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ADULT MEDICAID MANUAL TABLE OF CONTENTS

AGED, BLIND, AND DISABLED MEDICAID TABLE OF CONTENTS

MA-200 DEFINITIONS
  1. ACRONYMS
  2. PROGRAMS
  3. DEFINITIONS
MA-300 Confidentiality
  1. INTRODUCTION
  2. REQUIREMENTS
  3. DEFINITIONS
  4. OWNERSHIP OF RECORDS
  5. CLIENT ACCESS AND RELEASE OF INFORMATION
  6. RELEASE OF INFORMATION TO OTHER SOURCES WITHOUT CONSENT
  7. RELEASE OF INFORMATION TO FEDERAL, STATE AND COUNTY LAW ENFORCEMENT
  8. RELEASE OF INFORMATION WITHOUT CLIENT CONSENT CHART
  9. CONFIDENTIALITY OF INFORMATION RECEIVED FROM THE SOCIAL SECURITY ADMINISTRATION
  10. CONFIDENTIALITY OF ELIGIBILITY INFORMATION SYSTEM (EIS) DATA
  11. CONFIDENTIALITY OF INFORMATION RECEIVED FROM THE EMPLOYMENT SECURITY COMMISSION (ESC)
MA-400 INTRODUCTION TO MEDICAID
  1. INTRODUCTION TO MEDICAID
  2. BACKGROUND
  3. REQUIREMENTS
MA-500 CLASSIFICATION
  1. AGED, BLIND, AND DISABLED MEDICAID CLASSIFICATIONS
  2. COVERAGE OF MEDICARE BENEFICIARIES
  3. SUMMARY OF DIFFERENCES IN CLASSIFICATIONS
  4. DETERMINATION OF THE CORRECT CLASSIFICATION
  5. CLASSIFICATION TABLE
MA-1000 SSI MEDICAID AUTOMATED PROCESS
  1. INTRODUCTION TO SSI MEDICAID
  2. POLICY PRINCIPLES FOR SSI MEDICAID
  3. AUTOMATION OVERVIEW
  4. SSI APPROVAL
  5. LIMITATIONS TO MEDICAID ELIGIBILITY FOR SSI RECIPIENTS
  6. SSI DENIAL
  7. SSI TERMINATIONS
  8. SSI OPEN/SHUTS
MA-1100 SSI MEDICAID-COUNTY DSS RESPONSIBILITY
  1. COUNTY DSS RESPONSIBILITY FOR SSI APPROVALS
  2. COUNTY DSS RESPONSIBILITY FOR RETROACTIVE SSI MEDICAID
  3. COUNTY DSS RESPONSIBILITY FOR SSI APPLICANTS WHO DIE PRIOR TO DISPOSITION
  4. COUNTY DSS RESPONSIBILITY when AN SSI RECIPIENT enters LONG TERM CARE (LTC)
  5. COUNTY DSS RESPONSIBILITY WHEN SSI TERMINATES FOR INDIVIDUALS IN LTC
  6. COMMUNITY ALTERNATIVES PROGRAM (CAP
  7. IN-HOME HEALTH SERVICES AND SUPPLIES
  8. EMERGENCY CERTIFICATION FOR MEDICAID
  9. COUNTY DSS RESPONSIBILITY FOR AN SSI CHILD IN HSF
  10. NON-ELIGIBILITY RELATED MEDICAID PROCEDURES
MA-2000 NON-SSI ELIGIBILITY REGULATIONS
  1. INTRODUCTION TO NON-SSI MEDICAID ELIGIBILITY DETERMINED BY DSS
  2. CATEGORICAL REQUIREMENTS FOR NON-SSI MEDICAID COVERAGE GROUPS
  3. NON-FINANCIAL REQUIREMENTS APPLICABLE TO ADULT MEDICAID COVERAGE GROUPS
  4. FINANCIAL REQUIREMENTS APPLICABLE TO ADULT MEDICAID COVERAGE GROUPS
  5. NON-SSI AGED, BLIND, AND DISABLED COVERAGE GROUPS BY CLASSIFICATION
MA-2100 CATEGORICALLY NEEDY-NO MONEY PAYMENT
  1. INTRODUCTION TO CATEGORICALLY NEEDY - NO MONEY PAYMENT (N)
  2. POLICY RULES FOR CATEGORICALLY NEEDY
MA-2110 PASSALONG
  1. INTRODUCTION TO PASSALONG
  2. COLA PASSALONG PICKLE AMENDMENT GROUP
  3. DAC PASSALONG
  4. WIDOW(ER)S (INCLUDING SOME SURVIVING, DIVORCED SPOUSES) NOT RECEIVING MEDICARE
  5. WIDOW(ER)S (INCLUDING SOME UNMARRIED, DIVORCED SPOUSES) WHO LOST SSI IN 1984
MA-2120 MEDICALLY NEEDY REGULATIONS
  1. INTRODUCTION TO MEDICALLY NEEDY (M)
  2. POLICY RULES FOR MEDICALLY NEEDY
MA-2130 QUALIFIED MEDICARE BENEFICIARIES-Q
MA-2140 QUALIFIED MEDICARE BENEFICIARIES-B
MA-2150 MEDICAID-WORKING DISABLED
  1. INTRODUCTION TO M-WD
  2. MWD ELIGIBILITY REQUIREMENTS
  3. M-WD SPECIAL REQUIREMENTS
MA-2160 QUALIFYING INDIVIDUALS 1 (QI1/MQB-E)
MA 2170 FAMILY PLANNING PROGRAM

