N.J. Admin. Code § 10:71-3.15

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:71-3.15 - County welfare agency responsibility and procedures; eligibility factors

(a) The CWA shall be responsible for determining income and resource eligibility, as outlined in N.J.A.C. 10:71-4 and 5, for Medicaid Only when the applicant is receiving care in institutions defined in N.J.A.C. 10:71-3.14(d). This does not include residents of the State psychiatric hospitals, the State schools for persons with intellectual disabilities, Bergen Pines County Psychiatric Hospital and Essex County Hospital Center, which are the responsibility of the Institutional Services Section of the Division of Medical Assistance and Health Services.

(b) When eligibility depends upon the disability or blindness factor, the determination of medical eligibility shall be the responsibility of the Medical Review Team (MRT). The CWA shall furnish the MRT with current, pertinent social and medical information as outlined in this subchapter.

(c) When eligibility for Medicaid Only has been determined, the CWA will complete and process a Medicaid Status File Transaction, Form MAP-1, within 10 working days from the date of such determination. The CWA will issue and distribute Medicaid validation stubs to Medicaid Only beneficiaries who are not in long-term care facilities. The CWA will complete the statement of income available for nursing home payment (PR-1) (formerly PA-3L) when appropriate.

(d) A determination of continuing eligibility shall be made in accordance with N.J.A.C. 10:71-5.

N.J. Admin. Code § 10:71-3.15

Amended by R.1995 d.651, effective 12/18/1995.
See: 27 N.J.R. 3543(a), 27 N.J.R. 5046(a).
Amended by R.2000 d.415, effective 10/16/2000.
See: 32 N.J.R. 2565(a), 32 N.J.R. 3844(a).
Substituted references to CBOSSs for references to CWAs throughout; and in (c), substituted "beneficiaries" for "recipients" in the second sentence, and substituted "(PR-1) (formerly PA-3L)" for "(PA-3L)" in the third sentence.
Amended by R.2012 d.025, effective 2/6/2012.
See: 43 N.J.R. 804(a), 44 N.J.R. 230(a).
Section was "County board of social services responsibility and procedures; eligibility factors". Rewrote the section.