10A N.C. Admin. Code 23E.0106

Current through Register Vol. 39, No. 9, November 1, 2024

Section 23E .0106 - BLINDNESS

(a) To qualify for Medicaid under the category of Aid to the Blind, the client shall meet one of the following conditions:

(1) receipt of Medicaid on the basis of blindness in December 1973, has continued to meet December 1973 eligibility criteria for each consecutive month thereafter, and determined by the Disability Determination Services Section to have visual acuity of 20/100 in the better eye with correction or visual field limitation in the better eye of 30 percent or less; or

(2) applied for Medicaid since January 1, 1974 and meets the definition of blindness, vocational, and medical factors applied under the Supplemental Security Income program, pursuant to 20 CFR 404, Subpart P.

(b) For clients applying for Medicaid since January 1, 1974, that do not meet the criteria in 20 CFR 404, Subpart P, blindness shall be determined by one of the following methods pursuant to 42 CFR 435.530 and 435.531:

(1) Documentary evidence including SDX, BENDEX, or an award letter that social security benefits, supplemental security income, or veterans benefits have been awarded on the basis of blindness; or

(2) A written decision from the physician consultant of the Division of Services for the Blind based on review of a medical eye examination report.

(c) Blindness shall be reverified for clients determined eligible under Paragraph (b) of this Rule at each review of the client's eligibility or when reexamination is recommended by the physician consultant in his or her professional opinion.

(d) The client shall cease to qualify for Medicaid as a blind individual when evidence is received from any of the sources described in Paragraphs (a)(1) or (b) of this Rule that the client no longer meets the conditions of blindness set out in this Rule and the Medicaid State Plan.

10A N.C. Admin. Code 23E .0106

Authority G.S. 108A-54; 108A-54.1B; 20 C.F.R. 404, Subpart P; 42 C.F.R. 435.530; 42 C.F.R. 435.531;
Eff. September 1, 1984;
Amended Eff. August 1, 1990;
Transferred from 10A NCAC 21B .0306 Eff. May 1, 2012;
Readopted Eff. June 1, 2019.

Authority G.S. 108A-54; 42 C.F.R. 435.530; 42 C.F.R. 435.531;
Eff. September 1, 1984;
Amended Eff. August 1, 1990;
Transferred from 10A NCAC 21B .0306 Eff. May 1, 2012.

Readopted by North Carolina Register Volume 34, Issue 01, July 1, 2019 effective 6/1/2019.