MA-2180 HEALTH COVERAGE FOR WORKERS WITH DISABILITIES
  1. INTRODUCTION TO HEALTH COVERAGE FOR WORKERS WITH DISABILITIES
  2. BACKGROUND
  3. COVERAGE GROUPS
  4. ELIGIBILITY REQUIREMENTS
  5. REDETERMINATIONS
  6. TERMINATIONS/DELETIONS
MA-2220 STATE RESIDENCY

MA-2221 COUNTY RESIDENCE
  1. POLICY RULES
  2. DETERMINING COUNTY RESIDENCE
  3. VERIFYING THE COUNTY OF RESIDENCE
  4. APPLICANT MOVES FROM ONE COUNTY TO ANOTHER
  5. VCOUNTY REASSIGNMENT OF ONGOING CASES
  6. TRANSFERS KEYED TO WRONG COUNTY
MA-2230 FINANCIAL RESOURCES

DMA Admin Letter 03-14, Asset Verification System (AVS)

  1. POLICY PRINCIPLES
  2. FINANCIAL RESOURCE PROCEDURES
  3. IWHOSE RESOURCES TO COUNT
  4. IAVAILABILITY OF RESOURCES
  5. VRESULTING TRUSTS/LEGALLY BINDING AGREEMENTS
  6. VINCOMPETENCY
  7. REAL PROPERTY ASSETS
  8. PERSONAL PROPERTY ASSETS
  9. INCOME PRODUCING REAL/PERSONAL PROPERTY
  10. LIQUID ASSETS
  11. TRUST FUNDS
  12. LIFE INSURANCE AND ANNUITIES
  13. BURIAL EXCLUSION
  14. A/B IS A BENEFICIARY OF A TRUST

MA-2231 COMMUNITY SPOUSE RESOURCE PROTECTION

  1. PROCEDURES FOR SPOUSAL RESOURCE PROTECTION
  2. CHANGES AFFECTING SPOUSAL RESOURCE PROTECTION
MA-2240 TRANSFER OF ASSETS
  1. INTRODUCTION
  2. POLICY PRINCIPLE
  3. DEFINITION OF TERMS RELATED TO TRANSFER POLICY
  4. TRANSFER OF ASSET RULES
  5. LOOKBACK DATE
  6. EXPLORING TRANSFER OF ASSETS
  7. ALLOWABLE TRANSFERS (NON-TRUSTS)
  8. ALLOWABLE TRANSFERS TO A TRUST
  9. TRANSFERS THAT MAY OR MAY NOT BE ALLOWED
  10. ADDITIONAL EXCEPTIONS TO APPLYING TRANSFER SANCTION
  11. NON-ALLOWABLE TRANSFERS
  12. TRANSFER SANCTION
  13. REBUTTAL
  14. DECISION AND NOTIFICATION PROCEDURES (DENIAL/REBUTTAL/UNDUE HARDSHIP)
  15. TRACKING TRANSFER OF ASSETS SANCTION PERIOD
MA-2242 HOME EQUITY VALUE & ELIGIBILITY FOR INSTITUTIONAL SERVICES
  1. INTRODUCTION
  2. LIMITATION ONLY ON PAYMENT FOR INSTITUTIONAL SERVICES
  3. DETERMINING HOME EQUITY VALUE
  4. DEMONSTRATED HARDSHIP
MA-2245 UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS
  1. UNDUE HARDSHIP
  2. POLICY RULES
  3. PROCEDURES FOR REQUESTING UNDUE HARDSHIP DETERMINATION AND DOCUMENTATION
  4. INFORMATION AND DOCUMENTATION TO SUPPORT CLAIM FOR UNDUE HARDSHIP
  5. UNDUE HARDSHIP DECISION
MA-2250 INCOME
  1. POLICY RULEs
  2. A/B'S RESPONSIBILITIES
  3. DOCUMENTATION
  4. BASE PERIOD
  5. CHANGES AND/OR TERMINATED INCOME
  6. NON-COUNTABLE INCOME
  7. COUNTABLE EARNED INCOME
  8. COUNTABLE UNEARNED INCOME
  9. COMPUTATION
  10. APPEAL REVERSALS
MA-2251 REASONABLE COMPATIBILITY

