N.J. Admin. Code § 10:69-3.35

Current through Register Vol. 56, No. 11, June 3, 2024

Section 10:69-3.35 - Repayment

(a) The CWA shall, in all circumstances, take appropriate action to recover all AFDC-related Medicaid improperly granted. The action taken shall be in accordance with the appropriate sections of this chapter, N.J.A.C. 10:49, and any other applicable authority.

1. Recoveries of funds applicable to more than one CWA shall be divided according to the mutual agreement of the directors of the CWAs involved.

(b) Properly granted AFDC-related Medicaid coverage rules are as follows:

1. Repayment of Medicaid coverage in the AFDC-related Medicaid program (all segments) is required in certain cases in which Medicaid coverage is provided for treatment where another third party is responsible for payment of the medical services. Medicaid coverage is granted while the beneficiary(ies) awaits receipt of funds from some other source (see N.J.A.C. 10:69-3.36 ).

(c) Rules when agreement to repay is not required are as follows:

1. Agreements to Repay are not to be used in any Medicaid program.

2. Upon signing an application for AFDC-related Medicaid (PA-1J), the applicant or beneficiary automatically assigns all support rights (whether for past due or future support) to the CWA. The signing of an Agreement to Repay is therefore not required when the pending payment arises from potential entitlement to payment of support from a relative.

N.J. Admin. Code § 10:69-3.35

Amended by 49 N.J.R. 3729(a), effective 12/4/2017