SECTION .0300 ‑ ELIGIBILITY PROCEDURES
10A NCAC 45A .0301 INCOME DOCUMENTATION
(a) Documentation of earned income of the
patient's family is required before services can be authorized in the following
(1) Whenever the applicant is requesting
payment program benefits for inpatient services, even when outpatient services
have been previously authorized.
(2) Whenever medical expense
deductions from income exceed three thousand dollars ($3,000).
(3) Whenever eligibility
personnel have reason to believe information given may be inaccurate.
(4) Whenever the Department
requests documentation for quality control purposes.
(b) Documentation of income is not required
for patients financially eligible pursuant to Rule .0202(g) of this Subchapter.
(c) For purposes of this Rule, earned income
means salaries, wages, and self‑employment income.
(d) Eligibility personnel may require
documentation of any component used in computing a patient's annual net family
(e) Notwithstanding the provisions of
Subparagraph (a)(2), eligibility personnel are not required to demand
documentation of information concerning the earned income of the patient's
family when reimbursement for inpatient services is requested through local
health department delivery funds, 10A NCAC 43C .0200 or perinatal program high
risk maternity clinic reimbursement funds, 10A NCAC 43C .0300.
History Note: Authority G.S. 130A‑5(3); 130A‑124;
130A‑127; 130A‑129; 130A‑205;
Eff. July 1, 1981;
Amended Eff. July 1, 1983; April 1, 1982; January 1,
Transferred and Recodified from 10 NCAC 4C .0301 Eff.
April 4, 1990;
Amended Eff. January 1, 1996; October 1, 1994; December
Pursuant to G.S. 150B-21.3A, rule is necessary without
substantive public interest Eff. January 13, 2015.