MA-2252 NON-MAGI MEDICAID INCOME AND RESERVE LIMITS

MA-2260 FINANCIAL ELIGIBILITY REGULATIONS-PLA
  1. FINANCIAL AND RESOURCE RESPONSIBILITY FOR ALL M-AABD AND MQB COVERAGE GROUPS
  2. FINANCIAL RESPONSIBILITY
  3. MAABD AND MQB SSI BUDGETING METHODOLOGY AND DEFINITIONS
  4. INCOME COMPUTATIONS (BASED ON COMPLETION OF DMA'S BUDGET SHEETS)
  5. MQB FAMILY SIZE BUDGETING
  6. RESOURCE RESPONSIBILITY
  7. INCOME TABLE
MA-2261 1/3 REDUCTION
  1. RULES FOR USE OF FULL INCOME LEVEL OR 1/3 REDUCTION
  2. 1/3 REDUCTION
MA-2262 SPONSOR DEEMING
  1. INTRODUCTION
  2. DEFINITIONS
  3. POLICY PRINCIPLES
  4. ALIENS EXEMPT FROM SPONSOR DEEMING
  5. IMMIGRANTS AFFECTED BY ALIEN SPONSOR DEEMING
  6. BATTERED ALIEN EXEMPTION
  7. INDIGENT ALIEN EXEMPTION
  8. SPONSORSHIP VERIFICATION AND DOCUMENTATION
  9. INCOME POLICY
  10. RESOURCES
  11. TIME LIMIT FOR SPONSOR DEEMING
MA-2270 LONG TERM CARE NEED AND BUDGETING
  1. INTRODUCTION
  2. WHEN TO USE LTC BUDGETING
  3. EXCEPTIONS TO LTC BUDGETING
  4. DETERMINING ELIGIBILITY FOR THE MONTHS PRIOR TO LONG-TERM CARE BUDGETING
  5. LONG TERM CARE BUDGETING COMPUTATION
  6. THE COMMUNITY SPOUSE INCOME ALLOWANCE (SPOUSE IN PLA)
  7. THE DEPENDENT FAMILY MEMBER ALLOWANCE
  8. UNMET MEDICAL NEEDS ALLOWANCE
  9. REPORTING PATIENT MONTHLY LIABILITY ON DMA-5016
  10. HOSPITAL LEVEL OF CARE CHANGE AND DECERTIFIED FACILITY PROCEDURES
  11. CHANGE IN SITUATION
  12. PROCEDURES FOR OTHER MEDICAID COVERED SERVICES ONLY (STEP III)
  13. PLA PROCEDURES WHEN THE A/B IS INELIGIBLE FOR COST OF CARE FOR REASONS NOT RELATED TO INCOME
  14. MEDICARE COVERAGE
  15. PRIOR APPROVALS (FL-2 AND MR-2)
  16. LONG TERM CARE OMBUDSMEN
MA-2275 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
  1. BACKGROUND
  2. INTRODUCTION
  3. PACE AND MEDICAID REFERRAL PROCEDURES
  4. ELIGIBILITY DOCUMENTATION FOR PACE
  5. POLICY PRINCIPLES
  6. PACE BUDGETING
  7. ALLOWABLE DEDUCTIONS
  8. MEDICAID AUTHORIZATION FOR PACE SERVICES
  9. MEDICAID CERTIFICATION AND AUTHORIZATION FOR PACE
  10. REDETERMINATION OF ELIGIBILITY/REVIEW
  11. CHANGE IN SITUATION
  12. ELIGIBILITY INFORMATION SYSTEM (EIS)
  13. XPTR REPORT
  14. AUTOMATED AND MANUAL NOTICES FOR PACE SERVICES
  15. PACE APPLICATION REPORT
  16. PACE SERVICES - INTERNAL APPEAL PROCESS
  17. MEDICAID APPEAL PROCESS
MA-2280 COMMUNITY ALTERNATIVES PROGRAM (CAP)
MA-2282 INNOVATIONS
MA-2283 TRAUMATIC BRAIN INJURY (TBI)
MA-2284 MONEY FOLLOWS THE PERSON
MA-2285 - ESTATE RECOVERY
MA 2290 MANAGED CARE

