA
- Part 373 - REFUGEE CASH ASSISTANCE AND REFUGEE MEDICAL ASSISTANCE
- Section 373.1 - General.
- Section 373.2 - Eligibility requirements for RCA and RMA.
- Section 373.3 - Documentation of immigration status.
- Section 373.4 - Consideration of income and resources.
- Section 373.5 - Need standards and payment levels.
- Section 373.6 - Requirements for employment related services and employ
- Section 373.7 - Conciliation.
- Section 373.8 - Fair hearings.
- Part 374 - TAX REFUND OFFSET FOR OVERPAYMENTS OF PUBLIC ASSISTANCE - OTDA
- Part 360 - MEDICAL ASSISTANCE
- Article 3 - Authorization and Payment
- Article 4 - Services to Individuals
- Part 385 - EMPLOYMENT RELATED REQUIREMENTS, PROGRAMS AND SERVICES - OTDA & DOL
- Part 386 - STAFF DEVELOPMENT
- Part 387 - FOOD STAMPS PROGRAM - OTDA
- Part 388 - FOOD ASSISTANCE PROGRAM - OTDA
- Part 390 - DONATED GRANTS OF MONEY, PROPERTY OR SERVICES
- Part 393 - HOME ENERGY ASSISTANCE PROGRAM - OTDA
- Part 394 - UTILITY DISCONNECTION AND FUEL NONDELIVERY PROCEDURES - OTDA
- Article 5 - Resources
- Part 395 - MILITARY SERVICE BENEFITS - DVA & OTDA
- Part 396 - Lottery Prize Intercept for Repayment of Public Assistance - OTDA
- Part 397 - EMERGENCY ASSISTANCE FOR ADULTS - OTDA
- Part 398 - STATE SUPPLEMENTAL PERSONAL NEEDS ALLOWANCE
- Part 399 - FOOD STAMP FRAUD AND FOOD STAMP INTENTIONAL PROGRAM VIOLATIONS--DISQUALIFICATION - OTDA
- Article 2 - Determination of Eligibility--Categorical
- SubChapter B - Public Assistance
- Chapter II - Regulations of the Department of Social Services