S.C. Code Regs. § 126-505

Current through Register Vol. 48, No. 5, May 24, 2024

Section 126-505 - Responsibilities for Eligibility Determination

A. The Department shall develop uniform criteria and materials for statewide use. A detailed description of the criteria, procedures, and materials which include an application form and letter of notification may be found in the MIAP Manual. Each county is responsible for determining eligibility in accordance with the policies and procedures in the MIAP Manual. If a county fails to meet this responsibility, claims for the county's residents may be suspended until it is determined that the county is fulfilling its responsibility.

B. The county government shall make arrangements for the determination of eligibility for the MIAP for its residents. The county shall notify the Department of who is designated to determine eligibility in the county. The Department shall provide a listing of each county's designee to each general hospital and to the Chief Administrative Officer and Clerk to County Council in each county. If a county intends to review claims prior to the submission of such claims for payment, the county must inform the Department of its intent to review claims.

C. General hospitals shall inform patients of the existence of the MIAP and shall refer the patient for an application if it is determined that the patient has no means to pay for hospital services. General hospitals shall submit claims to the Department. If a county has elected to review claims prior to submission to the Department, it must review the claims within fifteen (15) working days from the date the claim is provided by the hospital. If no response is received from the county within fifteen (15) working days, the hospital shall forward the claim to the Department.

S.C. Code Regs. 126-505

Replaced and amended by State Register Volume 42, Issue No. 05, eff. 5/25/2018.