MA-2295 DISCOURAGEMENT

MA-2296 INQUIRY

MA-2300 APPLICATION

MA 2301 POST ELIGIBILITY VERIFICATION

  1. WHO MAY APPLY
  2. INFORMATION REGARDING THE MEDICAID PROGRAM
  3. RIGHTS AND RESPONSIBILITIES
  4. TAKING THE APPLICATION

MA-2302 OUTSTATIONS

  • INTRODUCTION
  • POLICY PRINCIPLES
  • PROCEDURES
  • MA-2305 EVALUATING COUNTY/DDS PERFORMANCE

    1. INTRODUCTION
    2. POLICY PRINCIPLES
    3. DEFINITIONS
    4. APPLICATION PROCESSING REQUIREMENTS
    5. MONITORING TOOLS
    6. REPORTS
    MA-2306 APPLICATION PROCESSING - CORRECTIVE ACTION PROCEDURES
    1. PRINCIPLES
    2. REPORT CARD FAILURES
    3. WAIVER REQUESTS FOR FAILING THE ADJUSTED APPLICATION REPORT CARD
    4. MONITORING
    5. LOCAL CORRECTIVE ACTION PROCEDURES FOR COUNTY DSS NON- COMPLIANCE
    6. TRACKING AND NOTIFICATION OF NON-COMPLIANCE
    7. STATE CORRECTIVE ACTION TEAM
    MA-2309 LIS APPLICATION FOR MEDICAID
    1. INTRODUCTION
    2. POLICY PRINCIPLES
    3. AUTOMATED OVERVIEW
    4. COUNTY PROCEDURES
    5. SPECIAL SITUATIONS
    MA-2310 TAKING THE LIS APPLICATION
    1. INTRODUCTION AND OVERVIEW
    2. DEFINITIONS
    3. POLICY PRINCIPLES
    4. WHO MAY APPLY FOR THE LIS
    5. COMPLETING THE LIS APPLICATION FOR SUBMISSION TO SSA
    6. APPLICANT INSISTS THAT DSS PROCESS THE LIS APPLICATION
    MA-2311 LIS PROCESSING AND MAINTENANCE
    1. INTRODUCTION
    2. DEFINITIONS
    3. POLICY PRINCIPLES
    4. INCOME
    5. RESOURCES
    6. DETERMINING ELIGIBILITY FOR THE LIS
    7. APPLICATION OUTCOMES
    8. CASE MAINTENANCE
    9. LIS INCOME LIMITS
    MA-2312 MEDICARE PRESCRIPTION DRUG BENEFIT
    1. INTRODUCTION TO THE MEDICARE MODERNIZATION ACT OF 2003
    2. POLICY PRINCIPLES
    3. ENROLLMENT
    4. OTHER PROGRAM AREAS
    5. OTHER DRUG COVERAGE
    6. EXCLUDED AND NON COVERED-DRUGS
    7. MEDICAID ID CARD
    8. EIS
    9. NOTICES AND APPEALS
    10. OTHER PLACES TO CONTACT FOR MEDICARE INFORMATION
    MA-2320 REDETERMINATION OF ELIGIBILITY
    1. POLICY RULES
    2. ITEMS TO BE VERIFIED AT REDETERMINATION
    3. THE REDETERMINATION INTERVIEW
    4. COOPERATING WITH THE COUNTY DSS
    5. ENUMERATION REQUIREMENT
    6. U.S. CITIZENSHIP AND IDENTITY DOCUMENTATION
    7. INFORMING THE RECIPIENT/REPRESENTATIVE OF HIS RIGHTS AND RESPONSIBILITIES
    8. TRANSFER OF RESOURCES
    9. PROTECTION AGAINST DISCRIMINATION
    10. FAMILY PLANNING WAIVER (FPW)
    11. HEALTH CHECK PROGRAM
    12. COMMUNITY CARE OF NORTH CAROLINA/CAROLINA ACCESS (CCNC/CA)
    13. MEDICAL TRANSPORTATION
    14. EXPLAIN THE FOOD AND NUTRITION SERVICES PROGRAM
    15. EXPLAIN THE WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM
    16. OTHER AVAILABLE SERVICES
    17. REDETERMINATION/VERIFICATION FORMS
    18. COLLATERAL CONTACTS
    19. HOME VISIT
    20. ACTIONS REQUIRED AT THE END OF CERTIFICATION PERIOD
    21. REDETERMINATION ALTERNATIVES
    22. REVIEW CHARTS
    MA-2340 CHANGE IN SITUATION
    1. GENERAL INSTRUCTIONS APPLICABLE TO ANY CHANGE IN SITUATION
    2. TYPES OF CHANGES
    MA-2350 CERTIFICATION AND AUTHORIZATION
    1. POLICY PRINCIPLES
    2. LENGTH OF CERTIFICATION PERIODS
    3. SPECIAL SITUATIONS
    4. AUTHORIZATION
    MA-2352 TERMINATIONS/DELETIONS/EX PARTES
    1. POLICY PRINCIPLES
    2. WHEN MEDICAID TERMINATES
    3. EXCEPTIONS TO CONTINUING MEDICAID WHEN MEDICAID, INCLUDING WORK FIRST TERMINATES.
    MA-2355 MAABD/MQB PROGRAM TRANSFERS
    1. POLICY RULES
    2. TRANSFERS FROM M-QB TO M-AABD
    3. TRANSFERS FROM M-AABD TO MQB-Q or B
    MA-2360 MEDICAID DEDUCTIBLE
    1. POLICY RULE
    2. COMPUTING A DEDUCTIBLE
    3. HOW TO MEET A DEDUCTIBLE
    4. ALLOWABLE CHARGES
    5. THIRD PARTY RESPONSIBILITY
    6. DOCUMENTATION AND VERIFICATION
    7. AUTHORIZATION AND REPORTING OF DEDUCTIBLE BALANCE
    8. APPLYING DRG POLICY

