Ala. Admin. Code r. 560-X-1-.04

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-1-.04 - Agencies Responsible For Medicaid Eligibility

(See Chapter 25 for detailed eligibility criteria.) Applicants eligible for Medicaid services are certified to the Alabama Medicaid Agency by the following agencies:

(1) The Social Security Administration certifies aged, blind, and disabled applicants for the Federal Supplemental Security Income (SSI) Program. In Alabama, individuals eligible for SSI are eligible for Medicaid under Title XVI, Section 1902(b) of the Social Security Act and Section 1634, Public Law 92-603.

(2) The Alabama Department of Human Resources (DHR) certifies eligibility at county DHR offices for some groups noteligible for SSI. These groups are discussed in Chapter 25.

(3) The Alabama Medicaid Agency certifies Medicaid eligibility for individuals listed in Chapter 25 through its certification district offices located throughout Alabama. Generally, there is no Medicaid coverage for individuals who are confined to a public institution unless it is a medical institution. See Chapter 25 for eligibility criteria and the descriptions of the groups covered.

(4) The Alabama Medicaid Agency restricts and terminates eligibility in cases of fraud, abuse, and misuse.

Ala. Admin. Code r. 560-X-1-.04

Rule effective October 1, 1982. Amended: effective August 10, 1987. Emergency Rule: Effective January 8, 1988. Amended effective April 12, 1988. Emergency Rule effective July 1, 1988. Amended: Effective July 12, 1988; September 9, 1988. Emergency Rule effective January 1, 1989. Amended: Effective April 14, 1989; January 13, 1993.

Author: John H. Ziegler; Thera Herring

Statutory Authority: Executive Order No. 83, dated September 26, 1977; Social Security Act, §1902(a)(10)(A)(ii)(V) as amended by §9510 of COBRA 1985; 42 C.F.R. § 431.10; Public Law 100-203, §§9108, 9116, 9119; 42 C.F.R. §435.231 ; Public Law 100-360, §301.