    MA-2375 CHILD SUPPORT

    1. INTRODUCTION
    2. REQUIREMENTS FOR REFERRING CHILDREN TO THE CHILD SUPPORT ENFORCEMENT AGENCY
    3. CARETAKER RESPONSIBILITIES WHERE COOPERATION IS REQUIRED
    4. DETERMINING GOOD CAUSE FOR NOT COOPERATING WITH CHILD SUPPORT ENFORCEMENT
    5. MAKING A REFERRAL TO IV-D
    6. AUTOMATED REFERRAL PROCESS
    7. PENALTY FOR FAILURE TO COOPERATE
    8. REPORTING CHANGES TO IV-D
    MA-2380 MEDICAID IDENTIFICATION CARD
    1. INTRODUCTION
    2. PROCEDURES
    MA-2395 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS
    1. BACKGROUND
    2. REQUIREMENTS
    3. PROCEDURES
    4. FINANCIAL RESPONSIBILITY
    MA-2400 THIRD PARTY RECOVERY
    1. POLICY RULES
    2. PROCEDURES
    3. TYPES OF THIRD PARTY RESOURCES
    4. INTERVIEW QUESTIONS FOR DETERMINING TYPES OF THIRD PARTY RESOURCES
    5. MEDICAID AS PAYER OF LAST RESORT OR AS PRIMARY PAYER
    6. THIRD PARTY RECOVERY NON COMPLIANCE
    7. Third party insurance for nchc and bccm
    MA-2410 MEDICARE ENROLLMENT & BUY-IN
    1. INTRODUCTION
    2. WHO IS ENTITLED TO MEDICARE?
    3. POLICY PRINCIPLES
    4. OVERVIEW OF MEDICARE COVERAGE
    5. OVERVIEW OF MEDICARE BUY-IN
    6. EFFECTIVE DATE OF BUY-IN COVERAGE
    7. RECIPIENT ENROLLMENT IN BUY-IN
    8. COUNTY RESPONSIBILITY TO ASSIST WITH MEDICARE APPLICATION
    9. CHARGEBACKS FOR COUNTY ERRORS
    10. PROCEDURES FOR ALIENS
    11. INFORMATIONAL MATERIALS SENT TO COUNTIES
    MA-2420 NOTICE AND HEARINGS PROCESS

    MA-2425 COMMUNITY CARE OF NORTH CAROLINA (CCNC)/CAROLINA ACCESS (CA)

    MA-2430: AUTOMATED INQUIRY AND MATCH PROCEDURES
    1. INTRODUCTION
    2. POLICY PRINCIPLES
    3. MATCHES REQUIRED BY IEVS
    4. OTHER MATCHES
    5. FRR RESOURCE TYPES AND DESCRIPTIONS
    MA-2440 AUTOMATED SOLQ PROCEDURES
    1. INTRODUCTION
    2. BENEFIT VERIFICATION
    3. MANUAL VERIFICATION OF BENEFITS
    4. THE SOLQ/TPQY SYSTEM
    MA-2450 Enumeration

    MA-2500 AGE/NAME/MARITAL STATUS
    1. POLICY RULE
    2. VERIFICATION PROCEDURES
    MA 2504 ALIEN REQUIREMENTS

    MA-2505 CITIZENSHIP/IDENTITY SSA DATA MATCH
    1. INTRODUCTION
    2. PROCEDURES TO VERIFY CITIZENSHIP AND IDENTITY USING SSA DATA MATCH
    MA-2506 US CITIZENSHIP REQUIREMENTS
    1. INTRODUCTION
    2. PRINCIPLE
    3. UNITED STATES CITIZEN
    4. CITIZENSHIP AND IDENTITY REQUIREMENTS AT APPLICATION
    5. CITIZENSHIP AND IDENTITY REQUIREMENTS AT REDETERMINATION
    6. CITIZENSHIP AND IDENTITY DOCUMENTATION
    7. HIERARCHY CHARTS: ACCEPTABLE DOCUMENTATION OF CITIZENSHIP AND IDENTITY
    8. COLLECTIVE NATURALIZATION
    MA-2510 LIVING ARRANGEMENT
    1. OVERVIEW OF LIVING ARRANGEMENT
    2. SPECIFIC TYPES OF INSTITUTIONS/FACILITIES
    3. MEDICAID SUSPENSION/TERMINATION FOR INCARCERATED BENEFICIARIES AND BENEFICIARIES WHO ENTER AN INSTITUTION FOR MENTAL DISEASE (IMD)
    MA-2525 DISABILITY
    1. INTRODUCTION
    2. DEFINITIONS
    3. POLICY PRINCIPLES
    4. APPLICATIONS/REAPPLICATIONS - DISABILITY NOT ESTABLISHED
    5. APPLICATIONS/REAPPLICATIONS - DISABILITY ALREADY ESTABLISHED
    6. APPLICATIONS/REAPPLICATIONS - DISABILITY ESTABLISHED BY SSA - PRIOR MAD DISABILITY DENIAL
    7. APPEAL REVERSAL OF MAD DISABILITY DENIAL
    8. ACTIVE MAD BENEFICIARY WITH SSA/SSI TERMINATION OR DENIAL
    9. ACTIVE MAD BENEFICIARY APPEALS MEDICAID TERMINATION OF DISABILITY THROUGH THE STATE HEARING PROCESS
    10. MAB/MAD BENEFICIARIES WHO ARE WORKING AND TERMINATED FROM RSDI/SSI
    11. PROTECTED MEDICAID STATUS FOR NON-SSI CHILDREN
    12. REDETERMINATIONS OF DISABILITY FOR NON-SSI MAD CHILDREN UNDER AGE 18
    13. REDETERMINATIONS OF CONTINUED DISABILITY FOR NON-SSI ADULTS OVER AGE 18
    14. TRANSPORTATION FOR MAD APPLICANTS TO ESTABLISH DISABILITY
    MA-2531 BLINDNESS - MAB
    1. INTRODUCTION
    2. POLICY PRINCIPLES
    3. WHEN A DETERMINATION OF BLINDNESS IS NOT REQUIRED
    4. REDETERMINATION AND BENEFICIARIES NEEDING AN INITIAL BLINDNESS DETERMINATION
    5. SUBMITTAL PROCEDURES FOR DSB-2202 "REPORT OF EYE EXAMINATION"
    6. SPECIAL PROCEDURES FOR REAPPLICATIONS
    MA-2900 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES
    1. PURPOSE
    2. LEGAL RESPONSIBILITY AND REFERENCES
    3. NORTH CAROLINA GENERAL STATUTES
    4. FRAUD VS. MISREPRESENTATION
    5. PREVENTION
    6. DETECTION
    7. INVESTIGATIONS
    8. CALCULATING OVERPAYMENTS
    9. CONCLUSIONS AND RECOMMENDATIONS
    10. NOTICES AND APPEALS
    11. ADMINISTRATIVE COLLECTION PROCEDURES
    12. BANKRUPTCY
    13. DISTRIBUTION OF CASH REPAYMENT
    14. EPICS REPORTING REQUIREMENTS
    15. NC DEBT SETOFF (TAX INTERCEPT) CRITERIA FOR MEDICAID CLAIMS
    16. NORTH CAROLINA TITLE XIX MEDICAID RECIPIENT/NCHC PROFILES
    17. CITATIONS AND REFERENCES
    MA-2905- MEDICAID COVERED SERVICES
    1. INTRODUCTION
    2. POLICY PRINCIPLES
    3. PHYSICIAN SERVICES
    4. CLINIC SERVICES
    5. HOSPITAL INPATIENT SERVICES
    6. HOSPITAL OUTPATIENT SERVICES
    7. NURSING FACILITY SERVICES
    8. PSYCHIATRIC AND PSYCHOLOGICAL SERVICES
    9. RESIDENTIAL SERVICES
    10. MENTAL HEALTH CENTERS
    11. STATE AND PRIVATE MENTAL HOSPITALS
    12. NORTH CAROLINA SPECIALTY HOSPITALS
    13. DENTAL SERVICES
    14. CHIROPRACTORS
    15. PODIATRISTS
    16. HOSPICE
    17. DURABLE MEDICAL EQUIPMENT (DME)
    18. HOME HEALTH SERVICES
    19. IN-HOME CARE FOR ADULTS (IHCA) AND IN-HOME CARE FOR CHILDREN (IHCC)
    20. HOME INFUSION THERAPY (HIT)
    21. PRIVATE DUTY NURSING (PDN)
    22. PRESCRIPTION DRUGS
    23. HEARING AID SERVICES
    24. OPTICAL SERVICES
    25. LABORATORY SERVICES
    26. RADIOLOGICAL (X-RAY) SERVICES
    27. OUTPATIENT SPECIALIZED THERAPIES
    28. HEALTH RELATED SERVICES PROVIDED BY INDEPENDENT PRACTITIONERS
    29. HEALTH RELATED SERVICES PROVIDED IN PUBLIC SCHOOLS
    30. ANESTHESIOLOGY SERVICES
    31. FAMILY PLANNING SERVICES
    32. OB/GYN SERVICES
    33. STERILIZATIONS/HYSTERECTOMIES/ABORTIONS
    34. BABY LOVE
    35. MEDICAID FOR PREGNANT WOMEN
    36. NURSE-MIDWIFE SERVICES
    37. NURSE PRACTITIONERS
    38. EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT) AND HEALTH CHECK
    39. PREVENTIVE MEDICAL SERVICES
    40. REFUGEE HEALTH ASSESSMENTS PROVIDED IN HEALTH DEPARTMENTS
    41. DIALYSIS SERVICES
    42. COMMUNITY ALTERNATIVES PROGRAMS (CAP)
    43. CASE MANAGEMENT FOR ADULTS AND CHILDREN AT RISK OF ABUSE, NEGLECT, AND EXPLOITATION (AT-RISK CASE MANAGEMENT)
    44. CASE MANAGEMENT FOR HIV
    45. MEDICAL TRANSPORTATION
    46. BUY-IN PROGRAM
    47. MISCELLANEOUS NON-COVERED ITEMS

    MA-2910 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT)

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